Prognostic Survival Factors of Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

Czech version

Authors: Tomáš Rohan ¹; Michal Uher ²; Peter Matkulčík ¹; Jan Zavadil ¹; Lenka Ostřížková ³; Igor Kiss ⁴; Tomáš Andrašina ¹; Vlastimil Válek ¹
Authors‘ workplace: Klinika radiologie a nukleární medicíny LF MU a FN Brno2 Institut biostatistiky a analýz, LF MU Brno ¹; Interní hematologická a onkologická klinika FN Brno4 Masarykův onkologický ústav, Brno ³
Published in: Klin Onkol 2020; 33(3): 214-219
Category: Original Articles
doi: https://doi.org/10.14735/amko2020214

Overview

Purpose: Identification of prognostic survival factors of hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) in a single center in 2005–2018.

Background: Transarterial chemoembolization in hepatocellular carcinoma is indicated in Barcelona Liver Cancer Clinic (BLCC) stage B. This stage includes a very large group of patients unsuitable for curative treatment, who are in a good clinical condition and do not show extra-hepatic spread. The aim of this retrospective analysis is to identify factors influencing patient survival and to divide the patients into subgroups based on these risk factors.

Materials and methods: All patients with HCC indicated for TACE in complex oncological center in 2005–2018 were included in the analysis. The survival rates from the 1^st TACE were evaluated in relation to HCC on computed tomography/magnetic resonance prior to the 1^st TACE (size of the biggest lesion, single/multiple lesions, unilobar/bilobar involvement), presence and severity of liver disease (cirrhosis, Child-Pugh, portal vein thrombosis) and a combination of other invasive treatment (resection, percutaneous ablation) (single and multivariate analysis). The survival of HCC patients was compared according to the year of the diagnosis and the year of the 1^st TACE (log-rank test).

Results: Out of 382 patients, 157 (29 women) of them were treated with TACE (540 TACEs in total, median 3 TACEs per patient). The most important risk factors for survival were the presence of portal vein thrombosis (hazard ratio (HR) = 3.279), bilobar involvement (HR = 2.257), lesion size (HR = 1.125/cm) and Child-Pugh B in chronic liver disease (HR = 1.922). Based on these risk factors, the patients were divided into 3 prognostic groups with different median survival (52.1 vs. 21.5 vs. 9.0 months).

Conclusion: Based on the retrospective analysis, predictive factors of HCC survival after TACE were identified and the patients were divided into 3 prognostic groups based on these factors.

Keywords:

hepatocellular carcinoma – Survival analysis – transarterial chemoembolization – risk factors

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