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Abstract
<h3>Purpose</h3> To investigate the survivals of patients (pts) with mHCC treated with DEB TACE. <h3>Materials and Methods</h3> Consecutive pts with mHCC who received DEB TACE over last 82 months (m) were studied. Progressive enlargement of the lymph node or lung nodule in subsequent scans was considered as metastasis (mets). Survivals were analyzed according to different staging from diagnosis (dx), from 1st DEB TACE (OS-Emb) and from dx of extra-hepatic mets. Statistical analysis was performed using Kaplan-Meier estimator with log-rank testing. Multivariate analysis was performed using Cox proportional Hazard model. <h3>Results</h3> 69 pts (mean age 59.4 years, SD 12.7) were included in this study. Median overall survivals (OS) from dx, 1st DEB TACE and mets were 10.9, 7.4 and 7.2 m. Median OS-Emb per site of extra-hepatic mets are shown in the Table. Two patients received adrenal radiofrequency ablation (RFA) of adrenal mets (n=2) had a median OS of 20m vs 4.8 in patients who did not receive adrenal RFA (p=0. 65). Extra-hepatic mets were present before 1st DEB TACE in 81% of pts vs after 1st DEB TACE in 19%; median OS-Emb 6.7 vs 7.7 m (p=0.9). Child-Pugh Class A, B and C stage were present in 62.3%, 29% and 8.7% of the pts with corresponding median OS-Emb were 10.5m, 5.2m and 1.6m respectively (p<0.001). Okuda stage I, II and III were present in 31.9%, 58% and 10.1% of the pts with corresponding median OS-Emb were 10.6m, 7.4m and 1.6m respectively (p<0.001). 50.7% of pts had portal vein thrombosis (PVT) with median OS-Emb was 4.9m vs 12.1m who did not have PVT (p=0.1). 44.9% of pts received sorafenib systemic chemotherapy with median OS-Emb was 10.5 m vs 5.5 m who did not receive the sorafenib (p=0.1). The following variables were significant prognostic indicators of survival on multivariate analysis; site of mets, Child-Pugh class and Okuda stage. <h3>Conclusion</h3> mHCC patients in Child-Pugh A, isolated mets to adrenal or lung or portahepatic node and Okuda stage I benefited most from DEB TACE therapy. Table 1 Table 2
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