title: Conventional Ethiodized Oil Transarterial Chemoembolization for Treatment of Hepatocellular Carcinoma: Contemporary Single-Center Review of Clinical Outcomes.
abstract: OBJECTIVE
  The purpose of this study is to investigate the outcomes of conventional transarterial chemoembolization (TACE) treatment of hepatocellular carcinoma (HCC) in contemporary clinical practice.
  
  
  METHODS
  In this single-institution retrospective study, 188 patients underwent conventional TACE for HCC between 2007 and 2013. Medical record and imaging review was used to collect baseline demographic and disease data, tumor response, time to progression (TTP), and progression-free survival (PFS) outcomes, as well as transplant-free survival, calculated from the time of the first conventional TACE treatment. Data were censored in April 2014.
  
  
  RESULTS
  The study cohort included 140 men and 48 women (mean age, 60 years; Barcelona Clinic Liver Cancer [BCLC] stage 0 = 5%, BCLC stage A = 41%, BCLC stage B = 28%, BCLC stage C = 15%, and BCLC stage D = 11%) with 207 index tumors (mean size, 4.0 cm; 11% with portal vein invasion) treated with a mean of 1.6 selective (79%) or lobar (21%) conventional TACE sessions. Concurrent thermal ablation was performed for 19% of patients. Objective response rates included size response in 29% (World Health Organization) and 28% (Response Evaluation Criteria for Solid Tumors [RECIST]) of patients, and necrosis response in 79% (European Association for the Study of the Liver) and 70% (modified RECIST) of patients. Median local TTP, distant site TTP, local PFS, and other site PFS were 51.7, 11.2, 10.8, and 10.5 months. Eighteen percent of patients underwent liver transplantation; 48% of United Network for Organ Sharing stage T3 tumors were downstaged to stage T2. Transplant-free survival for the entire cohort was 16.8 months (not reached, 33.9, 16.0, 4.4, and 6.9 months for BCLC stages 0, A, B, C, and D, respectively). Postembolization syndrome requiring extended hospital stay or readmission occurred in only 6% of patients.
  
  
  CONCLUSIONS
  Conventional TACE is effective and safe for HCC therapy and may confer a survival benefit. The current data are in line with reported conventional TACE outcomes, and the minor postembolization syndrome incidence supports the low morbidity of this approach.
authors.affiliation: 1 University of Illinois College of Medicine, Chicago, IL.
authors.forename: Leigh C
authors.initials: LC
authors.lastname: Casadaban
authors.affiliation: 2 Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor St, MC 931, Chicago, IL 60612.
authors.forename: Jeet
authors.initials: J
authors.lastname: Minocha
authors.affiliation: 2 Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor St, MC 931, Chicago, IL 60612.
authors.forename: James T
authors.initials: JT
authors.lastname: Bui
authors.affiliation: 2 Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor St, MC 931, Chicago, IL 60612.
authors.forename: M Grace
authors.initials: MG
authors.lastname: Knuttinen
authors.affiliation: 2 Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor St, MC 931, Chicago, IL 60612.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Ray
authors.affiliation: 2 Department of Radiology, Division of Interventional Radiology, University of Illinois Hospital and Health Sciences System, 1740 West Taylor St, MC 931, Chicago, IL 60612.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Gaba
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D015331:Cohort Studies; D004998:Ethiodized Oil / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004998:Ethiodized Oil
keywords: clinical outcomes; conventional; ethiodized oil; hepatocellular carcinoma; transarterial chemoembolization