Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes
ObjectivesTo evaluate the safety and efficacy of TACE and factors predicting survival in patients with advanced hepatocellular carcinoma (HCC) without macrovascular invasion (MVI) or extrahepatic spread (EHS).MethodsThis single-center retrospective study included 236 treatment-naïve patients who und...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1072922/full |
| _version_ | 1797810565971705856 |
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| author | Ji Hoon Kim Ji Hoon Kim Jin Hyoung Kim Hyun-Ki Yoon Gi-Young Ko Ji Hoon Shin Dong Il Gwon Heung-Kyu Ko Hee Ho Chu Seong Ho Kim Gun Ha Kim Yonghun Kim Shakir Aljerdah |
| author_facet | Ji Hoon Kim Ji Hoon Kim Jin Hyoung Kim Hyun-Ki Yoon Gi-Young Ko Ji Hoon Shin Dong Il Gwon Heung-Kyu Ko Hee Ho Chu Seong Ho Kim Gun Ha Kim Yonghun Kim Shakir Aljerdah |
| author_sort | Ji Hoon Kim |
| collection | DOAJ |
| description | ObjectivesTo evaluate the safety and efficacy of TACE and factors predicting survival in patients with advanced hepatocellular carcinoma (HCC) without macrovascular invasion (MVI) or extrahepatic spread (EHS).MethodsThis single-center retrospective study included 236 treatment-naïve patients who underwent TACE as first-line treatment for advanced HCC without MVI or EHS between January 2007 and December 2021.ResultsFollowing TACE, the median overall survival (OS) was 24 months. Multivariate Cox regression analyses revealed that tumor number ≥4 (risk point: 3), maximal tumor size >10 cm (risk point: 2), Child–Pugh class B (risk point: 2), alpha-fetoprotein (AFP) concentration ≥400 ng/mL (risk point: 2), and presence of HCC rupture (risk point: 2) were risk factors significantly associated with OS. The expected median OS among patients with <2, 2–4, and 5–9 risk points were 72, 29, and 12 months respectively. The major complication rates were significantly lower in patients with maximal tumor size ≤10 cm than in those with maximal tumor size >10 cm (4% [5/138] vs 21% [21/98], p = 0.001).ConclusionTACE may be safe and effective in selected patients with advanced HCC without MVI or EHS, with a median OS of 24 months. Patients with limited tumor burden, compensated liver function, absence of HCC rupture, and favorable biologic markers may benefit the most from TACE. TACE is not recommended for patients with huge HCCs (>10 cm) because of its high rate of major complications (21%). |
| first_indexed | 2024-03-13T07:10:49Z |
| format | Article |
| id | doaj.art-6826730c9270406ca087dca88fc55f40 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-13T07:10:49Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-6826730c9270406ca087dca88fc55f402023-06-06T04:30:23ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-06-011310.3389/fonc.2023.10729221072922Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomesJi Hoon Kim0Ji Hoon Kim1Jin Hyoung Kim2Hyun-Ki Yoon3Gi-Young Ko4Ji Hoon Shin5Dong Il Gwon6Heung-Kyu Ko7Hee Ho Chu8Seong Ho Kim9Gun Ha Kim10Yonghun Kim11Shakir Aljerdah12Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAjou University Hospital, College of Medicine, Ajou University, Najran, Saudi ArabiaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaAsan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of KoreaCollege of Medicine, Najran University, Najran, Saudi ArabiaObjectivesTo evaluate the safety and efficacy of TACE and factors predicting survival in patients with advanced hepatocellular carcinoma (HCC) without macrovascular invasion (MVI) or extrahepatic spread (EHS).MethodsThis single-center retrospective study included 236 treatment-naïve patients who underwent TACE as first-line treatment for advanced HCC without MVI or EHS between January 2007 and December 2021.ResultsFollowing TACE, the median overall survival (OS) was 24 months. Multivariate Cox regression analyses revealed that tumor number ≥4 (risk point: 3), maximal tumor size >10 cm (risk point: 2), Child–Pugh class B (risk point: 2), alpha-fetoprotein (AFP) concentration ≥400 ng/mL (risk point: 2), and presence of HCC rupture (risk point: 2) were risk factors significantly associated with OS. The expected median OS among patients with <2, 2–4, and 5–9 risk points were 72, 29, and 12 months respectively. The major complication rates were significantly lower in patients with maximal tumor size ≤10 cm than in those with maximal tumor size >10 cm (4% [5/138] vs 21% [21/98], p = 0.001).ConclusionTACE may be safe and effective in selected patients with advanced HCC without MVI or EHS, with a median OS of 24 months. Patients with limited tumor burden, compensated liver function, absence of HCC rupture, and favorable biologic markers may benefit the most from TACE. TACE is not recommended for patients with huge HCCs (>10 cm) because of its high rate of major complications (21%).https://www.frontiersin.org/articles/10.3389/fonc.2023.1072922/fullhepatocellular carcinomachemoembolizationethiodized oiltreatment outcomeBarcelona clinic liver cancer (BCLC) staging |
| spellingShingle | Ji Hoon Kim Ji Hoon Kim Jin Hyoung Kim Hyun-Ki Yoon Gi-Young Ko Ji Hoon Shin Dong Il Gwon Heung-Kyu Ko Hee Ho Chu Seong Ho Kim Gun Ha Kim Yonghun Kim Shakir Aljerdah Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes Frontiers in Oncology hepatocellular carcinoma chemoembolization ethiodized oil treatment outcome Barcelona clinic liver cancer (BCLC) staging |
| title | Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes |
| title_full | Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes |
| title_fullStr | Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes |
| title_full_unstemmed | Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes |
| title_short | Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes |
| title_sort | transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis analysis of factors prognostic of clinical outcomes |
| topic | hepatocellular carcinoma chemoembolization ethiodized oil treatment outcome Barcelona clinic liver cancer (BCLC) staging |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1072922/full |
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