Clin Mol Hepatol.  2017 Mar;23(1):42-50. 10.3350/cmh.2016.0058.

The role of scheduled second TACE in early-stage hepatocellular carcinoma with complete response to initial TACE

• Kim JH
• Sinn DH
• Shin SW
• Cho SK
• Kang W
• Gwak GY
• Paik YH
• Lee JH
• Koh KC
• Paik SW
• Choi MS

• KMID: 2412113
• DOI: http://doi.org/10.3350/cmh.2016.0058

Abstract

BACKGROUND/AIMS
We investigated the outcomes of early-stage hepatocellular carcinoma (HCC) patients who showed a complete response (CR) to initial transarterial chemoembolization (TACE), with a focus on the role of scheduled TACE repetition.
METHODS
A total of 178 patients with early-stage HCC who were initially treated with TACE and showed a CR based on the modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria on one month follow-up computed tomography (CT) were analyzed. Among them, 90 patients underwent scheduled repetition of TACE in the absence of viable tumor on CT.
RESULTS
During a median follow-up period of 4.6 years (range: 0.4-8.8 years), mortality was observed in 71 patients (39.9%). The overall recurrence-free and local recurrence-free survival rates at 1 year were 44.4% and 56.2%. In the multivariable model, scheduled repetition of TACE was an independent factor associated with survival (hazard ratio [95% confidence interval]: 0.56 [0.34-0.93], P=0.025). When stratified using Barcelona clinic liver cancer (BCLC) stage, scheduled repetition of TACE was associated with a favorable survival rate in BCLC stage A patients, but not in BCLC 0 patients.
CONCLUSIONS
Scheduled repetition of TACE was associated with better survival for early-stage HCC patients showing a CR after initial TACE, especially in BCLC stage A patients.

Keyword

Carcinoma, Hepatocellular; Transarterial chemoembolization; Survival

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/diagnostic imaging/mortality/pathology/*therapy
*Chemoembolization, Therapeutic
Disease-Free Survival
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Liver Neoplasms/diagnostic imaging/mortality/pathology/*therapy
Male
Middle Aged
Neoplasm Staging
Prognosis
Proportional Hazards Models
Remission Induction
Retrospective Studies
Tomography, X-Ray Computed