title: Is transarterial chemoembolization beneficial for patients with diffuse infiltrative hepatocellular carcinoma?
abstract: OBJECTIVE
  Diffuse infiltrative hepatocellular carcinoma (D-HCC) is an incurable disease with short survival time. Transarterial chemoembolization (TACE) was often used to alleviate patient's symptoms and reduce tumor burden. However, it remains unknown if the TACE benefits the survival of D-HCC patients.
  
  
  METHODS
  A hospital-based retrospective study was conducted at a large referral hospital in Taiwan for a 9-year period (2000-2008).
  
  
  RESULTS
  Of the 150 D-HCC patients, 106 patients were related to hepatitis B virus (HBV), 17 to hepatitis C virus (HCV), 3 to both HBV and HCV, and 24 not to HBV or HCV. Multivariate Cox regression analysis showed treatment strategy, serum alpha-fetoprotein level, model for end-stage liver disease (MELD) score, serum gamma glutamyl transferase, and serum lactic acid dehydrogenase were associated with survival time. Compared to supportive treatment, the adjusted hazard ratios of transarterial chemoembolization (TACE) and chemotherapy including oral or systemic chemotherapy were 0.383 (p < 0.001) and 0.711 (p = 0.289), respectively.
  
  
  CONCLUSIONS
  TACE is a preferred therapy for D-HCC patients.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan, Republic of China.|School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.|Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming School of Medicine, No-201, Sec 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China.
authors.forename: Tsung-Hsing
authors.initials: TH
authors.lastname: Hung
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan, Republic of China.|Division of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan, Republic of China.
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming School of Medicine, No-201, Sec 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China.
authors.forename: Chung-Chi
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming School of Medicine, No-201, Sec 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China.
authors.forename: Hsing-Feng
authors.initials: HF
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming School of Medicine, No-201, Sec 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China. cjchu@vghtpe.gov.tw.
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chu
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, and National Yang-Ming School of Medicine, No-201, Sec 2, Shih-Pai Road, Taipei, Taiwan, 11217, Republic of China.
authors.forename: Han-Chieh
authors.initials: HC
authors.lastname: Lin
keywords: Diffuse infiltrative type; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Transarterial chemoembolization