Analysis of Prognostic Factors in Patients with Hepatocellular Carcinoma after Transcatheter Hepatic Arterial Chemoembolization(TAE)

ABSTRACT

PURPOSE: To evaluate long-term survival rates and prognostic factors of patients with hepatocellularcarcinoma after TAE. MATERIALS AND METHODS: 225 patients with hepatocellular carcinoma treated with TAE between January 1988 and December 1994 were studied. Hepatocellular carcinoma was diagnosed either histologically(n=13) orclinically on the basis of findings characteristic for hepatocellular carcinoma obtained using such as diagnostic imaging methods such as ultrasonography, CT, MRI, and angiography as well as on the basis of high serumalpha-fetoprotein level(n=212). TAE was carried out between one and six times(mean, 1.4 time) using a mixture of lipiodol and Adriamycin, together with Gelfoam. Cumulative survival rates from the day of the first TAE were obtained by the Kaplan-Meier method. Parameters likely to influence the prognosis were subjected to univariate analysis using the log-rank test RESULTS: Cumulative survival rates at the end of the first, second, third, fourth, and fifth year were 55.9%, 32.6%, 21.9%, 17.9%, and 15.0%, respectively. The mean survival time was 727+/-76 days. Several factors, including Child-Pugh classification, Okuda's stage, tumor size, presence of portalvein invasion by tumor, of arterio-portal shunt, and of extra hepatic metastases, catheter selection level, and number of TAE showed significant correlation with the outcome. Degrees of Lipiodol accumulation in a tumor onfollow up CT were also correlated with survival rates. CONCLUSION: TAE is an effective measure for prolonging the patient's life expectancy and evaluation of prognostic factor is helpful for prognosis and in deciding on the optimal therapeutic modality.