Hepatic artery embolization for inoperable hepatocellular carcinoma; prognosis and Risk Factors

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During a 7-year period in our hospital, 69 patients with inoperable hepatocellular carcinoma (HCC) underwent 111 courses of transcatheter hepatic artery embolization (TAE) and/or chemoinfusion with lipiodol. Patient survival was 0.5–37 months following therapy and the factors affecting prognosis were evaluated. Survival rates at 1, 2 and 3 years after TAE were 53%, 24% and 15%, respectively. Survival rates at 1, 2 and 3 years in relation to tumor size were 100%, 100% and 100% in 5 patients (tumor size <2 cm in diameter), 81%, 33% and 16% in 23 patients (2.1–5.0 cm), and 35%, 9% and 0% in 41 patients (>5.1 cm). An analysis of prognostic factors showed that the size of the main tumor significantly influenced the prognosis following TAE (P<0.01), whereas the frequency of TAE, intrahepatic metastasis and the degree of liver dysfunction showed a slight correlation (P<0.1). These results suggest that TAE has a significant potential for becoming the first choice of treatment for patients with small multiple HCCs (<2 cm), provided that neither severe hepatic dysfunction nor a tumor thrombus in the main portal vein is present.