Chemoembolization of Hepatocellular Carcinoma: Long-term Survival and Prognostic Factors

ABSTRACT

PURPOSE: To analyse the long-term survival rate after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma and to determine prognostic factors. MATERIALS AND METHODS: In 1067 hepatocellularcarcinoma patients who had undergone TACE, of long-term survival rate and prognostic factors were retrospecfively analysed. Chemoembolization was accomplished by hepatic arterial infusion of a mixture of Lipiodol and Adriamycin(51%) or by Gelfoam embolization after infusion of the Lipiodol mixture(49%). The survival rate was calculated by the Kaplan-Meier method and multivariate analysis using the weibull model was applied to determine which prognostic factors were statistically significant. RESULTS: Among the 1067 patients, survival rates were asfollows one-year, 60.6% ; two-year 42.3% ; three-year, 29.1% ; four-year, 23.7% ; and five-year, 14.7 %. The oneyear survival rate and median survival period of 432 patients with tumors 5cm in diameter or smaller were 77.7%and 33 months respectively, significantly higher than those of patients with larger tumors for whom the corresponding figures were 44.8% and 11 months. Other significant prognostic factors(p<0.0001) shown bymultivariate analysis included type of tumor, portal vein invasion and child-pugh classification. CONCLUSION: Theone-year survival rate agter chemoembolization in 1067 patients with hepatocellular carcinoma was 60.6%. The significant prognostic factors were size and type of the tumor, portal vein invasion, and Child-Pugh classification.