Gut Liver.  2017 May;11(3):409-416. 10.5009/gnl16001.

Predictive Factors for Complete Response and Recurrence after Transarterial Chemoembolization in Hepatocellular Carcinoma

• Jeong SO
• Kim EB
• Jeong SW
• Jang JY
• Lee SH
• Kim SG
• Cha SW
• Kim YS
• Cho YD
• Kim HS
• Kim BS
• Kim YJ
• Goo DE
• Park SY

• KMID: 2412215
• DOI: http://doi.org/10.5009/gnl16001

Abstract

BACKGROUND/AIMS
To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).
METHODS
Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS).
RESULTS
Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (≤5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p<0.001), respectively. Elevated serum α-fetoprotein (AFP) (>20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p<0.001), respectively. Tumor size (>5 cm), multinodularity, elevated serum AFP (>20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS.
CONCLUSIONS
In patients treated with TACE as a first therapy, tumor size (≤5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (>20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.

Keyword

Carcinoma, hepatocellular; Chemoembolization, therapeutic; Complete response; Recurrence

MeSH Terms

Aged
Carcinoma, Hepatocellular/blood/complications/*therapy
Chemoembolization, Therapeutic/*methods
Female
Humans
Liver Neoplasms/blood/complications/*therapy
Male
Middle Aged
Neoplasm Recurrence, Local/*etiology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Severity of Illness Index
Treatment Outcome
Venous Thrombosis/etiology
alpha-Fetoproteins/analysis
alpha-Fetoproteins