MEDIUM-TERM SURVIVAL AFTER TRANSARTERIAL CHEMOEMBOLIZATION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA IN RADIOLOGY CENTER OF BACH MAI HOSPITAL
Main Article Content
Abstract
Purpose: Evaluation the survival of the patients with hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE).
Subjects and methods: Retrospective study on transcatheter arterial chemoembolization in patients with hepatocellular carcinoma from July 2017 to July 2020 at Radiology Center - Bach Mai Hospital.
Results:. 70 patients including 64 men (92.9%) and 6 women (7.1%) had a confirmed diagnosis of HCC with a mean age of 61.5 ± 11.34 years (from 32 to 83 years). The mean number of treatment sessions were 4.5±0.4 lần (1-16). Progression-free survival after initial TACE and overall survival median was 29.7±3.3 months, 43.3±2.5 months, respectively. Cumulative survival time at 1 year, 2 years, 3 years and 5 years is 91.4%, 77.1%, 63.7% and 29.4%, respectively. Patients treated with cTACE were 67.1% and Deb-TACE were 32.9%. mRECIST after the first TACE: complete response, partial response, stable disease and advanced disease were 30.0%, 55.7%, 4.3%, 10.0%, respectivel. Patients with objective response had a survival of 47.8±2.3 months, and patients with poor response had a survival of 12.2±2.7 months, respectively (p = 0.001). mRECIST response predicted survival among the patients on univariate analysis (HR=15.13, p=0.000). The independent predictors for survival were mRECIST response (p=0.001).
Conclusion: Use of TACE in intermediate stage HCC patients gives a significant survival advantage when objective response is achieved as per mRECIST
Article Details
Keywords
TACE, Progression-free survival, overall survival
References
2. European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182-236. doi:10.1016/j.jhep.2018.03.019
3. Kong JY, Li SM, Fan HY, Zhang L, Zhao HJ, Li SM. Transarterial chemoembolization extends long-term survival in patients with unresectable hepatocellular carcinoma. Medicine (Baltimore). 2018;97(33):e11872. doi:10.1097/MD.0000000000011872
4. Skowasch M, Schneider J, Otto G, et al. Midterm follow-up after DC-BEADTM-TACE of hepatocellular carcinoma (HCC). Eur J Radiol. 2012;81(12):3857-3861. doi:10.1016/j.ejrad.2012.07.002
5. Massarweh NN, El-Serag HB. Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. Cancer Control J Moffitt Cancer Cent. 2017;24(3):1073274817729245. doi:10.1177/1073274817729245
6. Llovet JM, Real MI, Montaña X, et al. Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trial. Lancet Lond Engl. 2002;359(9319):1734-1739. doi:10.1016/S0140-6736(02)08649-X
7. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Hepatol Baltim Md. 2003;37(2):429-442. doi:10.1053/jhep.2003.50047
8. Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021;149(4):778-789. doi:10.1002/ijc.33588
9. Chen CJ, Yang HI, Su J, et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA. 2006;295(1):65-73. doi:10.1001/jama.295.1.65
10. Takaki H, Yamakado K, Sakurai H, et al. Radiofrequency Ablation Combined With Chemoembolization: Treatment of Recurrent Hepatocellular Carcinomas After Hepatectomy. Am J Roentgenol. 2011;197(2):488-494. doi:10.2214/AJR.10.4933
11. Kim JW, Kim JH, Won HJ, et al. Hepatocellular carcinomas 2-3 cm in diameter: transarterial chemoembolization plus radiofrequency ablation vs. radiofrequency ablation alone. Eur J Radiol. 2012;81(3):e189-193. doi:10.1016/j.ejrad.2011.01.122
12. Young M, John S. Hepatic Chemoembolization. In: StatPearls. StatPearls Publishing; 2022. Accessed September 9, 2022. http://www.ncbi.nlm.nih.gov/books/NBK507822/
13. Takayasu K, Arii S, Ikai I, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461-469. doi:10.1053/j.gastro.2006.05.021
14. Olivo M, Valenza F, Buccellato A, et al. Transcatheter arterial chemoembolisation for hepatocellular carcinoma in cirrhosis: survival rate and prognostic factors. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2010;42(7):515-519. doi:10.1016/j.dld.2009.09.012
15. Elkadeem M. Transarterial chemoembolization in patients with hepatocellular carcinoma: study of different outcomes and their predictive factors. Liver Res Disord Ther. 2018;4(4). doi:10.15406/jlrdt.2018.04.00120
16. George B, Devadas K, S, et al. Post Tace Hepatocellular Carcinoma Response Assessment by Modified Recist and Short Term Post Tace Survival. J Clin Gastroenterol Hepatol. 2022;6(4):33-40. doi:10.36648/2575-7733.6.4.19
17. Haywood N, Gennaro K, Obert J, et al. Does the Degree of Hepatocellular Carcinoma Tumor Necrosis following Transarterial Chemoembolization Impact Patient Survival? J Oncol. 2016;2016:e4692139. doi:10.1155/2016/4692139