Predictive Factors for Complete Response and Recurrence after Transarterial Chemoembolization in Hepatocellular Carcinoma

Gut Liver. 2017 May 15;11(3):409-416. doi: 10.5009/gnl16001.

Abstract

Background/aims: To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).

Methods: Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS).

Results: Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS.

Conclusions: In patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.

Keywords: Carcinoma; Chemoembolization; Complete response; Recurrence; hepatocellular; therapeutic.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods*
  • Female
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / complications
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / etiology*
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome
  • Venous Thrombosis / etiology
  • alpha-Fetoproteins / analysis

Substances

  • alpha-Fetoproteins