Prognostic Factors Affecting Survival Rate in Patients with Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization.
- Author:
Sung Woo KIM
1
;
Soong Hwan LEE
;
Byung Joo ROH
;
Jong Cheol KIM
;
Sung Soo PARK
;
Dong Hoo LEE
Author Information
1. Research Institute of Digestive Diseases, Hanyang University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Neoplasm/Liver/Hepatocellular carcinoma;
Transcatheter arterial chemoembolization;
Prognostic factor;
Survival rate;
Epidemiology
- MeSH:
Alkaline Phosphatase;
Ascites;
Bilirubin;
Carcinoma, Hepatocellular*;
Classification;
Epidemiology;
Female;
Gelatin Sponge, Absorbable;
Humans;
Liver;
Liver Cirrhosis;
Male;
Multivariate Analysis;
Neoplasm Metastasis;
Portal Vein;
Prognosis;
Retrospective Studies;
Sodium;
Survival Rate*;
Venous Thrombosis
- From:The Korean Journal of Hepatology
2000;6(3):311-320
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: There have been studies concerning prognostic factors in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) but they reported different prognostic factors from each other. The aim of this study is to determine which prognostic factors contribute to long-term survival after TACE of hepatocellular carcinoma. MATERIAL AND METHOD: Two hundred and forty-one patients with HCC who had been treated by TACE were analyzed retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipodol and anticancer drugs (Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. RESULTS: Male to female ratio was 4.7:1. Mean survival was 13.98 months. Maximum survival was 101 months. The overall cumulative survival rates at the end of the first and second years were, respectively, 41.54% and 20.06%. According to univariate analysis (log-rank scale test), variables significantly associated with survival were: sex, liver cirrhosis, Child-Pugh classification, gross type of the tumor, location of the tumor, size of the tumor, TNM stage, metastasis, portal vein thrombosis, arterioportal shunt, ascites, AFP, protein, albumin, alkaline phosphatase, AST, AST/ALT ratio, total bilirubin, and sodium. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univarariate analysis revealed that the gross type of the tumor, portal vein thrombosis, and Child-Pugh classification were statistically significant independent prognostic factors. CONCLUSION: The prognosis of patients with HCC treated with TACE was affected favorably by the nodular type tumor, the patent main and the first-order portal vein, and the good liver function (Child-Pugh class A).
