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Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

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Abstract

Purpose

The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand.

Materials and Methods

173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %).

Results

Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival.

Conclusion

DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

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Authors and Affiliations

  1. Second Department of Radiology, University of Athens, 1 Rimini Str. Haidari, 12462, Athens, Greece

    Katerina Malagari, Alexios Kelekis, Efthymia Alexopoulou, Katerina Chatzimichael & Nikolaos Kelekis

  2. Imaging and Research Unit, University of Athens, 20 Papadiamandopoulou street, 11538, Athens, Greece

    Mary Pomoni, Evanthia Bouma, Aspasia Stefaniotou & Dimitrios Kelekis

  3. Department of Radiology, Tzanion Hospital, Zanni & Afentouli 1 Str, 18536, Pireus, Greece

    Hippocrates Moschouris

  4. Department of Surgery, Tzanion Hospital, Zanni & Afentouli 1 Str, 18536, Pireus, Greece

    Athanasios Marinis & Spyros Rizos

  5. First Department of Radiology, University of Athens, Athens, Greece

    Achilles Chatziioannou

  6. Department of Internal Medicine and Hepatology, Ippokration Hospital, University of Athens, 11 Vassilisis Sofias Str., 11538, Athens, Greece

    John Koskinas & Spyridon Dourakis

Authors
  1. Katerina Malagari
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Correspondence to Katerina Malagari.

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Malagari, K., Pomoni, M., Moschouris, H. et al. Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis. Cardiovasc Intervent Radiol 35, 1119–1128 (2012). https://doi.org/10.1007/s00270-012-0394-0

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