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KMID : 0378120020290010113
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Chungnam Medical Journal
2002 Volume.29 No. 1 p.113 ~ p.124
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Prognostic Factors Affecting Survival Rate in Patients with Hepatocellular Carcinoma Treated by Transarterial Chemoembolization
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Lim Jung-Muk
Lee Tae-Won
Park Seon-Mee
Youn Sei-Jin
Park kil-Sun
Chae Hee-Bok
Lee Heon-Young
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Abstract
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Transarterial Chemoembilization (TACE) has been shown to be effective in patients with unresectable hepatocellular carcinoma (HCC) and can be applicable to patients with resectable HCC who reject operation. There have been studies concerning prognostic factors in patients with (HCC) undergoing TACE but they reported diffenrent prognostic factors from each other. The aim of this study is to estimate the survival rates and to determine which prognostic factors contribute to long-term survival after TACE of HCC. Thirty eight patients with HCC who had been treated by TACE were analized retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipiodol and anticancer drugs (Adriamycin), either alone or followed by gelfoam embolization. Male to female ratio was 4.4:l. Mean survival time was 463 days. Maximum survival time was 1,683 days. The overall cumulative survival rates at the end of the first and second years were, respectively, 54% and 38%. According to univariate analysis (log-rand scale test), variables significantly associated with survival were: tumor type, hepatic vein thrombosis, portal vein thrombosis, lipiodol uptake pattern, remained enhancement after TACE, AST, ALT, height and tumor size. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univariate analysis revealed that the AST level, hepatic vein thrombosis, remained enhancement after TACE were statistically significant independent prognostic factors. The criteria of known contraindication may still be applied for TACE treatment of HCC. Additionally we should select the good prognostic patients without hepatic vein thrombosis and try to normalize the AST level if abnormal level before undergoing TACE. Thereafter, intensive chemoembilization to minimize the remained tumor is required to improve survival rates.
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KEYWORD
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TACE, HCC, Survival rate, Prognostic factor
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