Survival and prognostic factors after adjuvant131iodine-labeled lipiodol for hepatocellular carcinoma: a retrospective analysis of 106 patients over 20 years.
OBJECTIVE
Hepatocellular carcinoma (HCC) has high recurrence rate after curative treatment. The aim of the present study was to report our experience with adjuvant use of131I-lipiodol after curative treatment of HCC in terms of recurrence and survival in a large cohort of patients with a long follow-up.


METHODS
All patients treated with131I-lipiodol after curative treatment of HCC in two French centers from 1991 to 2009 were included in a retrospective cohort study.


RESULTS
One hundred and six patients were included. The median (range) follow-up was 6 years (0.3-22). Forty-three patients (41%) had cirrhosis. Recurrence-free survival rates at 1, 2, 5, 10, and 20 years were 73, 57, 40, 30, and 14%, respectively. Cirrhosis was an independent predictive factor of recurrence [RR = 1.18, 95% CI (1.11-3.02), p = 0.019]. Overall, survival rates at 1, 2, 5, 10, and 20 years were 90, 83, 59, 37, and 23%, respectively. Prognostic factors were recurrence [RR = 2.73, 95% CI (1.35-5.54); p = 0.005], age over 60 years (RR = 1.91, 95% CI [1.02-3.61]; p = 0.044), and tumor number over 3 [RR = 3.31, 95% CI (1.25-8.77); p = 0.016].


CONCLUSIONS
Our results suggest that the effect of131I-lipiodol after curative treatment of HCC could be related to a beneficial impact on risk factors of early tumor recurrence. This could be evaluated in further studies using modern radioembolization methods.
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.
Jonathan
J
Olesinski
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.
François
F
Mithieux
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.
Olivier
O
Guillaud
Service d'hépato-gastro-entérologie, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France.
Marie-Noëlle
MN
Hilleret
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.
Catherine
C
Lombard-Bohas
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.
Luc
L
Henry
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.|Université Claude Bernard Lyon 1, Lyon, France.
Olivier
O
Boillot
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.|Université Claude Bernard Lyon 1, Lyon, France.
Thomas
T
Walter
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.|Université Claude Bernard Lyon 1, Lyon, France.
Christian
C
Partensky
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.|Université Claude Bernard Lyon 1, Lyon, France.
Pierre
P
Paliard
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France.|Université Claude Bernard Lyon 1, Lyon, France.
Pierre-Jean
PJ
Valette
Service de Médecine nucléaire, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France.|Université Joseph Fourier, Grenoble, France.
Jean-Philippe
JP
Vuillez
Service de Médecine Nucléaire, Hospices civils de Lyon, Hôpital Cardiologique Louis Pradel, Lyon, France.
Françoise
F
Borson-Chazot
Université Claude Bernard Lyon 1, Lyon, France.|Service Central d'Anatomie et Cytologie Pathologiques, Hospices civils de Lyon, Hôpital Edouard Herriot, Lyon, France.
Jean-Yves
JY
Scoazec
Hospices civils de Lyon, Hôpital Edouard Herriot, Fédération des Spécialités Digestives, pavillon L, 69437, Lyon Cedex 03, France. jerome.dumortier@chu-lyon.fr.|Service de Médecine nucléaire, CHU de Grenoble, Hôpital A. Michallon, La Tronche, France. jerome.dumortier@chu-lyon.fr.
Jérôme
J
Dumortier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000532:radiotherapy*; D015331:Cohort Studies; D004998:Ethiodized Oil / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012008:Recurrence; D012189:Retrospective Studies; D012449:Safety; D016896:Treatment Outcome; D055815:Young Adult
D007457:Iodine Radioisotopes; D004998:Ethiodized Oil
Adjuvant therapy; Hepatocellular carcinoma; Iodine-lipiodol, survival.