Journal Article

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

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

2012

Overview

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.

• Publisher: Springer-Verlag,Springer Nature B.V
• Subject: Adult / Aged / Aged, 80 and over / Antineoplastic Agents - administration & dosage / ANTINEOPLASTIC DRUGS / BODY / Carcinoma, Hepatocellular - therapy / CARCINOMAS / Cardiology / Chemoembolization, Therapeutic - methods / Clinical Investigation / COLLOIDS / CONTRAST MEDIA / Diagnostic Imaging / DIGESTIVE SYSTEM / DISEASES / DISPERSIONS / DRUGS / Ethiodized Oil - administration & dosage / Female / GELATIN / GLANDS / HEPATOMAS / Humans / Imaging / INJECTION / INTAKE / LIPIODOL / LIVER / Liver Neoplasms - therapy / Male / MATERIALS / Medicine / Medicine & Public Health / Middle Aged / Neoplasm Recurrence, Local / NEOPLASMS / Nuclear Medicine / OILS / ORAL CAVITY / ORGANIC COMPOUNDS / ORGANIC HALOGEN COMPOUNDS / ORGANIC IODINE COMPOUNDS / ORGANS / OTHER ORGANIC COMPOUNDS / PATIENTS / PROTEINS / Radiology / RADIOLOGY AND NUCLEAR MEDICINE / Survival Rate / Treatment Outcome / Ultrasound