Treatment Outcome of Transcatheter Arterial Chemoinfusion According to Anticancer Agents and Prognostic Factors in Patients with Advanced Hepatocellular Carcinoma (TNM Stage IVa) .
10.3349/ymj.2004.45.5.847
- Author:
Sang Hoon AHN
1
;
Kwang Hyub HAN
;
Jeong Youp PARK
;
Young Hoon YOUN
;
Chang Mo MOON
;
Kwan Sik LEE
;
Chae Yoon CHON
;
Young Myoung MOON
;
Do Yun LEE
;
Jong Tae LEE
Author Information
1. Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea. gihankhys@yumc.yonsei. ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Hepatocellular carcinoma;
transcatheter arterial chemoinfusion;
treatment outcome;
prognostic factors
- MeSH:
Adult;
Aged;
Antineoplastic Agents/*administration & dosage/adverse effects;
Carcinoma, Hepatocellular/*drug therapy/mortality;
Cause of Death;
Female;
Humans;
*Infusions, Intra-Arterial;
Liver Neoplasms/*drug therapy/mortality;
Male;
Middle Aged;
Prognosis;
Research Support, Non-U.S. Gov't;
Survival Rate;
alpha-Fetoproteins/analysis
- From:Yonsei Medical Journal
2004;45(5):847-858
- CountryRepublic of Korea
- Language:English
-
Abstract:
Transcatheter arterial chemoinfusion (TACI) is the main treatment modality for advanced hepatocellular carcinoma (HCC). However, the therapeutic efficacy of TACI according to anti-cancer agents and prognostic factors for advanced HCC (TNM stage IVa) has not been previously clarified. A total of 127 patients with TNM stage IVa HCC were divided into intra-arterial Adriamycin (Group I) and intra-arterial Cisplatin (Group II) infused groups, according to the anticancer agents that were used. We compared the therapeutic efficacy of TACI applied anticancer agents, and we also analyzed the prognostic factors which influenced the survival rates. Chi-square test, t- test, Cox's proportional hazard regression model, and Kaplan- Meier method were performed. The overall survival was significantly different (10.0 vs 5.7 months, respectively) and the results favored Group I. On univariate analysis, the significant prognostic factors included age, portal vein thrombosis (PVT), tumor size (diameter< 5 cm), type of tumor, the reduction rate (tumor size & alpha- fetoprotein) after 3 months of chemotherapy, serum albumin level, serum alkaline phosphatase level and total serum bilirubin levels at the time of diagnosis. After repeated chemotherapy, Group I showed better survival (14.0 vs 7.9 months). However, there was no statistical difference in the survival rate of the two groups for cases involving large tumors, PVT and diffuse type of HCC. Group I showed better survival than Group II. However, when the other prognostic factors were taken into consideration, there was no significant difference in the survival rate of the two groups, except for the cases with small or nodular HCC.
