Transarterial oily chemoembolization for the treatment of hepatocellular carcinoma: A multivariate analysis of prognostic factors

Abstract

A total of 84 patients with hepatocellular carcinoma and cirrhosis were analyzed retrospectively to investigate prognostic factors. All patients received transarterial oily chemoembolization as the only anticancer therapy. The follow-up range was 1 to 39 mo (median, 9.5 mo). The overall actuarial survival rates at 12, 24 and 30 mo were 62%, 31% and 24%, respectively. According to univariate analysis, variables significantly associated with survival were age, Child-Pugh grade, total serum bilirubin, Okuda stage, tumor size, degree of labeling of the tumor with Lipiodol, gelatin foam use, changes with treatment in tumor size and changes with treatment in alpha-fetoprotein concentration. Two multivariate analyses were performed. When pretreatment and treatment variables were considered, parameters with independent prognostic value were age, Child-Pugh grade, total serum bilirubin, tumor size and degree of Lipiodol labeling of the tumor. When follow-up variables were also considered, we (a) confirmed the prognostic significance of all these parameters (age, Child-Pugh grade, total serum bilirubin, tumor size) and (b) found the independent prognostic value of the change in tumor size (or change in alpha-fetoprotein concentration). Both models yielded different risk coefficients for each class of each variable. Two simple prognostic indexes, based on these coefficients, are proposed: an "initial" index (including pretreatment and treatment variables) and a "follow-up" index (also including follow-up variables). According to the two indexes, the patients were classified into three groups with different prognoses: good (93% and 100% actuarial survival at 1 yr for the initial and follow-up indexes, respectively), intermediate (65% and 53%, respectively) and poor (27% for both indexes).

Sorafenib versus cytotoxic chemotherapy for patients with advanced hepatocellular carcinoma: a retrospective, single-institution study

“…As a part of our research, we conducted an exploratory analysis of prognostic factors impacting survival. Good performance status, absence of overt vascular invasion, and baseline AFP<400 ng/mL were all favorable parameters relative to PFS and OS; and our findings are in accord with other publication [19][20][21][22]. Adequate liver function has also been associated with better outcomes in HCC patients and was established via univariate analysis of our data.…”

Prognostic Index for Survival in Patients After Treatment for Primary Hepatocellular Carcinoma

“…The number of tumor lesions and the diameter of the tumor have also been reported as poor prognosis factors in other studies [21][22][23][24]. It is known that HCC elevates the degree of malignancy from a well-differentiated to a moderately or poorly differentiated tumor concomitantly with an increase in the diameter of the tumor.…”

A randomized controlled trial of hepatectomy with adjuvant transcatheter arterial chemoembolization versus hepatectomy alone for Stage III A hepatocellular carcinoma

“…Although the use of iodized oil (Lipiodol) was controversial, it was reported that iodized oil, with its selective accumulation in tumors when delivered intra-arterially and as a carrier for anticancer drugs, improved the outcome of adjuvant chemotherapy (Roayaie et al 2002;Ueno et al 2000). Also the iodized oil uptake pattern served as a reasonable prognostic index (Mondazzi et al 1994;Stefanini et al 1995). From the results of our study, the rates of potential curative treatment for recurrences and disease-free survival of the HT arm were higher than that of HA arm, as a result, the overall survival of HT arm was signiWcantly better than that of control arm.…”