Transcatheter arterial chemoembolization as primary treatment for hepatocellular carcinoma
D M Rose1, W C Chapman, A T Brockenbrough
1Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4753, USA.
Insights
Transcatheter arterial chemoembolization (TACE) significantly improves survival for hepatocellular carcinoma (HCC) patients compared to supportive care. This retrospective study highlights TACE as a safe and effective treatment option for unresectable HCC.
Area of Science:
- Hepatology
- Oncology
- Interventional Radiology
Background:
- Hepatocellular carcinoma (HCC) historically presents with poor survival rates in Western populations.
- Identifying effective treatments for unresectable HCC is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) for HCC.
- To compare outcomes of TACE versus supportive care in HCC patients.
Main Methods:
- A 7-year retrospective analysis of HCC patients undergoing TACE.
- Comparison of demographics, outcomes, and complications between TACE and supportive care groups.
Main Results:
- TACE significantly improved median survival (9.2 months) compared to supportive care (less than 3 months) (P < 0.0001).
- Overall actuarial survival at 1, 2, and 3 years for TACE patients was 35%, 20%, and 11%, respectively.
- TACE was associated with manageable complications like nausea, pain, vomiting, and fever.
Conclusions:
- Transcatheter arterial chemoembolization (TACE) is a safe and effective therapeutic option for selected HCC patients.
- TACE offers a survival benefit for patients with HCC not amenable to surgical intervention.
Background:
Hepatocellular carcinoma (HCC) in Western populations has historically been associated with poor survival.
Methods:
In this study, we conducted a 7-year retrospective analysis of patients with HCC undergoing transcatheter arterial chemoembolization (TACE) at our institution and examined demographics, outcomes, and complications.
Results:
During the period of study, 39 patients (25 male [64%], mean age 58 [range 17 to 86]) underwent a total of 78 chemoembolization treatments. During the same time period, an additional 31 patients received supportive care only. The majority of patients had late stage disease (American Joint Committee on Cancer stage III, IVa, or IVb) with no statistical difference noted between the two groups (P = 0.2). However, patients receiving supportive care only had significantly worse hepatic dysfunction by Child's classification (P = 0.005). Twenty-nine patients (74%) had documented cirrhosis, with hepatitis C being the most common cause in 11 of 29 (38%). In patients undergoing TACE, overall actuarial survival was 35%, 20%, and 11% at 1, 2, and 3 years with a median survival of 9.2 months, significantly improved over the group receiving supportive care only (P < 0.0001). Median survival for the group receiving supportive care was less than 3 months. Neither age nor stage had a significant impact on survival. The most common complications of TACE included transient nausea, abdominal pain, vomiting, and fever.
Conclusions:
TACE is a safe and effective therapeutic option for selected patients with HCC not amenable to surgical intervention.
