Predisposing factors for hepatocellular carcinoma recurrence following initial remission after transcatheter arterial chemoembolization

Abstract

Abstract. Hepatocellular carcinoma (HCC) is prone to recurrence following curative treatment. The purpose of the present study was to identify the predisposing factors of HCC recurrence following complete remission achieved by transarterial chemoembolization (TACE). A retrospective cohort study of 70 consecutive patients with HCC who underwent TACE as the initial treatment was conducted. The patients were divided into two groups according to their 1-year disease-free survival (DFS) status; the early recurrence group (ER group; n=32), with HCC recurring within 1 year of initial TACE; and the non-early recurrence group (NER group; n=38), who did not experience recurrence within 1 year. The parameters identified as significantly associated with DFS time on univariate analysis were aspartate aminotransferase (AST), alanine aminotransferase and α-fetoprotein levels, as well as the tumor number (P=0.003, P=0.027, P=0.002 and P=0.005, respectively). Multivariate analysis revealed that AST levels and tumor number were significantly associated with a shorter DFS period (P=0.009 and P=0.038, respectively). The Mantel-Haenszel test revealed a significant trend of decreasing DFS with increasing tumor number. Among the patients with HCC in the ER group, locoregional recurrence occurred more frequently in those who received TACE alone compared with those treated with TACE combined with radiofrequency ablation treatment. In summary, multinodularity of HCC is the most potent predictive factor for the recurrence of HCC within 1 year of initial TACE.

Prognostic role of alpha-fetoprotein in patients with hepatocellular carcinoma treated with repeat transarterial chemoembolisation

“…Along with AFP level, we found like others on multivariate analysis that markers of both hepatic reserve and tumour burden are key prognostic markers being associated with poorer survival following repeat TACE [14,[55][56][57][58][59]. In particular, decreasing liver reserve had the greatest impact on mortality in our cohort with post TACE liver failure and decompensation associated with the highest risk of reduced survival [HR 4.50, (95% CI 1.86-10.89), p = 0.001], (p = 0.001).…”

Reason of Discontinuation After Transarterial Chemoembolization Influences Survival in Patients with Hepatocellular Carcinoma

“…Radiological pattern of progression has been shown to impact post-progression survival of HCC patients treated with sorafenib [ 18 ]. Prior studies have reported the incidence of tumor progression [ 3 , 4 ] and pattern of tumor recurrence following TACE [ 19 – 21 ], but data on the prognostic impact of pattern of tumor progression following TACE are lacking. Lastly, the advent of multiple lines of subsequent treatments is making it increasingly difficult to assess the benefit of TACE based on overall survival (OS) alone.…”

Predictive Factors of Tumor Recurrence and Survival in Patients with Hepatocellular Carcinoma treated with Transarterial Chemoembolization

“…Several papers from Asia reported that multinodularity was the most strong predictor for recurrence and survival after TACE [34,35]. Our study is the first one from Central and Eastern Europe that evaluates OS and the clinical determinants of recurrence and survival in TACE treated patients.…”