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Transcatheter arterial chemoembolisation for hepatocellular carcinoma in cirrhosis: survival rate and prognostic factors.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2010 Jul; Vol. 42 (7), pp. 515-9. Date of Electronic Publication: 2009 Nov 13. - Publication Year :
- 2010
-
Abstract
- Background: The role of prognostic variables in the treatment of hepatocellular carcinoma (HCC) by transarterial chemoembolisation (TACE) is controversial.<br />Aims: To evaluate the survival of patients with HCC on cirrhosis treated with TACE and to analyse the prognostic factors affecting survival.<br />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.<br />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.<br />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.<br /> ((c) 2009 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 42
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 19914153
- Full Text :
- https://doi.org/10.1016/j.dld.2009.09.012