Multivariate Analysis of Prognostic Factors for Survival following Doxorubicin-eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

Sellers, Marty T.; Huggins, Sidney; Kegley, Kristy M.; Pollinger, H. S.; Shrestha, Roshan; Johnson, Mark W.; Stein, Lance L.; Panjala, Chakri; Tan, Miguel; Arepally, Aravind; Jacobs, Louis; Caldwell, Christopher; Bosley, Michael; Citron, Steven J.

doi:10.1016/j.jvir.2012.12.003

Cited by 17 publications

(18 citation statements)

References 19 publications

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“…The Child Pugh Class of HCC patient is considered to be the one of the main prognostic factors for survival following TACE in HCC patients. [24][25][26] In our study, there was a survival difference in the patients between Child A and B disease. However, statistically it was found nonsignificant.…”

Section: [17]mentioning

confidence: 43%

Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma after orthotopic liver transplantation

Prajapati¹,

Kavali²

2017

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How to cite this article: Prajapati HJ, Kavali P, Kim HS. Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma after orthotopic liver transplantation. Hepatoma Res 2017;3:182-8. Aim:To investigate the survivals and efficacy of the doxorubicin drug eluting beads transcatheter arterial chemoembolization (TACE) in patients with recurrent hepatocellular carcinoma (HCC) status post orthotopic liver transplantation. Methods: Consecutive patients with HCC who underwent orthotopic liver transplantation from 2005 to 2012 were reviewed. Patients who developed recurrent HCC after orthotopic liver transplantation and received doxorubicin drug eluting beads TACE therapy were identified and included in the study. Survivals were calculated from the time of 1st doxorubicin drug eluting beads TACE of recurrent HCC. Kaplan Meier estimator with log rank test was used for survival analysis. Results: Eight patients had recurrent HCC after orthotopic liver transplantation and received doxorubicin drug eluting beads TACE. The overall median survival of these patients was 15.6 months. Two patients had significantly poorer overall median survival from doxorubicin drug eluting beads TACE (3.4 months) and both showed elevated serum alpha-fetoprotein levels (> 400 ng/mL) and extra-hepatic metastases (P = 0.03). Patients with poorly differentiated HCC in explant liver had the poor median overall survival (3.6 months) compared to the patients with well-to-moderately differentiated HCC (21.7 months, P = 0.004). Conclusion: Doxorubicin drug eluting beads TACE appears to be an effective treatment option for patients with recurrent HCC after orthotopic liver transplantation.

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Section: [17]mentioning

confidence: 43%

Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma after orthotopic liver transplantation

Prajapati¹,

Kavali²

2017

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“…Vesselle et al 19 revealed that tumor size was a negative predicitive factor for CR in HCC patients receiving DEB-TACE. Brown et al 20 and Sellers et al 21 showed that Child-Pugh stage was a negative predicitive factor for survival in HCC patients treated by TACE. Other factors, such as albumin-bilirubin, platelet-albumin-bilirubin grades, ECOG stage, BCLC stage, portal vein invasion, CA-199, Hb, ALP, ALB and AFP level, have also been proved to predict tumor response and survival.…”

Section: Discussionmentioning

confidence: 99%

<p>Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study</p>

Liang

Xiang

et al. 2020

CMAR

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This study aimed to compare the efficacy and safety between transarterial chemoembolization (TACE) with CalliSpheres ® microspheres (CSM-TACE) and conventional TACE (cTACE) in patients with hepatocellular carcinoma (HCC). Patients and Methods: Three hundred and thirty-five HCC patients receiving CSM-TACE or cTACE were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into CSM-TACE group and cTACE group accordingly. Complete response (CR), objective response (ORR) and disease control response (DCR) was assessed according to mRECIST criteria at 1 month (M1), 3 months(M3) and 6 months(M6) after treatment. Progression-free survival (PFS) and overall survival (OS) were assessed. Liver function indexes and adverse events (AEs) were also evaluated. Results: CR at M3 (P=0.020) and ORR at M1 (P<0.001), M3 (P<0.001) and M6 (P=0.017) after treatment were significantly higher in the CSM-TACE compared with cTACE group. DCRs, PFS (25.3 months vs 24.2 months, P=0.503) and OS (27.8 months vs 25.3 months, P=0.203) were similar between the two groups. CSM-TACE was independently correlated with higher ORR at M1 (P=0.002) and longer OS (P=0.023). Abnormal alkaline phosphatase (ALP) (P=0.049) was independently associated with lower ORR at M3, and history of alcohol intake (P=0.019) and largest nodule size ≥7 cm (P=0.015) independently correlated with lower ORR at M6 (P=0.015). Largest nodule size ≥7 cm (P=0.029) and abnormal albumin (ALB) (P=0.046) were independently associated with shorter PFS. Child-Pugh stage B/C (P=0.023), abnormal ALB (P=0.001), ALP (P=0.008) and alpha-fetoprotein (AFP) (P=0.005) were independently associated with shorter OS. Most liver function indexes and AEs were similar between the two groups (P>0.05), except that ALP (P=0.005), total bilirubin (P=0.031), pain during procedure (P=0.034) and occurrence of fever post(treatment (P=0.017) were significantly elevated in the CSM-TACE compared with cTACE group. Conclusion: CSM-TACE presents with a better treatment response and similar survival profile compared with cTACE in HCC patients.

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“…TACE using DC Bead, drug-eluting microsphere (Biocompatibles UK Ltd, Farnham, United Kingdom), is a relatively novel modality related with favorable systemic doxorubicin exposure/toxicity and liver-specific toxicity compared to conventional TACE [26] . A recent study involving BCLC B HCC patients showed that DC Bead TACE resulted in a significantly better clinical outcome compared to conventional TACE [27] .…”

Section: Drug-eluting Bead Tacementioning

confidence: 99%

“…A recent study involving BCLC B HCC patients showed that DC Bead TACE resulted in a significantly better clinical outcome compared to conventional TACE [27] . However, Sellers et al [26] reported poor OS in HCC patients accompanying PVTT underwent DC Bead TACE. Further studies are warranted to evaluate the efficacy of DC Bead TACE and sorafenib in HCC patients accompanying PVTT.…”

Section: Drug-eluting Bead Tacementioning

confidence: 99%

Effective treatment strategies other than sorafenib for the patients with advanced hepatocellular carcinoma invading portal vein

Yu¹

2015

WJH

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Patients with hepatocellular carcinoma (HCC) accompanying portal vein tumor thrombosis (PVTT) have relatively few therapeutic options and an extremely poor prognosis. These patients are classified into barcelona clinic liver cancer stage C and sorafenib is suggested as the standard therapy of care. However, overall survival (OS) gain from sorafenib is unsatisfactory and better treatment modalities are urgently required. Therefore, we critically appraised recent data for the various treatment strategies for patients with HCC accompanying PVTT. In suitable patients, even surgical resection can be considered a potentially curative strategy. Transarterial chemoembolization (TACE) can be performed effectively and safely in a carefully chosen population of patients with reserved liver function and sufficient collateral blood flow nearby the blocked portal vein. A recent meta-analysis demonstrated that TACE achieved a substantial improvement of OS in HCC patients accompanying PVTT compared with best supportive care. In addition, transarterial radioembolization (TARE) using yttrium-90 microspheres achieves quality-of-life advantages and is as effective as TACE. A large proportion of HCC patients accompanying PVTT are considered to be proper for TARE. Moreover, TACE or TARE achieved comparable outcomes to sorafenib in recent studies and it was also reported that the combination of radiotherapy with TACE achieved a survival gain compared to sorafenib in HCC patients accompanying PVTT. Surgical resection-based multimodal treatments, transarterial approaches including TACE and TARE, and TACE-based appropriate combination strategies may improve OS of HCC patients accompanying PVTT.

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Multivariate Analysis of Prognostic Factors for Survival following Doxorubicin-eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

Abstract: Independent prognostic factors in patients with HCC undergoing DEB chemoembolization have been identified. Increased bilirubin level was not an independent risk factor. These data can be used in HCC patient selection and counseling for DEB chemoembolization.

Cited by 17 publications

References 19 publications

Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma after orthotopic liver transplantation

Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma after orthotopic liver transplantation

<p>Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study</p>

Effective treatment strategies other than sorafenib for the patients with advanced hepatocellular carcinoma invading portal vein

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