Japanese Journal of Radiology

, Volume 30, Issue 7, pp 560–566

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

  • Koichiro Yamakado
  • Shiro Miyayama
  • Shozo Hirota
  • Kimiyoshi Mizunuma
  • Kenji Nakamura
  • Yoshitaka Inaba
  • Akihiro Maeda
  • Kunihiro Matsuo
  • Norifumi Nishida
  • Takeshi Aramaki
  • Hiroshi Anai
  • Shinichi Koura
  • Shigeo Oikawa
  • Ken Watanabe
  • Taku Yasumoto
  • Kinya Furuichi
  • Masato Yamaguchi
Original Article

DOI: 10.1007/s11604-012-0088-1

Cite this article as:
Yamakado, K., Miyayama, S., Hirota, S. et al. Jpn J Radiol (2012) 30: 560. doi:10.1007/s11604-012-0088-1

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.

Keywords

Hepatocellular carcinomaArterial embolizationPrognosis

Copyright information

© Japan Radiological Society 2012

Authors and Affiliations

  • Koichiro Yamakado
    • 1
  • Shiro Miyayama
    • 2
  • Shozo Hirota
    • 3
  • Kimiyoshi Mizunuma
    • 4
  • Kenji Nakamura
    • 5
  • Yoshitaka Inaba
    • 6
  • Akihiro Maeda
    • 3
  • Kunihiro Matsuo
    • 7
  • Norifumi Nishida
    • 8
  • Takeshi Aramaki
    • 9
  • Hiroshi Anai
    • 10
  • Shinichi Koura
    • 11
  • Shigeo Oikawa
    • 12
  • Ken Watanabe
    • 13
  • Taku Yasumoto
    • 14
  • Kinya Furuichi
    • 15
  • Masato Yamaguchi
    • 16
  1. 1.Department of Interventional RadiologyMie University School of MedicineTsuJapan
  2. 2.Department of Diagnostic RadiologyFukui-ken Saiseikai HospitalFukuiJapan
  3. 3.Department of RadiologyHyogo College of MedicineNishinomiyaJapan
  4. 4.Department of RadiologyOhtawara Red Cross HospitalOhtawaraJapan
  5. 5.Department of RadiologyDaito Central HospitalDaitoJapan
  6. 6.Department of Diagnostic and Interventional RadiologyAichi Cancer Center HospitalNagoyaJapan
  7. 7.Department of RadiologyNarumi HospitalHirosakiJapan
  8. 8.Department of RadiologyOsaka City UniversityOsakaJapan
  9. 9.Department of Diagnostic RadiologyShizuoka Cancer CenterShizuokaJapan
  10. 10.Department of RadiologyNara Medical UniversityKashiharaJapan
  11. 11.Department of RadiologyFukuoka UniversityFukuokaJapan
  12. 12.Department of RadiologyIwate Prefectural Central HospitalMoriokaJapan
  13. 13.Department of RadiologyJikei UniversityTokyoJapan
  14. 14.Department of RadiologyToyonaka Municipal HospitalToyonakaJapan
  15. 15.Department of RadiologyHigashiosaka City General HospitalHigashiosakaJapan
  16. 16.Department of RadiologyKobe UniversityKobeJapan