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Long-Term Outcome of Transcatheter Subsegmental and Segmental Arterial Chemoemobolization Using Lipiodol for Hepatocellular Carcinoma

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Abstract

Purpose

To clarify the efficacy of transcatheter hepatic sub-subsegmental, subsegmental, and segmental arterial chemoembolization using lipiodol (subseg/seg lip-TACE) for hepatocellular carcinoma (HCC), long-term outcomes of patients who had been treated using subseg/seg lip-TACE alone were retrospectively examined.

Materials and Methods

Subjects comprised 199 patients with HCC (T1/2/≥3 = 30/108/61; Child–Pugh A/B/C = 115/52/32; Japan Integrated Staging [JIS] score ≤1/2/≥3 = 88/64/47) who underwent subseg/seg lip-TACE using lipiodol mixed with an anticancer drug followed by injection of gelatin sponge particles. Each patient was followed-up every 3 months, and repeat subseg/seg lip-TACE and/or conventional lip-TACE was performed in cases showing recurrence. One-, 3-, 5-, 7-, and 10-year cumulative survival rates were calculated. Subgroup analyses were performed by stratifying the population according to T-factor, Child–Pugh classification, and JIS score.

Results

Median duration of follow-up was 3.8 years (range 0.2 to 16.4). Median overall survival was 3.8 years. One-, 3-, 5-, 7- and 10-year survival rates were 91.5, 66.1, 38.8, 20.3, and 9.4% for all patients, and 95.5, 76.9, 51.9, 27.9 and 20.4% for patients with JIS ≤1, respectively. Significant survival differences were found across two subgroups of staging systems (T2 vs. T3≤ [P = 0.0012] and JIS score ≤1 vs. 2 [P = 0.0036]).

Conclusion

This study demonstrated that subseg/seg lip-TACE is a feasible treatment for obtaining prolonged survival in patients with localized HCC showing rich vasculature. Outcomes are influenced by both tumor stage and liver function, as seen in the best prolonged survival in patients with JIS score ≤1.

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Authors and Affiliations

  1. Department of Radiology, Nara Medical University, Nara, 634-8522, Japan

    Satoshi Takaki, Hiroshi Sakaguchi, Hiroshi Anai, Toshihiro Tanaka, Kiyosei Yamamoto, Kengo Morimoto, Hideyuki Nishiofuku, Masayoshi Inoue, Satoru Sueyoshi, Teruyuki Hidaka & Kimihiko Kichikawa

  2. Department of Radiology, Nagaoka Red Cross Hospital, Niigata, 940-2085, Japan

    Satoshi Takaki

  3. Interventional Radiology Center, Daiyukai General Hospital, Aichi, 491-8551, Japan

    Takeshi Nagata & Hideo Uchida

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  1. Satoshi Takaki
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Correspondence to Hiroshi Anai.

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Takaki, S., Sakaguchi, H., Anai, H. et al. Long-Term Outcome of Transcatheter Subsegmental and Segmental Arterial Chemoemobolization Using Lipiodol for Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 35, 544–554 (2012). https://doi.org/10.1007/s00270-011-0224-9

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