Chemoembolization for Hepatocellular Carcinoma: Comprehensive Imaging and Survival Analysis in a 172-Patient Cohort
- 1 June 2010
- journal article
- Published by Radiological Society of North America (RSNA) in Radiology
- Vol. 255 (3), 955-965
- https://doi.org/10.1148/radiol.10091473
Abstract
Purpose To determine comprehensive imaging and long-term survival outcome following chemoembolization for hepatocellular carcinoma (HCC). Materials and Methods One hundred seventy-two patients with HCC treated with chemoembolization were studied retrospectively in an institutional review board approved protocol; this study was HIPAA compliant. Baseline laboratory and imaging characteristics were obtained. Clinical and laboratory toxicities following treatment were assessed. Imaging characteristics following chemoembolization were evaluated to determine response rates (size and necrosis) and time to progression (TTP). Survival from the time of first chemoembolization treatment was calculated. Subanalyses were performed by stratifying the population according to Child-Pugh, United Network for Organ Sharing, and Barcelona Clinic for Liver Cancer (BCLC) staging systems. Results Cirrhosis was present in 157 patients (91%); portal hypertension was present in 139 patients (81%). Eleven patients (6%) had metastases at baseline. Portal vein thrombosis was present in 11 patients (6%). Fifty-five percent of patients experienced some form of toxicity following treatment; 21% developed grade 3 or 4 bilirubin toxicity. Post-chemoembolization response was seen in 31% and 64% of patients according to size and necrosis criteria, respectively. Median TTP was 7.9 months (95% confidence interval: 7.1, 9.4) but varied widely by stage. Median survival was significantly different between patients with BCLC stages A, B, and C disease (stage A, 40.0 months; B, 17.4 months; C, 6.3 months; P < .0001). Conclusion The determination of TTP and survival in patients with HCC is confounded by tumor biology and background cirrhosis; chemoembolization was shown to be a safe and effective therapy in patients with HCC. © RSNA, 2010Keywords
This publication has 41 references indexed in Scilit:
- Imaging Response in the Primary Index Lesion and Clinical Outcomes Following Transarterial Locoregional Therapy for Hepatocellular CarcinomaJAMA, 2010
- Sorafenib in Advanced Hepatocellular CarcinomaNew England Journal of Medicine, 2008
- Molecular targeted therapies in hepatocellular carcinomaHepatology, 2008
- Phase II Study of Sorafenib in Patients With Advanced Hepatocellular CarcinomaJournal of Clinical Oncology, 2006
- CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatmentSeminars in Radiation Oncology, 2003
- Chemoembolization of Hepatocellular CarcinomaJournal of Vascular and Interventional Radiology, 2002
- Arterial embolisation or chemoembolisation versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomised controlled trialThe Lancet, 2002
- Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL ConferenceJournal of Hepatology, 2001
- New Guidelines to Evaluate the Response to Treatment in Solid TumorsJNCI Journal of the National Cancer Institute, 2000
- Nonparametric Estimation from Incomplete ObservationsJournal of the American Statistical Association, 1958