AIM: To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC). METHODS: A total of 146 consecutive patients were included in the analysis, and their medical records and radiological data were reviewed retrospectively. RESULTS: In total, 119 patients received TACE-based multi-modal treatments, and the remaining 27 received conservative management. Overall survival (P<0.001) and objective tumor response (P=0.003) were significantly better in the treatment group than in the conservative group. After subgroup analysis, survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group (P=0.002) but also in the surgical treatment group compared with the loco-regional treatment-only group (P<0.001). Multivariate analysis identified tumor stage (P<0.001) and tumor type (P=0.009) as two independent pre-treatment factors for survival. After adjusting for significant pre-treatment prognostic factors, objective response (P<0.001), surgical treatment (P=0.009), and multi-modal treatment (P=0.002) were identified as independent post-treatment prognostic factors. CONCLUSION: TACE-based multi-modal treatments were safe and more beneficial than conservative management. Salvage surgery after successful downstaging resulted in long-term survival in patients with large, unresectable HCC.
AIM: To investigate the efficacy and safety of transarterial chemoembolization (TACE)-based multimodal treatment in patients with large hepatocellular carcinoma (HCC). METHODS: A total of 146 consecutive patients were included in the analysis, and their medical records and radiological data were reviewed retrospectively. RESULTS: In total, 119 patients received TACE-based multi-modal treatments, and the remaining 27 received conservative management. Overall survival (P<0.001) and objective tumor response (P=0.003) were significantly better in the treatment group than in the conservative group. After subgroup analysis, survival benefits were observed not only in the multi-modal treatment group compared with the TACE-only group (P=0.002) but also in the surgical treatment group compared with the loco-regional treatment-only group (P<0.001). Multivariate analysis identified tumor stage (P<0.001) and tumor type (P=0.009) as two independent pre-treatment factors for survival. After adjusting for significant pre-treatment prognostic factors, objective response (P<0.001), surgical treatment (P=0.009), and multi-modal treatment (P=0.002) were identified as independent post-treatment prognostic factors. CONCLUSION:TACE-based multi-modal treatments were safe and more beneficial than conservative management. Salvage surgery after successful downstaging resulted in long-term survival in patients with large, unresectable HCC.
Authors: Riad Salem; Robert J Lewandowski; Laura Kulik; Edward Wang; Ahsun Riaz; Robert K Ryu; Kent T Sato; Ramona Gupta; Paul Nikolaidis; Frank H Miller; Vahid Yaghmai; Saad M Ibrahim; Seanthan Senthilnathan; Talia Baker; Vanessa L Gates; Bassel Atassi; Steven Newman; Khairuddin Memon; Richard Chen; Robert L Vogelzang; Albert A Nemcek; Scott A Resnick; Howard B Chrisman; James Carr; Reed A Omary; Michael Abecassis; Al B Benson; Mary F Mulcahy Journal: Gastroenterology Date: 2010-10-30 Impact factor: 22.682
Authors: Francis Y Yao; Robert K Kerlan; Ryutaro Hirose; Timothy J Davern; Nathan M Bass; Sandy Feng; Marion Peters; Norah Terrault; Chris E Freise; Nancy L Ascher; John P Roberts Journal: Hepatology Date: 2008-09 Impact factor: 17.425
Authors: William C Chapman; M B Majella Doyle; Jourdan E Stuart; Neeta Vachharajani; Jeffrey S Crippin; Christopher D Anderson; Jeffrey A Lowell; Surendra Shenoy; Michael D Darcy; Daniel B Brown Journal: Ann Surg Date: 2008-10 Impact factor: 12.969