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Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients

Published on: September 20, 2020

Alpha-fetoprotein response following transarterial chemoembolization indicates improved survival for

Guanghua Liu¹, Qiang Ouyang², Fang Xia³

¹Department of Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Department of Interventional Radiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China; Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association

|July 19, 2018

Abstract

Background:

To investigate the clinical value of the alpha-fetoprotein (AFP) response following transcatheter arterial chemoembolization (TACE) in intermediate-stage hepatocellular carcinoma (HCC).

Methods:

Data on patients with Barcelona Clinic Liver Cancer B staging system were analyzed. An AFP response was defined as a decrease in AFP of more than 20% after a TACE session. The association between AFP response and treatment outcome regarding imaging response and overall survival (OS) was explored. Cox proportional hazards models were applied to identify independent risk factors for OS after TACE.

Results:

Of the enrolled 376 patients with elevated serum AFP >20 ng/mL, 214 (57%) with AFP responses were identified. AFP responders had improved median survival than non-responders (20 vs. 12 months, P = 0.002). AFP response was significantly correlated with imaging response (P < 0.001). The Cox proportional hazards model revealed that AFP response was an independent factor for OS (hazard ratio, 0.59; 95% confidence interval, 0.45-0.78; P < 0.001). In stratified analyses, an AFP response achieved improved survival in patients with tumor diameters ≤5 cm, diameters >5 cm, tumor number ≤3 and without underlying cirrhosis.

Conclusions:

The AFP response indicates enhanced survival after TACE in patients with intermediate-stage BCLC.

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