Abstract
Purpose: To evaluate the effect of chronic liver disease (CLD) in a multivariate analysis of associated risk factors in patients with hepatocellular carcinoma (HCC) using transarterial chemoembolization (TACE). Materials and methods: A total of 145 patients with HCC (99 men, 46 women; mean age: 63 years ±8.1; age range: 46-84 years) underwent 598 TACE procedures. The presence of CLD, number and location of lesions, tumor size, Child-Pugh score, vascularity, portal involvement and alpha fetoprotein value were analyzed using the multivariate regression model. Cox regression was used for survival analysis. Results: The median survival time was 26.7 months, and 78.6% of all treated lesions showed tumor responses. The presence of CLD (OR 2.12, P=0.004), Child-Pugh score B (OR 2.24, P=0.002), alpha fetoprotein >100ng/dl (OR 1.18, P 5cm (OR 4.12, P=0.002) and hypervascularity (OR 7.94, P=0.003) were significant effective factors for a local response when analyzed using a multivariate logistic model. Multivariate survival analysis using Cox's regression model during the median follow-up period of 25 months (range: 1-42 months) demonstrated a significant difference in survival rates (P values 5cm and hypervascularity statistically led to a significant effect in tumor response in HCC patients treated with TACE. Patient gender, location of lesion and involvement of portal vein showed no significant difference in response.
Highlights
Hepatocellular carcinoma is the most common primary liver tumor worldwide
The presence of chronic liver disease as well as associated risk factors including Child-Pugh score B, alpha fetoprotein 100ng/dl, multinodularity ( 3 lesions), lesion size 5cm and hypervascularity statistically led to a significant effect in tumor response in hepatocellular carcinoma (HCC) patients treated with transarterial chemoembolization (TACE)
Location of lesion and involvement of portal vein showed no significant difference in response
Summary
Hepatocellular carcinoma is the most common primary liver tumor worldwide. Most patients with HCC (60-90%) typically have chronic cirrhosis [1]. The cause of cirrhosis may vary, but the most common associated diseases are hepatitis B, hepatitis C, hemochromatosis, chronic alcoholism and chronic exposure to mycotoxins, such as aflatoxin B1 [1, 2]. Surgical resection is the optimal treatment of HCC but due to advanced cancer at the time of first presentation, the presence of underlying chronic liver disease (CLD), the multifocality and/or insufficient remnant liver volume, the majority of HCC cases are unresectable [3,4,5,6,7]. Received 8 February 2014 Revised 15 April 2014 Accepted 22 April 2014 Published 29 April 2014
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