Clinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial chemoembolization

• Published in: The Korean journal of internal medicine Vol. 34; no. 6; pp. 1223 - 1232
• Main Authors: Baek, Min Young, Yoo, Jeong-Ju, Jeong, Soung Won, Jang, Jae Young, Kim, Yong Kwon, Jeong, Shin Ok, Lee, Sae Hwan, Kim, Sang Gyune, Cha, Sang-Woo, Kim, Young Seok, Cho, Young Deok, Kim, Hong Soo, Kim, Boo Sung, Kim, Yong Jae, Park, Su Yeon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.11.2019; 대한내과학회
• Subjects: Aged; carcinoma, hepatocellular; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; chemoembolization, therapeutic; Chemoembolization, Therapeutic - adverse effects; Chemoembolization, Therapeutic - mortality; Disease Progression; Female; Humans; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Middle Aged; Neoplasm Recurrence, Local; Original; Retrospective Studies; Risk Assessment; Risk Factors; Seoul; survival; Time Factors; Treatment Outcome; Tumor Burden; 내과학; Seoul; Carcinoma, hepatocellular; Chemoembolization, therapeutic; Survival
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2018.058

Transarterial chemoembolization (TACE) is performed for single hepatocellular carcinoma (HCC) that are not eligible for surgery or ablation therapy. We investigated the clinical outcomes of patients with a single HCC ≤ 5 cm treated with TACE. This study analyzed 175 consecutive patients who underwent TACE as an initial treatment for single HCC ≤ 5 cm. Predictive factors for complete response (CR), recurrence after CR, and overall survival (OS) were evaluated. Total 119 patients (68%) achieved CR after TACE. Tumor size < 3 cm and hepatitis B virus infection were significant predictors of CR (p < 0.05). Recurrent HCC was detected in 73 patients (61.3%) after CR. Age > 65 years and absence of liver cirrhosis were predictive factors for non-recurrence after CR (p < 0.05). The OS for all patients was 80.7 ± 5.6 months, and the 1-, 3-, and 5-year OS rates were 88.1%, 64.8%, and 49.9%, respectively. In multivariate analysis for OS, CR (hazard ratio [HR], 0.467; 95% confidence interval [CI], 0.292 to 0.747) and Child class A (HR, 0.390; 95% CI, 0.243 to 0.626) were significant factors. The OS for the CR and Child class A group were 92 and 93.6 months, respectively, and that of the non-CR and Child B, C group were 53.3 and 50.7 months, respectively (p < 0.001). TACE can be a valid treatment in patients with a single HCC ≤ 5 cm not suitable for curative treatment, especially in patients with Child class A and CR after TACE.