Chemoembolization for Single Large Hepatocellular Carcinoma with Preserved Liver Function: Analysis of Factors Predicting Clinical Outcomes in a 302 Patient Cohort

The purpose of this study was to define the role of transcatheter arterial chemoembolization (TACE) in patients with a single large hepatocellular carcinoma (HCC) and define the patient groups benefiting from TACE. Treatment-naïve patients with preserved liver function who received TACE as the first...

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Published inLife (Basel, Switzerland) Vol. 11; no. 8; p. 840
Main Authors Kim, Gun Ha, Kim, Jin Hyoung, Shim, Ju Hyun, Ko, Heung-Kyu, Chu, Hee Ho, Shin, Ji Hoon, Yoon, Hyun-Ki, Ko, Gi-Young, Gwon, Dong Il
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 17.08.2021
MDPI
Subjects
Clinical outcomes
Complications
Embolization
Hepatocellular carcinoma
Hypertension
Laboratories
Liver
Liver cancer
Metastases
Mortality
Multivariate analysis
Patients
Prediction models
Predictions
risk factors
Survival
transarterial chemoembolization
Tumors
United States > US
Japan
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Summary:The purpose of this study was to define the role of transcatheter arterial chemoembolization (TACE) in patients with a single large hepatocellular carcinoma (HCC) and define the patient groups benefiting from TACE. Treatment-naïve patients with preserved liver function who received TACE as the first-line treatment for single large (>5 cm) HCC without macrovascular invasion and extrahepatic metastasis between 2007 and 2019 were retrospectively analyzed. Overall survival, progression-free survival, radiologic tumor response, complications, and predictors of survival were analyzed using multivariate analysis, and then a pretreatment risk-prediction model was created using the four predictive factors of tumor size, tumor type, ALBI grade, and ECOG performance status. Patients with scores of 0 (n = 54), 1–2 (n = 170), and 3–6 (n = 78) according to the model were classified as low-, intermediate-, and high-risk, respectively. The corresponding median OS values were 141, 55, and 28 months, respectively. The percentage of major complications increased as tumor size increased (4–21%). Asymptomatic, nodular HCC patients with a tumor size of 5–7 cm and ALBI grade 1 benefited the most from TACE. By contrast, the value of TACE in the treatment of single huge HCC (>10 cm) with high complication rates remains unclear.
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ISSN:2075-1729
2075-1729
DOI:10.3390/life11080840