Hepatic arterial embolization for unresectable hepatocellular carcinomas: do technical factors affect prognosis?
| Autor: | Kenji Nakamura, Hiroshi Anai, Taku Yasumoto, Shiro Miyayama, Kunihiro Matsuo, Norifumi Nishida, Yoshitaka Inaba, Koichiro Yamakado, Takeshi Aramaki, Shigeo Oikawa, Ken Watanabe, Masato Yamaguchi, Akihiro Maeda, Shinichi Koura, Shozo Hirota, Kinya Furuichi, Kimiyoshi Mizunuma |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Hepatic Artery Carcinoma Humans Medicine Radiology Nuclear Medicine and imaging Chemoembolization Therapeutic Survival rate Aged Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Arterial Embolization Liver Neoplasms Disease progression Iodized Oil Retrospective cohort study Middle Aged Prognosis medicine.disease humanities digestive system diseases Survival Rate body regions Radiation therapy Multicenter study Hepatocellular carcinoma Disease Progression Female alpha-Fetoproteins Radiology business |
| Zdroj: | Japanese Journal of Radiology. 30:560-566 |
| ISSN: | 1867-108X 1867-1071 |
| DOI: | 10.1007/s11604-012-0088-1 |
| Popis: | To evaluate retrospectively whether technical factors of hepatic arterial embolization affect the prognosis of patients with hepatocellular carcinoma (HCC).Inclusion criteria of this study were the following: (1) patients received embolization as the initial treatment during 2003-2004, (2) Child A or B liver profile, (3) five or fewer HCCs with maximum diameter of 7 cm or smaller, and (4) no extrahepatic metastasis. Patient data were gathered from 43 centers. Prognostic factors were evaluated using univariate and multivariate analyses.Eight hundred fifteen patients were enrolled. The 1-, 3-, 5-, and 7-year overall survival rates were 92.0 % (95 % CI 90.1-93.9), 62.9 % (95 % CI 59.3-66.6), 39.0 % (95 % CI 35.1-43.0), and 26.7 % (95 % CI 22.6-30.8) in all patients. Univariate analysis showed a Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, tumor number of 3 or fewer, one-lobe tumor distribution, nodular tumor type, within the Milan criteria, stage I or II, no portal venous invasion, use of iodized oil, and selective embolization were significantly better prognostic factors. In the multivariate Cox model, the benefit to survival of selective embolization remained significant (hazard ratio 0.68; 95 % CI 0.48-0.97; p = 0.033).Selective embolization contributes to survival in patients with HCCs. |
| Databáze: | OpenAIRE |
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