title: Conventional versus drug-eluting beads chemoembolization for hepatocellular carcinoma: Emphasis on the impact of tumor size.
abstract: OBJECTIVE
  This study aims to evaluate clinical outcomes of patients with hepatocellular carcinoma who underwent transarterial chemoembolization (TACE) using drug-eluting beads (DEB).
  
  
  METHODS
  This study retrospectively compared the clinical outcomes of 250 consecutive patients who underwent DEB-TACE (n = 106) or conventional TACE (cTACE) (n = 144) in a tertiary center between January 2010 and April 2014. The median age of the patients was 62 years and 81.6% were men. The primary endpoint was overall survival (OS). The time to progression (TTP), radiological response rate using modified response evaluation criteria in solid tumors criteria at 1 month after treatment, and complication rates within 1 month were also compared.
  
  
  RESULTS
  The most common etiology was hepatitis B virus infection. The median index tumor size was 2.8 cm, and 150 (60.0%) patients had Barcelona Clinic Liver Cancer stage B. Median TTP in the cTACE group was longer than in the DEB-TACE group (13.3 vs10.8 months; P = 0.023). However, DEB-TACE and cTACE groups showed no significant differences for mean OS (46.6 vs 44.9 months; P = 0.660) and disease control rate at 1 month (78.3% vs 86.8%; P = 0.076). The OS, TTP, and disease control rate were also not different between two groups, even when subgrouped by index tumor size. The complication rates within 1 month were higher in the cTACE group (6.6% vs 14.6%; P = 0.048).
  
  
  CONCLUSIONS
  Drug-eluting beads TACE appears to be a safe intra-arterial therapy. However, it is not superior to cTACE in terms of efficacy. Tumor size might not be a criterion to select treatment modality between cTACE and DEB-TACE in terms of efficacy.
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Yong Kang
authors: YK
authors: Lee
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Kyu Sik
authors: KS
authors: Jung
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Do Young
authors: DY
authors: Kim
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jin Young
authors: JY
authors: Choi
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Beom Kyung
authors: BK
authors: Kim
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Seung Up
authors: SU
authors: Kim
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jun Yong
authors: JY
authors: Park
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Sang Hoon
authors: SH
authors: Ahn
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Gyoung Min
authors: GM
authors: Kim
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Man Deuk
authors: MD
authors: Kim
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Sung Il
authors: SI
authors: Park
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jong Yun
authors: JY
authors: Won
authors: Department of Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Do Yun
authors: DY
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: drug-eluting beads; hepatocellular carcinoma; outcomes; transarterial chemoembolization