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Transarterial chemoembolization for huge hepatocellular carcinoma with diameter over ten centimeters: a large cohort study

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Abstract

Patients with huge hepatocellular carcinoma >10 cm in diameter represent a special subgroup for treatment. To date, there are few data and little consensus on treatment strategies for huge hepatocellular carcinoma. In this study, we summarized the effects and safety of transarterial chemoembolization for huge hepatocellular carcinoma. A retrospective study was performed based on a large cohort of patients (n = 511) with huge hepatocellular carcinoma who underwent serial transarterial chemoembolization between January 2008 to December 2011 and were followed up until March 2013. We found median survival time was 6.5 months. On multivariate analysis, Child-Pugh class (A versus B) (p < 0.0001), alpha-fetoprotein (≤400 µg/L) (p = 0.002), Barcelona Clinic Liver Cancer stage (B versus C) (p = 0.013), and other treatments after transarterial chemoembolization such as surgical resection (p = 0.008), radiation (p = 0.018), and local radiofrequency ablation (p = 0.002) were factors significantly associated with better overall patient survival after chemoembolization. Twenty-nine percent of these patients showed a tumor response after serial transarterial chemoembolization. Severe complications were few (4.9 %), including oncolytic syndrome (n = 3), tumor rupture (n = 3), gastrointestinal bleeding (n = 4), deep venous thrombosis (n = 3), acute cholecystitis (n = 4), femoral artery pseudoaneurysm (n = 1), acute pancreatitis (n = 1), and acute hepatic failure (n = 6). In conclusion, transarterial chemoembolization is a safe and effective treatment for selected patients with huge hepatocellular carcinoma and is recommended as a component of combination therapy. In addition, patients with good liver function and low alpha-fetoprotein levels may acquire greater survival benefits from transarterial chemoembolization.

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Acknowledgments

This study was supported by the National Clinical Key Special Subject of China, the National Natural Science Foundation of China (81172275 and 21272565), and the National Basic Research Program of China (973 Program, 2009CB521700).

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    Authors and Affiliations

    1. Liver Cancer Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People’s Republic of China

      Tongchun Xue, Fan Le, Rongxin Chen, Xiaoying Xie, Lan Zhang, Ningling Ge, Yi Chen, Yanhong Wang, Boheng Zhang, Shenglong Ye & Zhenggang Ren

    2. Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, Shanghai, People’s Republic of China

      Tongchun Xue, Fan Le, Rongxin Chen, Xiaoying Xie, Lan Zhang, Ningling Ge, Yi Chen, Yanhong Wang, Boheng Zhang, Shenglong Ye & Zhenggang Ren

    3. Department of Medical Statistics, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China

      Boheng Zhang

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    1. Tongchun Xue
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    2. Fan Le
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    Correspondence to Zhenggang Ren.

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    Tongchun Xue and Fan Le have contributed equally to this study.

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    Xue, T., Le, F., Chen, R. et al. Transarterial chemoembolization for huge hepatocellular carcinoma with diameter over ten centimeters: a large cohort study. Med Oncol 32, 64 (2015). https://doi.org/10.1007/s12032-015-0504-3

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