, Volume 30, Issue 7, pp 560-566
Date: 30 May 2012

Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?

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Abstract

Purpose

To evaluate retrospectively whether technical factors of hepatic arterial embolization affect the prognosis of patients with hepatocellular carcinoma (HCC).

Materials and methods

Inclusion criteria of this study were the following: (1) patients received embolization as the initial treatment during 2003–2004, (2) Child A or B liver profile, (3) five or fewer HCCs with maximum diameter of 7 cm or smaller, and (4) no extrahepatic metastasis. Patient data were gathered from 43 centers. Prognostic factors were evaluated using univariate and multivariate analyses.

Results

Eight hundred fifteen patients were enrolled. The 1-, 3-, 5-, and 7-year overall survival rates were 92.0 % (95 % CI 90.1–93.9), 62.9 % (95 % CI 59.3–66.6), 39.0 % (95 % CI 35.1–43.0), and 26.7 % (95 % CI 22.6–30.8) in all patients. Univariate analysis showed a Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, tumor number of 3 or fewer, one-lobe tumor distribution, nodular tumor type, within the Milan criteria, stage I or II, no portal venous invasion, use of iodized oil, and selective embolization were significantly better prognostic factors. In the multivariate Cox model, the benefit to survival of selective embolization remained significant (hazard ratio 0.68; 95 % CI 0.48–0.97; p = 0.033).

Conclusion

Selective embolization contributes to survival in patients with HCCs.

On behalf of the Clinical Research Group of the Japanese Society for Transcatheter Hepatic Arterial Embolization and Japanese Society of Interventional Radiology.