Prognostic Factors Affecting Survival Rate in Patients with Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization / 대한간학회지

ABSTRACT

PURPOSE: There have been studies concerning prognostic factors in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) but they reported different prognostic factors from each other. The aim of this study is to determine which prognostic factors contribute to long-term survival after TACE of hepatocellular carcinoma. MATERIAL AND METHOD: Two hundred and forty-one patients with HCC who had been treated by TACE were analyzed retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipodol and anticancer drugs (Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. RESULTS: Male to female ratio was 4.71. Mean survival was 13.98 months. Maximum survival was 101 months. The overall cumulative survival rates at the end of the first and second years were, respectively, 41.54% and 20.06%. According to univariate analysis (log-rank scale test), variables significantly associated with survival were sex, liver cirrhosis, Child-Pugh classification, gross type of the tumor, location of the tumor, size of the tumor, TNM stage, metastasis, portal vein thrombosis, arterioportal shunt, ascites, AFP, protein, albumin, alkaline phosphatase, AST, AST/ALT ratio, total bilirubin, and sodium. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univarariate analysis revealed that the gross type of the tumor, portal vein thrombosis, and Child-Pugh classification were statistically significant independent prognostic factors. CONCLUSION: The prognosis of patients with HCC treated with TACE was affected favorably by the nodular type tumor, the patent main and the first-order portal vein, and the good liver function (Child-Pugh class A).