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Transcatheter arterial chemoembolization (TACE) is the recommended treatment modality for intermediate stage hepatocellular carcinoma (HCC). The aim of this study was to determine the HCC radiological characteristics associated with prognosis of patients with intermediate stage HCC receiving TACE. Patients with HCC BCLC stage B from January 2005 to December 2009 were collected. According to mRECIST criteria, patients with complete response and partial response were assigned to the objective response (OR) group, while those with stable disease and progressive disease were assigned to the nonobjective response (non-OR) group. Among a total of 128 enrolled patients, there were 66 (51.6%) and 62 (48.4%) patients in the OR group and non-OR group, respectively. The clinical parameters in the two groups were similar, although HCC size was smaller in the OR group. Logistic analysis found combined radiological characteristics including complete lipiodol retention, tumor feeding artery blockage, and no residual tumor blush were significant correlated with achievement of OR (odds ratio 2.46, 95% CI 1.08-5.61, P = .032). However, no radiological characteristics had significant strength to predict overall survival. Patients with OR after TACE had significantly longer survival time than those with non-OR. Combined characteristics of complete lipiodol retention, tumor feeding artery blockage, and no residual tumor blush had a positive impact on OR in TACE. In patients receiving TACE, those who achieved OR had a better overall survival.

Background: For hepatocellular carcinoma (“HCC”), the current standard of treatment is hepatic artery embolization, generally through trans-catheter arterial chemoembolization (“TACE”). There are two types: traditional (“conventional” or “cTACE”) and microsphere (“DC bead TACE”). Unfortunately, the literature comparing the relative effectiveness of cTACE versus DC bead TACE is inconclusive, partially due to the complexity of HCC and its response to treatment. Data mining is an excellent method to extract meaning from complex data sets. Purpose: Through the application of data mining techniques, to compare the relative effectiveness of cTACE and DC bead TACE using a large patient database and to use said comparison to establish usable guidelines for developing treatment plans for HCC patients. Materials and Methods: The data of 372 HCC patients who underwent TACE in Taichung Veterans General Hospital were analyzed. The chi-square test was used to compare the difference in the effectiveness of the two therapies was compared. Logistic regression was used to calculate the odds ratios. Furthermore, using the C4.5 decision tree, the two therapies were classified into applicable fields. Chi-square test, the t-test, and logistic regression were used to verify the classification results. Results: In Barcelona Clinic Stages A and B cancers, cTACE was found to be 22.7% more effective than DC bead TACE. By using the decision tree C4.5 as a classifier, the effectiveness of either treatment for small tumors was 8.475 times than that for large tumors. DC bead TACE was 3.39 times more successful in treating patients with a single tumor than with multiple tumors. For patients with a single tumor, the chi-square test showed that 100–300 μm microspheres were significantly more effective than 300–500 μm. While these findings provide a reference for the selection of an appropriate TACE approach, we noted that overall accuracy was somewhat low, possibly due to the limited population. Conclusions: We found that data mining could be applied to develop clear guidelines for physician and researcher use in the case of complex pathologies such as HCC. However, some of our results contradicted those elsewhere in the literature, possibly due to a relatively small sample size. Significantly larger data sets with appropriate levels of granularity could produce more accurate results.

Transcatheter arterial chemoembolization (TACE) is a standard treatment modality for intermediate stage hepatocellular carcinoma (HCC). The aim of this study was to determine the tumor radiological characteristics associated with prognosis of patients with early-staged HCC receiving TACE. Patients with BCLC stage A HCC were enrolled at Taichung Veterans General Hospital from January 2005 to December 2009. According to mRECIST criteria, patients with or without complete response (CR) were assigned to either the CR group or the non-CR group. Clinical and radiological characteristics were compared between the two groups. In 40 enrolled patients, 24 (60%) were in the CR group, and 16 (40%) in the non-CR group. Clinical parameters were similar between the 2 groups. Radiological characteristics including complete lipidol retention and the absence of residual tumor blush were significantly correlated with achievement of CR in the patients with small-sized HCC. Patients with CR after TACE had a significantly longer overall survival than those without (31.29 vs 22.63 months, P = .021). Complete lipidol retention and the absence of residual tumor blush were correlated with the radiological complete tumor response of these patients with small-sized early-stage HCC receiving TACE.

Background Hepatitis B virus (HBV) relapse is a practical issue after nucleos(t)ide analogue (NA) therapy discontinuation in chronic hepatitis B (CHB). However a prospective multi-centre study remains lacking. The aim of this study was to prospectively investigate virological and clinical outcomes after NA therapy. Methods CHB patients, who discontinued tenofovir disoproxil fumarate (TDF) or entecavir (ETV) therapy based on the NA stopping guidelines, were prospectively recruited from January 2015 to January 2018. Patients with liver cirrhosis, active malignancies, hepatitis C virus, hepatitis D virus or human immunodeficiency virus coinfection, liver transplantation history, immune disorders, a history of NA therapy other than TDF or ETV, or a follow-up period of fewer than 4 weeks were excluded. Serum HBV DNA and quantitative hepatitis B surface antigen (qHBsAg) levels were measured every 3 months. Both cumulative incidences of and hazard ratios (HRs) for the predictors of HBV relapse were analysed. Results Totally, 178 patients (40 HBeAg-positive and 138 HBeAg-negative prior to NA therapy) were enrolled for this analysis (98 TDF and 80 ETV users), and the median follow-up period was 10.6 (interquartile range [IQR]: 5.6–7.2) months. The cumulative incidences of virological (VR) and clinical relapse (CR) in 2 years were 59.5% (95% confidence interval [CI]: 50.6%–68.3%) and 49.0% (95% CI: 34.0%–65.0%), respectively. Moreover, the cumulative incidences of severe hepatitis flare (ALT >500 IU/L) and liver decompensation were 11.8% (95% CI: 3.4%–19.6%) and 1.4% (95% CI: 0%–3.3%), respectively. No patient died of liver disease. In multivariable analysis, qHBsAg >100 IU/mL at the end of therapy was an independent risk factor of VR (HR 2.47, 95% CI: 1.30–4.70) and of CR (HR 3.16, 95% CI: 1.25–7.89), respectively. TDF users initially demonstrated a faster pattern of HBV relapse when compared to ETV users, but the relapse rates were not significantly different in 2 years. Conclusions In this study for non-cirrhotic patients, HBV relapse was common after cessation of NA therapy, and serum qHBsAg can be used as a predicting marker. A longer study period is essential for investigating long-term outcomes.