Efficacy of chemoembolization for recurrent HCC after curative ablation therapy

Hepatogastroenterology. 2013 May;60(123):395-99. doi: 10.5754/hge12767.

Abstract

Background/aims: Transarterial chemoembolization (TACE) is a widely applied standard treatment option for treatment-naïve patients with multifocal hepatocellular carcinoma (HCC). However, the treatment strategy in patients with multi-nodular recurrences has not been well addressed. This retrospective cohort study aimed to evaluate the efficacy of TACE for recurrent HCC.

Methodology: Two hundred seventeen consecutive patients who received curative ablation therapy for HCC were followed up. Forty-three of the 217 underwent TACE for recurrent HCC, and the treatment efficacy after TACE was compared with that in 99 treatment-naïve patients who underwent TACE for multifocal HCC during the same period.

Results: The overall survival rates of the patients after TACE for recurrent HCC were not different (P=0.136) from those of the treatment-naïve patients after TACE. No serious adverse events related to TACE were observed in either group. Serum albumin levels (>3.5g/dL, p=0.001), alpha-fetoprotein levels (<300ng/mL, p=0.021), protein induced by vitamin K absence or antagonist II levels (<300ng/mL, p=0.045), and the number of recurrent tumors (<=3 nodules, p=0.047) were prognostic factors after TACE in patients with recurrent HCC.

Conclusions: TACE for multifocal recurrent HCC is safe and effective, with good survival results, similar to those of initial TACE for treatment-naïve patients with multifocal HCC.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Catheter Ablation* / adverse effects
  • Catheter Ablation* / mortality
  • Chemoembolization, Therapeutic* / adverse effects
  • Chemoembolization, Therapeutic* / mortality
  • Chi-Square Distribution
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Liver Neoplasms / blood
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / therapy*
  • Protein Precursors / blood
  • Prothrombin
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Serum Albumin / analysis
  • Serum Albumin, Human
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • alpha-Fetoproteins / analysis

Substances

  • AFP protein, human
  • ALB protein, human
  • Biomarkers
  • Protein Precursors
  • Serum Albumin
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin
  • Serum Albumin, Human