Abstract No. 411 - Survivals and predictive factors of atypical unresectable hepatocellular carcinoma (MHCC) treated with doxorubicin drug eluting beads transcatheter chemoembolization (DEB TACE)

Abstract

Purpose To investigate the survivals of patients (pts) with atypical HCC treated with DEB TACE. Materials and Methods Pretreatment contrast enhanced dynamic abdominal MR or CT studies of 366 consecutive pts treated with DEB TACE over last 82 months were reviewed. HCCs which did not show conventional features were separated and assigned as atypical HCCs by imaging criteria. Morphological imaging features were analyzed and correlated with median overall survival (OS) from 1st DEB TACE. HCCs with heterogeneity, ill-defined extents with invasion of peri or intra-tumoral portal or hepatic veins (PVT) were diagnosed as infiltrative HCC. HCC imaging characteristics were accounted in multivariate analysis. Kaplan Meier estimator by log rank test and Cox Proportional Hazard model were used for survival analysis. Results 71 pts (mean 60.2 years, SD 10.4) had atypical appearance of HCC. The Table shows median OS according to the appearance of HCC HCC containing fat or fibrous scar had highest median OS. 53.5% of pts had PVT with median OS of 4.5 m vs 34 m in pts without PVT (p Conclusion HCC containing fat or fibrous scar had highest median OS. Infiltrative HCC had poorest survival among others. Pts with Child-Pugh class A, Okuda stage I and without PVT or infiltrative HCC benefited most from DEB TACE treatment.