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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2023; 07(03): 141-146
DOI: 10.1055/s-0042-1756647
Original Article

Predictors of Refractoriness and Survival following Transarterial Chemoembolization for Hepatocellular Carcinoma: Outcomes from a Southeast Asian Cohort

Authors

  • Rudolf V. Kuhn 

    1   Department of Medical Imaging and Therapeutic Radiology, National Kidney and Transplant Institute, East Avenue, Quezon City, Philippines

  • Glenn Marc G. Ignacio

    1   Department of Medical Imaging and Therapeutic Radiology, National Kidney and Transplant Institute, East Avenue, Quezon City, Philippines

  • Jade D. Jamias 

    2   Division of Internal Medicine, National Kidney and Transplant Institute, East Avenue, Quezon City, Philippines

  • Catherine S.C. Teh 

    3   Department of Surgery, National Kidney and Transplant Institute, East Avenue, Quezon City, Philippines
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Abstract

Purpose Patients with hepatocellular carcinoma (HCC) become refractory to repeated sessions of transarterial chemoembolization (TACE). The aim of this study was to identify predictors associated with overall survival and refractoriness following repetitive TACE of HCC among patients in Southeast Asia.

Methods The clinical and laboratory characteristics and radiologic response of 39 patients treated with conventional TACE (range 2 to 5) with mitomycin from January 2012 to June 2018 were retrospectively analyzed. Patients were mostly male with a median age of 59 years and belonged to the BCLC B stage with a median tumor size of 7.5 cm.

Results The median overall survival was 23.2 months and the overall mortality at 5 years was 36%. Multivariate Cox regression analysis revealed that Child–Pugh (CP) score (hazard ratio [HR] = 3.47, p = 0.044), AST (HR = 7.6, p = 0.021), tumor size (HR = 5.47, p = 0.033), progressive disease on Choi criteria (HR = 5.47, confidence interval [CI] 1.15–25.99, p = 0.033), neutrophil-lymphocyte ratio (HR = 1.25, p = 0.049), and nodular enhancement on follow-up computed tomography (CT; HR = 1.98, p = 0.034) were independent risk factors for poor survival. ALT (p = 0.005), enhancement (p = 0.003), CP score (p = 0.010), and progressive disease on Choi criteria (p = 0.022) were predictive of TACE refractoriness/failure.

Conclusion Elevated liver enzymes, CP score, and progressive disease on Choi criteria accurately predict TACE refractoriness and failure, allowing early identification of patients who might benefit from other therapies.

Keywords

TACE - liver cancer - response - survival

Ethical Approval

This work is an original research work of the authors and has been approved by the Research Ethics Committee of the National Kidney and Transplant Institute, Philippines. It follows international guidelines on the ethical conduct of research, including the Declaration of Helsinki and the Committee on Publication Ethics.




Publikationsverlauf

Artikel online veröffentlicht:
29. September 2022

© 2022. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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