Locoregional Therapy in Patients with Hepatocellular Carcinoma: A Real Life Experience

Abstract

Introduction: Hepatocellular carcinoma (HCC) has dismal prognosis but recently, survival has improved with treatment.Aims: To analyze our experience of treatment of HCC patients at our tertiary care center especially those who received locoregional therapies.Materials and Methods: We studied the records of 92 HCC patients attending our hospital from March 2013 to March 2015. Out of 92 patients, 62 received treatment and 26 patients were lost to follow up, 2 patients expired and treatment is planned for 2 patients.Results: Out of 62 treated patients with HCC, 35 received locoregional therapies, 1 patient underwent liver transplant and 1 patient underwent segmental hepatectomy. 25 patients were treated with Sorafenib due to advanced disease stage or unwillingness of patient for other treatment modalities. 35 patients (31 males, 4 females; mean age 58 years) were subjected to 43 sessions of locoregional therapies (21 – TACE, 4 – RFA, 2 – TARE and 8 – combination of these therapies). Barcelona Clinic staging in these 35 patients was: 0 – 1 patient, A – 9 patients, B – 3 patients, and C – 22 patients. No significant postprocedure complications were encountered. 82.86% (29) patients had complete response, 2.86% (1) patients had partial response and 5.71% (2) patients had stable disease at 1month of follow-up imaging as per mRECIST criteria. 3 patients were lost to follow up. At 1 year of follow-up imaging in 14 patients, only 3 had progression of disease. Overall only 22.86% (8) patients had progression of disease on follow up at the end of 2 years. Among patients who followed-up, mean survival was 15.19 months (range 1–108 months) in patients who underwent locoregional therapies where as mean survival in patients who received sorafenib was only 3 months.Conclusion: Locoregional therapies are safe and improve survival of patients with HCC. Introduction: Hepatocellular carcinoma (HCC) has dismal prognosis but recently, survival has improved with treatment. Aims: To analyze our experience of treatment of HCC patients at our tertiary care center especially those who received locoregional therapies. Materials and Methods: We studied the records of 92 HCC patients attending our hospital from March 2013 to March 2015. Out of 92 patients, 62 received treatment and 26 patients were lost to follow up, 2 patients expired and treatment is planned for 2 patients. Results: Out of 62 treated patients with HCC, 35 received locoregional therapies, 1 patient underwent liver transplant and 1 patient underwent segmental hepatectomy. 25 patients were treated with Sorafenib due to advanced disease stage or unwillingness of patient for other treatment modalities. 35 patients (31 males, 4 females; mean age 58 years) were subjected to 43 sessions of locoregional therapies (21 – TACE, 4 – RFA, 2 – TARE and 8 – combination of these therapies). Barcelona Clinic staging in these 35 patients was: 0 – 1 patient, A – 9 patients, B – 3 patients, and C – 22 patients. No significant postprocedure complications were encountered. 82.86% (29) patients had complete response, 2.86% (1) patients had partial response and 5.71% (2) patients had stable disease at 1month of follow-up imaging as per mRECIST criteria. 3 patients were lost to follow up. At 1 year of follow-up imaging in 14 patients, only 3 had progression of disease. Overall only 22.86% (8) patients had progression of disease on follow up at the end of 2 years. Among patients who followed-up, mean survival was 15.19 months (range 1–108 months) in patients who underwent locoregional therapies where as mean survival in patients who received sorafenib was only 3 months. Conclusion: Locoregional therapies are safe and improve survival of patients with HCC.