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Korean J Intern Med. 2018 Oct 26. doi: 10.3904/kjim.2018.058. [Epub ahead of print]

Clinical outcomes of patients with a single hepatocellular carcinoma less than 5 cm treated with transarterial chemoembolization.

Author information

1
Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea.
2
Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
3
Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
4
Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Korea.
5
Department of Biostatistics, Soonchunhyang University Seoul Hospital, Seoul, Korea.

Abstract

Background/Aims:

Transarterial chemoembolization (TACE) is performed for single hepatocellular carcinoma (HCC) that are not eligible for surgery or ablation therapy. We investigated the clinical outcomes of patients with a single HCC ≤ 5 cm treated with TACE.

Methods:

This study analyzed 175 consecutive patients who underwent TACE as an initial treatment for single HCC ≤ 5 cm. Predictive factors for complete response (CR), recurrence after CR, and overall survival (OS) were evaluated.

Results:

Total 119 patients (68%) achieved CR after TACE. Tumor size < 3 cm and hepatitis B virus infection were significant predictors of CR (p < 0.05). Recurrent HCC was detected in 73 patients (61.3%) after CR. Age > 65 years and absence of liver cirrhosis were predictive factors for non-recurrence after CR (p < 0.05). The OS for all patients was 80.7 ± 5.6 months, and the 1-, 3-, and 5-year OS rates were 88.1%, 64.8%, and 49.9%, respectively. In multivariate analysis for OS, CR (hazard ratio [HR], 0.467; 95% confidence interval [CI], 0.292 to 0.747) and Child class A (HR, 0.390; 95% CI, 0.243 to 0.626) were significant factors. The OS for the CR and Child class A group were 92 and 93.6 months, respectively, and that of the non-CR and Child B, C group were 53.3 and 50.7 months, respectively (p < 0.001).

Conclusions:

TACE can be a valid treatment in patients with a single HCC ≤ 5 cm not suitable for curative treatment, especially in patients with Child class A and CR after TACE.

KEYWORDS:

Carcinoma, hepatocellular; Chemoembolization, therapeutic; Survival

PMID:
30360019
DOI:
10.3904/kjim.2018.058
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