Long-term survival of patients with unresectable hepatocellular carcinoma treated with transcatheter arterial chemoinfusion

Department of Medicine, Stanford University, Palo Alto, California, United States
Alimentary Pharmacology & Therapeutics (Impact Factor: 5.73). 10/2007; 26(6):839-46. DOI: 10.1111/j.1365-2036.2007.03424.x
Source: PubMed


Transcatheter arterial chemoembolization (TACE) has become one of the most common treatments for unresectable hepatocellular carcinoma. Published studies of TACE report a 5-16% risk of serious complications. Compared with TACE, transcatheter arterial chemoinfusion (TACI) may have similar efficacy and fewer side effects.
To examine the clinical outcomes of TACI.
We performed a retrospective cohort study of 345 consecutive TACI cases in 165 patients performed at a single United States medical center between 1998 and 2002. Primary outcomes were tumour response and survival rates.
Only seven patients were hospitalized for more than 24 h after the procedure, and only three patients had worsening of liver function within 30 days of TACI. Survival was significantly poorer for patients with tumour-node-metastasis (TNM) IV compared to those with TNM I-III and also for patients with Child's class B/C vs. A. Following adjustment for age, gender, ethnicity and aetiology of liver diseases, independent predictors of poor survival were Child's class B/C [Hazard Ratio (HR) = 1.69, P = 0.024] and TNM IV staging (HR = 1.63, P = 0.014).
TACI appears to be safe and effective for unresectable hepatocellular carcinoma with TNM stage I-III; randomized controlled trials are needed to compare TACI to TACE.

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Available from: Daniel Y Sze, Mar 15, 2015
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