Treatment of hepatocellular carcinoma with transcatheter arterial embolization. Analysis of prognostic factors.

Abstract

Transcatheter arterial embolization (TAE) is a useful treatment modality for hepatocellular carcinoma (HCC). To study the prognostic factors, survival time of patients with HCC after TAE was analyzed retrospectively using clinical manifestations of coexisting liver cirrhosis and clinical features of HCC. Eighty-seven patients with HCC were treated with TAE between 1984 and 1991 and observed at Nagasaki University Hospital. All the patients also had liver cirrhosis. The survival time of the 87 patients after TAE ranged from 2 months to 8.1 years (mean +/- standard deviation, 2.7 +/- 0.3 years). Survival curves after TAE did not differ between men and women (P > 0.5) or between hepatitis B and C viral infection (P > 0.8), but they depended on clinical stages of coexisting liver cirrhosis (P < 0.01). The cumulative survival after TAE was significantly longer in patients with uninodular tumors than in patients with multinodular tumors (P < 0.0001) (3-year survival, 53.3% vs. 13.3%; 5-year survival, 32.2% vs. 3.3%, respectively). In contrast, patients' survival time was not associated with the size of the tumor detected at the time of treatment with TAE (P > 0.1). Treatment of HCC with TAE is well indicated regardless of tumor size for patients with nonadvanced liver cirrhosis and uninodular tumors. Alternatively, treatment of HCC with TAE alone is still insufficient in patients with multinodular tumors. Other treatment modalities in combination with TAE should be considered to achieve a more favorable prognosis of these patients.