Japanese Journal of Radiology

, Volume 30, Issue 7, pp 560–566

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


    • Department of Interventional RadiologyMie University School of Medicine
  • Shiro Miyayama
    • Department of Diagnostic RadiologyFukui-ken Saiseikai Hospital
  • Shozo Hirota
    • Department of RadiologyHyogo College of Medicine
  • Kimiyoshi Mizunuma
    • Department of RadiologyOhtawara Red Cross Hospital
  • Kenji Nakamura
    • Department of RadiologyDaito Central Hospital
  • Yoshitaka Inaba
    • Department of Diagnostic and Interventional RadiologyAichi Cancer Center Hospital
  • Akihiro Maeda
    • Department of RadiologyHyogo College of Medicine
  • Kunihiro Matsuo
    • Department of RadiologyNarumi Hospital
  • Norifumi Nishida
    • Department of RadiologyOsaka City University
  • Takeshi Aramaki
    • Department of Diagnostic RadiologyShizuoka Cancer Center
  • Hiroshi Anai
    • Department of RadiologyNara Medical University
  • Shinichi Koura
    • Department of RadiologyFukuoka University
  • Shigeo Oikawa
    • Department of RadiologyIwate Prefectural Central Hospital
  • Ken Watanabe
    • Department of RadiologyJikei University
  • Taku Yasumoto
    • Department of RadiologyToyonaka Municipal Hospital
  • Kinya Furuichi
    • Department of RadiologyHigashiosaka City General Hospital
  • Masato Yamaguchi
    • Department of RadiologyKobe University
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



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.


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).


Selective embolization contributes to survival in patients with HCCs.


Hepatocellular carcinomaArterial embolizationPrognosis

Copyright information

© Japan Radiological Society 2012