Selective Versus Non-selective Transarterial Chemoembolization via the Intercostal Artery for the Treatment of Hepatocellular Carcinoma.

Abstract

To report the 1-month tumor response and safety of selective transarterial chemoembolization (TACE) via the intercostal artery (ICA) for the treatment of hepatocellular carcinoma (HCC) in comparison with those of non-selective TACE. This retrospective study included 79 HCC patients who underwent TACE via the ICA selectively (selective TACE group; n = 26) or non-selectively (non-selective TACE group; n = 53) between January 2001 and December 2016. Selective TACE was defined when TACE was performed with selective catheterization of the tumor feeding branch of the ICA. TACE performed without selective catheterization of the tumor feeding branch was defined as non-selective TACE. One-month target and overall tumor responses and complications of the two groups were compared. Univariate and multivariate analyses were performed to identify prognostic factors. Selective TACE group showed better 1-month target and overall tumor responses and lower frequency of complications than non-selective TACE group (P = .007, P = .018, and P < .001, respectively). Performing selective TACE was the only significant favorable factor for better target and overall tumor responses (P = .001 and P = .028, respectively). In univariate analysis for complications, serum α-fetoprotein > 200ng/mL and non-selective TACE were statistically significant. However, multivariate analysis showed that performing non-selective TACE was the only significant risk factor (odds ratio 13.56; 95% confidence interval 3.51-52.5; P < .001). Compared to non-selective TACE via the ICA, selective TACE via the ICA for the treatment of HCC can achieve better tumor response and safety.