Subgrouping of intermediate-stage (BCLC stage B) hepatocellular carcinoma based on tumor number and size and Child-Pugh grade correlated with prognosis after transarterial chemoembolization

Jpn J Radiol. 2014 May;32(5):260-5. doi: 10.1007/s11604-014-0298-9. Epub 2014 Mar 11.

Abstract

Purpose: To find a subgroup that benefits most from transarterial chemoembolization (TACE) in terms of tumor number and size and liver profile in patients with intermediate-stage hepatocellular carcinoma (HCC).

Materials and methods: Data of 325 intermediate-stage HCC patients who received TACE as the initial treatment were gathered. Four tumor numbers (3-6 tumors) and five maximum tumor diameters (3-7 cm) as well as all of their combinations but one (3 tumors and 3 cm) and Child-Pugh grade were used as variables to ascertain prognostic factors.

Results: The respective 1-, 3-, and 5-year overall survival rates in all patients were 86.5, 47.0, and 23.7%, respectively. Tumor numbers of 4 (P = 0.00145) and 5 (P = 0.036), and tumor size of 7 cm (P = 0.015), and 12 other combinations of tumor number and size, and Child-Pugh grade (P = 0.0015) were identified as significant prognostic factors in univariate analysis, and 4 tumors of 7 cm (P = 0.0008) and Child-Pugh grade (P = 0.0036) remained significant in the stepwise Cox proportional hazard model. The overall survival was significantly better in a patient subgroup having two factors other than patient subgroups having one or no prognostic factors.

Conclusion: A patient subgroup having two prognostic factors benefited most from TACE in intermediate-stage HCC patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / pathology*
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic*
  • Female
  • Humans
  • Liver Neoplasms / pathology*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Prognosis
  • Survival Rate
  • Treatment Outcome
  • Tumor Burden