Transarterial chemoembolization for inoperable hepatocellular carcinoma and postresection intrahepatic recurrence
1Centre of Liver Diseases, Department of Surgery and Diagnostic Radiology, The University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Journal of Surgical Oncology
|March 1, 2000
Summary
Transarterial chemoembolization (TACE) for inoperable liver cancer offers limited survival benefits and carries significant risks. Careful patient selection based on tumor size and liver function is crucial for improving outcomes.
Area of Science:
- Hepatobiliary Medicine
- Interventional Oncology
- Cancer Treatment Research
Background:
- Transarterial chemoembolization (TACE) role in inoperable hepatocellular carcinoma (HCC) remains debated.
- Efficacy of TACE for postresection intrahepatic recurrence is not fully established.
Purpose of the Study:
- Evaluate TACE treatment outcomes in patients with inoperable HCC.
- Assess prognostic factors influencing TACE efficacy.
- Analyze TACE effectiveness for postresection recurrent HCC.
Main Methods:
- Prospective data collection from 384 inoperable HCC patients and 100 postresection recurrent HCC patients.
- Analysis of clinicopathologic data and treatment results.
- Evaluation of survival rates, morbidity, and mortality associated with TACE.
Main Results:
- Overall TACE morbidity was 23% and mortality was 4.3%.
- High mortality (20%) observed in patients with tumors >10 cm and albumin ≤35 g/L.
- 1, 3, and 5-year survival rates were 49%, 23%, and 17% respectively.
- Tumor size ≤10 cm and albumin >35 g/L were favorable prognostic factors.
- Postresection recurrent HCC patients showed better outcomes than inoperable HCC patients.
Conclusions:
- TACE for inoperable HCC has limited survival benefit with significant morbidity and mortality.
- Improved patient selection (tumor size, liver function) may enhance TACE results.
- Patients with large tumors (>10 cm) and poor liver function (albumin ≤35 g/L) may not be ideal candidates for TACE.
