Abstract No. 518 Factors associated with recurrence of hepatocellular carcinoma with complete imaging response after treatment with transarterial chemoembolization

Abstract

To identify factors affecting tumor recurrence in patients with unresectable hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE), who present complete imaging response (CIR) postprocedure. Retrospective single-center study. Consecutive patients with unresectable HCC, treated with TACE from January 2005 to December 2016, who presented CIR in the first postprocedure imaging control, were included. Patients who received contemporary adjuvant treatment (radiofrequency, microwave or alcoholization) or patients without imaging follow-up were excluded. CIR was defined as absence of contrast-enhancement of the treated lesion in arterial phase. As local recurrence were considered: detection of contrast-enhancement in the treated lesions in arterial phase, washout of the treated lesions in portal-venous phase, or an increase in lesion size after CIR. Age, gender, etiology of chronic liver damage, Child-Pugh classification, MELD-Na score, number, size and location of HCC, and chemoembolization technique were analyzed. Chi-square test was used to compare qualitative variables, and Wilcoxon or t-student test for the quantitative variables. Multiple logistic regression analysis was performed to study factors that modify tumor recurrence. A p-value less than 0.05 was considered statistically significant. From a total of 206 HCC in 148 patients treated with TACE during the study period, 71 tumors were analyzed after applying the inclusion/exclusion criteria. The mean follow-up was 9.7 months (range, 1-36 months). Tumor recurrence at 6-, 12- and 24-months was 21%, 32% and 42%, respectively. In multivariate analysis, tumor size ≥ 3 cm was the only factor that demonstrated a significant association with tumor recurrence, with OR 6.41 (95% CI: 1.71-23.97) (p = 0.006). Recurrence of HCC with complete imaging response after treatment with TACE is common, a result that is consistent with previous reports. Tumor size ≥ 3 cm is significantly associated with an increased risk of tumor recurrence.