Is there a survival benefit in interventional radiology for hepatocellular carcinoma in patients with Child-Pugh C liver cirrhosis?: A multicenter study.
OBJECTIVE
A lack of donors in liver transplantation (LT) for hepatocellular carcinoma (HCC) has become a big issue. There is no consensus regarding whether interventional radiology for HCC in patients with Child-Pugh C liver cirrhosis will improve prognosis. To elucidate the effectiveness of such treatment, we evaluated the clinical features of affected patients.


METHODS
Patients with naive HCC of Child-Pugh C (n = 236) were enrolled. Two of them were treated with LT after transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were used as bridging treatments. After exclusion of a total of three patients who received LT, we evaluated clinical factors related to improved prognosis.


RESULTS
The percentage of all patients with total bilirubin of less than 3 mg/dL was 41.1%. The prognosis of patients who were received treatments (n = 30; ablative therapy 10, TACE 20) was better than non-treated patients (n = 18; mean survival time [MST] 22.2 vs 13.8 months, P = 0.021, respectively) in patients with up to 7 criteria and total bilirubin of less than 3 mg/dL (n = 48). On the other hand, there was no difference in prognosis between those who underwent ablative therapies (n = 10) and those who received TACE (n = 20) (MST 22.2 vs 16.9 months, P = 0.390).


CONCLUSIONS
Therapy for HCC may prolong survival in patients with naive HCC, with up to 7 criteria and total bilirubin of less than 3 mg/dL.
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Atsushi
A
Hiraoka
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Takashi
T
Kumada
Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.
Kojiro
K
Michitaka
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Hidenori
H
Toyoda
Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.
Toshifumi
T
Tada
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan.
Toru
T
Ishikawa
Department of Gastroenterology, Asahi General Hospital, Asahi, Japan.
Ei
E
Itobayashi
Division of Gastroenterology and Hepatology, Ootakanomori Hospital, Kashiwa, Japan.
Noritomo
N
Shimada
Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.
Koichi
K
Takaguchi
Department of Internal Medicine, Isezaki Municipal Hospital, Isezaki, Japan.
Daichi
D
Takizawa
Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Kunihiko
K
Tsuji
decompensated liver cirrhosis; hepatocellular carcinoma; radiofrequency ablation; total bilirubin; transcatheter arterial chemoembolization