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Treatment of hepatocellular carcinoma using transarterial chemoembolization: a real-life, single-centre study from
Lívia C Lionço1, Angelo A de Mattos, Alex F Horbe
1aDepartment of Gastroenterology, Federal University of Health Sciences of Porto Alegre bDepartment of Neuroradiology, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
Objective:
The main aim of this study was to evaluate the real-life survival rates of patients with intermediate-stage hepatocellular carcinoma treated with transarterial chemoembolization.
Methods:
A retrospective cohort study involving 95 patients was conducted and the studied variables were analysed according to survival. Treatment response was determined using the Modified Response Evaluation Criteria in Solid Tumors assessment. The Kaplan-Meier method and Cox regression were used to analyse survival.
Results:
Most (72.6%) patients were male, with a mean age of 64.8±9.7 years and mean Model for End-Stage Liver Disease score of 10.4±3.0. The median α-fetoprotein (AFP) level was 29.3 ng/ml. Complications were observed in 31.6% of the patients. A target response assessment revealed that 35.8% of patients exhibited complete response, 22.1% a partial response, 27.4% stable disease and 14.7% progressive disease. According to overall response rates, 63.2% exhibited progressive disease. Mean survival time was 32 months. The 1-, 2-, 3- and 5-year survival rates were 80, 59, 44 and 29%, respectively. In the multivariate model adjusted for overall response rates, only AFP level more than or equal to 100 ng/ml (hazard ratio=2.35, 95% confidence interval: 1.06-5.18, P=0.035) was associated with death.
Conclusion:
Transarterial chemoembolization is an effective therapy; however, AFP levels more than or equal to 100 ng/ml are associated with poorer prognosis.