1. Transcatheter arterial chemoembolisation for hepatocellular carcinoma in cirrhosis: survival rate and prognostic factors.
- Author
-
Olivo M, Valenza F, Buccellato A, Scala L, Virdone R, Sciarrino E, Di Piazza S, Marrone C, Orlando A, Fusco G, Madonia S, and Cottone M
- Subjects
- Adult, Aged, Aged, 80 and over, Antibiotics, Antineoplastic administration & dosage, Carcinoma, Hepatocellular mortality, Cohort Studies, Epirubicin administration & dosage, Female, Hemostatics administration & dosage, Hepatic Artery, Humans, Kaplan-Meier Estimate, Liver Neoplasms mortality, Male, Middle Aged, Proportional Hazards Models, Carcinoma, Hepatocellular complications, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic, Liver Cirrhosis complications, Liver Neoplasms complications, Liver Neoplasms therapy, Palliative Care
- Abstract
Background: The role of prognostic variables in the treatment of hepatocellular carcinoma (HCC) by transarterial chemoembolisation (TACE) is controversial., Aims: To evaluate the survival of patients with HCC on cirrhosis treated with TACE and to analyse the prognostic factors affecting survival., Methods: From 1996 to 2006, 580 consecutive patients with HCC in cirrhosis were observed. Of these 194 patients underwent TACE. The primary end-point was survival. Independent predictors of survival were identified using the Cox model., Results: The cumulative 1-year, 3-year, and 5-year survival rates were 96%, 60%, and 41%, respectively. The multivariate analysis showed significant reduction of survival among patients with serum bilirubin values >2mg/dl compared to patients with values <2mg/dl (Hazard ratio 3.84; CI 95% 1.70-8.66; p-value=0.001). Multivariate analysis performed in the group of patients treated with TACE alone showed that elevated serum bilirubin (Hazard ratio 2.96; CI 95% 1.20-7.3; p-value 0.02) and incomplete tumour response (Hazard ratio 2.88; CI 95% 1.18-7.05; p-value 0.02) are correlated with a worse outcome., Conclusions: TACE was well tolerated and overall survival rate was 41% after 5 years. Complete tumour response and serum bilirubin <2mg/dl were identified as predictors of survival., ((c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF