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World J Gastroenterol. Jan 21, 2014; 20(3): 745-754
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.745
Transarterial chemoembolization in Barcelona Clinic Liver Cancer Stage 0/A hepatocellular carcinoma
Heung Cheol Kim, Ki Tae Suk, Dong Joon Kim, Jai Hoon Yoon, Yeon Soo Kim, Gwang Ho Baik, Jin Bong Kim, Chang Hoon Kim, Hotaik Sung, Jong Young Choi, Kwang Hyub Han, Seung Ha Park
Heung Cheol Kim, Department of Radiology, Hallym University College of Medicine, Chuncheon 200-704, South Korea
Ki Tae Suk, Dong Joon Kim, Jai Hoon Yoon, Yeon Soo Kim, Gwang Ho Baik, Jin Bong Kim, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea
Chang Hoon Kim, College of Medicine, Upstate Medical University, State University of New York, Syracuse, NY 13210, United States
Hotaik Sung, Department of Biology, Stanford University, Stanford, CA 94305, United States
Jong Young Choi, Department of Internal Medicine, Catholic University College of Medicine, Seoul 137-701, South Korea
Kwang Hyub Han, Liver Cirrhosis Clinical Research Center, Yonsei University College of Medicine, Seoul 542-804, South Korea
Seung Ha Park, Department of Internal Medicine, Inje University College of Medicine, Busan 614-735, South Korea
Author contributions: Kim HC and Suk KT designed the study and wrote the manuscript; Kim HC and Suk KT contributed equally to this work; Kim DJ designed and performed the study and edited the manuscript; Choi JY and Han KH provided vital reagents and analytical tools, were involved in editing the manuscript, and provided financial support for this work; Yoon JH, Kim YS, Baik GH and Kim JB coordinated and collected all of the human data; Kim CH, Sung H and Park SH were involved in editing the manuscript.
Supported by A Grant from the Korea Healthcare Technology R and D Project, Ministry of Health and Welfare, Republic of Korea No. HI10C2020); by The Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology No. NRF-2010-0021482
Correspondence to: Dong Joon Kim, MD, PhD, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon 200-704, South Korea. djkim@hallym.ac.kr
Telephone: +82-33-2405647 Fax: +82-33-2418064
Received: July 22, 2013
Revised: October 17, 2013
Accepted: October 19, 2013
Published online: January 21, 2014
AIM: To evaluate the clinical characteristics of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 and A hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).
METHODS: Between January 2001 and September 2011, 129 patients with BCLC stage 0 and stage A HCC who underwent TACE were retrospectively enrolled. Patient characteristics, routine computed tomography and TACE findings, survival time and 1-, 5-, and 10-year survival rates, risk factors for mortality, and survival rates according to the number of risk factors were assessed.
RESULTS: The mean size of HCC tumors was 2.4 ± 1.1 cm, and the mean number of TACE procedures performed was 2.5 ± 2.1. The mean overall survival time and 1-, 5-, and 10-year survival rates were 80.6 ± 4.9 mo and 91%, 63% and 49%, respectively. In the Cox regression analysis, a Child-Pugh score > 5 (P = 0.005, OR = 3.86), presence of arterio-venous shunt (P = 0.032, OR = 4.41), amount of lipiodol used (> 7 mL; P = 0.013, OR = 3.51), and female gender (P = 0.008, OR = 3.47) were risk factors for mortality. The 1-, 5-, and 10-year survival rates according to the number of risk factors present were 96%, 87% and 87% (no risk factors), 89%, 65%, and 35% (1 risk factor), 96%, 48% and unavailable (2 risk factors), and 63%, 17%, and 0% (3 risk factors), respectively (P < 0.001).
CONCLUSION: TACE may be used as curative-intent therapy in patients with BCLC stage 0 and stage A HCC. The Child-Pugh score, arterio-venous shunt, amount of lipiodol used, and gender were related to mortality after TACE.
Core tip: In this study, transarterial chemoembolization (TACE) was associated with a relatively good survival rate in patients with stage 0 and stage A Barcelona Clinic Liver Cancer (BCLC). The Child-Pugh score, presence of arterio-venous shunt, amount of lipiodol used during TACE, and female gender were correlated with mortality in patients with BCLC stage 0 and stage A hepatocellular carcinoma who underwent TACE. Patients with more than 2 risk factors should be treated by other curative-intent treatments after the first TACE.
