Early evaluation of transcatheter arterial chemoembolization-refractory hepatocellular carcinoma

J Gastroenterol. 2012 Mar;47(3):343-6. doi: 10.1007/s00535-011-0511-x. Epub 2011 Dec 21.

Abstract

Background: There is no standard therapy for patients with transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). This study examined whether evaluating the tumor effect (TE) at 1 week after TACE was useful for predicting refractoriness to TACE.

Methods: We performed a historical cohort study involving 54 patients and 119 tumors. TE was evaluated at 1 week and 3 months after TACE, and an overall evaluation was also performed at 3 months based on the response evaluation criteria in cancer of the liver.

Results: Among 45 tumors evaluated as TE2 at 1 week, 43 tumors (95.6%) were classified as TE1 or TE2 at 3 months. Of the 24 patients whose tumors were categorized as TE2 at 1 week, none achieved a complete or partial response.

Conclusions: Evaluating the TE at 1 week after TACE is useful for the early diagnosis of TACE-refractory HCC and allows alternative treatment options, such as sorafenib, to be employed before the disease progresses.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Benzenesulfonates / therapeutic use
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods*
  • Cohort Studies
  • Female
  • Humans
  • Liver Neoplasms / pathology
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds
  • Pyridines / therapeutic use
  • Sorafenib
  • Time Factors
  • Treatment Failure
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Benzenesulfonates
  • Phenylurea Compounds
  • Pyridines
  • Niacinamide
  • Sorafenib