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

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Japanese Journal of Radiology Aims and scope Submit manuscript

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.

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Acknowledgments

We thank the following institutions and doctors for supporting this study: (1) Okitama Public General Hospital, Department of Radiology, Hitoshi Ito, MD, (2) Toho University Omori Hospital, Department of Department of Gastroenterology and Hepatology, Manabu Watanabe, MD, (3) National Center for Global Health and Medicine, Department of Radiology, Kanehiro Hasuo, MD, (4) Tokai University, Department of Radiology, Takeshi Hashimoto, MD, (5) Yamanashi University, Department of Radiology, Hiroki Okada, MD, (6) Shinshu University, Department of Radiology, Kazuhiko Ueda, MD, (7) Kouseiren Takaoka Hospital, Department of Radiology, Koji Nobata, MD, (8) Ishikawa Prefectural Central Hospital, Department of Radiology, Takeshi Kobayashi, MD, (9) Hamamatsu University School of Medicine, Department of Radiology, Mika Kamiya, MD, (10) Nagoya City University, Department of Radiology, Masashi Shimohira, MD, (11) Aichi Medical University, Department of Radiology, Seiji Kamei, MD, (12) Shiga University of Medical Science, Department of Radiology, Norihisa Nitta, MD, (13) Kohka Public Hospital, Department of Radiology, Michio Yamasaki, MD, (14) Japanese Red Cross Kobe Hospital, Department of Radiology, Koji Sugimoto, MD, (15) Nishi-Kobe Medical Center, Department of Radiology, Yoichiro Kuwata, MD, (16) Wakayama Medical University, Department of Radiology, Nobuyuki Kawai, MD, (17) Hiroshima University, Department of Radiology, Hideaki Kakizawa, MD, (18) Chugoku Rosai Hospital, Department of Radiology, Akira Naito, MD, (19) Tottori University, Department of Radiology, Toshio Kamino, MD, (20) Shimane University, Department of Radiology, Msakatsu Tsurusaki, MD, (21) Oita University, Department of Radiology, Hiromu Mori, MD, (22) Kumamoto University, Department of Radiology, Osamu Ikeda, MD, (23) Kagoshima University, Department of Radiology, Yasutaka Baba, MD, (24) Kanazawa University, Department of Radiology, Tetsuya Minami, MD, (25) Hokkaido University, Department of Radiology, Daisuke Abo, MD, (26) Okayama University, Department of Radiology, Hideo Gobara, MD, (27) Osaka University, Department of Radiology, Keigo Osuga, MD, (28) National Cancer Center, Department of Radiology, Yoshito Takeuchi, (29) Teikyo University, Department of Radiology, Hiroshi Kotake, MD, (30) Japan Red Cross Kyoto Daiichi Hospital, Department of Radiology, Hiroyuki Morishita, MD, (31) Kochi Health Science Center, Department of Radiology, Yasuhiro Hata, MD, (32) Nanbu Medical Center, Department of Radiology, Fumikiyo Ganaha, MD, and (33) Keio University, Department of Diagnostic Radiology, Sachio Kuribayashi, MD.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Interventional Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan

    Koichiro Yamakado

  2. Department of Diagnostic Radiology, Fukui-ken Saiseikai Hospital, Fukui, Japan

    Shiro Miyayama

  3. Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan

    Shozo Hirota & Akihiro Maeda

  4. Department of Radiology, Ohtawara Red Cross Hospital, Ohtawara, Japan

    Kimiyoshi Mizunuma

  5. Department of Radiology, Daito Central Hospital, Daito, Japan

    Kenji Nakamura

  6. Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Nagoya, Japan

    Yoshitaka Inaba

  7. Department of Radiology, Narumi Hospital, Hirosaki, Japan

    Kunihiro Matsuo

  8. Department of Radiology, Osaka City University, Osaka, Japan

    Norifumi Nishida

  9. Department of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan

    Takeshi Aramaki

  10. Department of Radiology, Nara Medical University, Kashihara, Japan

    Hiroshi Anai

  11. Department of Radiology, Fukuoka University, Fukuoka, Japan

    Shinichi Koura

  12. Department of Radiology, Iwate Prefectural Central Hospital, Morioka, Japan

    Shigeo Oikawa

  13. Department of Radiology, Jikei University, Tokyo, Japan

    Ken Watanabe

  14. Department of Radiology, Toyonaka Municipal Hospital, Toyonaka, Japan

    Taku Yasumoto

  15. Department of Radiology, Higashiosaka City General Hospital, Higashiosaka, Japan

    Kinya Furuichi

  16. Department of Radiology, Kobe University, Kobe, Japan

    Masato Yamaguchi

Authors
  1. Koichiro Yamakado
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  2. Shiro Miyayama
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  6. Yoshitaka Inaba
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  8. Kunihiro Matsuo
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  9. Norifumi Nishida
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  10. Takeshi Aramaki
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  11. Hiroshi Anai
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  13. Shigeo Oikawa
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  14. Ken Watanabe
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  15. Taku Yasumoto
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  16. Kinya Furuichi
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  17. Masato Yamaguchi
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Corresponding author

Correspondence to Koichiro Yamakado.

Additional information

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

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Yamakado, K., Miyayama, S., Hirota, S. et al. Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?. Jpn J Radiol 30, 560–566 (2012). https://doi.org/10.1007/s11604-012-0088-1

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  • DOI: https://doi.org/10.1007/s11604-012-0088-1

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