Abstract
Background and AimThe optimal treatment for huge unresectable hepatocellular carcinoma (HCC) remains controversial. The outcome of transcatheter arterial chemoembolization (TACE) for patients huge unresectable HCC is generally poor and the survival benefit of TACE in these patients is unclear. The aim of the study is to compare the effect of hepatic arterial infusion chemotherapy (HAIC) versus symptomatic treatment in patients with huge unresectable HCC.MethodsSince 2000 to 2005, patients with huge (size >8cm) unresectable HCC were enrolled. Fifty-eight patients received HAIC and 44 patients received symptomatic treatment. In the HAIC group, each patient received 2.4+1.4 (range: 1–6) courses of HAIC. Baseline characteristics and survival were compared between the HAIC and symptomatic treatment groups.ResultsThe HAIC group and the symptomatic treatment group were similar in baseline characteristics and tumor stages. The overall survival rates at one and two years were 29% and 14% in the HAIC group and 7% and 5% in the symptomatic treatment group, respectively. The patients in the HAIC group had significantly better overall survival than the symptomatic treatment group (P<0.001). Multivariate analysis revealed that HAIC was the significant factor associated with the overall survival (relative risk: 0.321, 95% confidence interval: 0.200–0.515, P<0.001). None of the patients died due to immediate complications of HAIC.ConclusionsHAIC is a safe procedure and provides better survival than symptomatic treatment in patients with huge unresectable HCC.
Highlights
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and it is the 2nd leading cause of cancer death in Taiwan [1,2]
According to the study from our hospital, Mok et al found that the advantage of hepatic resection in patients with huge hepatocellular carcinoma (HCC) is marginal as compared with multimodality treatment including transcatheter arterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC) or local ablation therapy [9]
The aim of this study is to investigate the effect of HAIC versus symptomatic treatment for the treatment of huge unresectable HCC
Summary
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and it is the 2nd leading cause of cancer death in Taiwan [1,2]. According to the study from our hospital, Mok et al found that the advantage of hepatic resection in patients with huge HCC is marginal as compared with multimodality treatment including transcatheter arterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC) or local ablation therapy [9]. Transcatheter arterial embolization/chemoembolization (TAE/TACE) has been considered as the choice for the palliative treatment of huge unresectable HCC [10]. From our study in 2004, HAIC with cisplatin, mitomycin C, leucovorin and 5-FU for advanced unresectable HCC has a tumor response rate of 28.3% and only one patient died due to the complication of HAIC during 211 courses of treatments [16]. The aim of the study is to compare the effect of hepatic arterial infusion chemotherapy (HAIC) versus symptomatic treatment in patients with huge unresectable HCC
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