Amar Mukund1, Krishna Bhardwaj2, Ashok Choudhury3, Shiv K Sarin3. 1. Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India. 2. Department of Radiology, VMMC & Safdarjung Hospital, Ansari Nagar, New Delhi, India. 3. Department of Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India.
Abstract
BACKGROUND/AIMS: This study aimed to study the outcome and survival of patients with large hepatocellular carcinoma (HCC) receiving drug-eluting beads (DEBs) transarterial chemoembolization (TACE). In addition, tumor morphologies were correlated with the response and survival to analyze the association of morphology with the outcome. METHODS: Patients with large HCC (>5 cm) who underwent DEB-TACE for palliation were analyzed retrospectively. Patients were assessed for objective response (OR) and overall survival (OS), which was calculated from the first session of DEB-TACE to the last follow-up/death. OR and OS were calculated for the entire study group and were compared among the subgroups consisting of solitary versus multifocal HCC, unilobar versus bilobar disease, well-defined versus ill-defined HCC, and HCC with homogeneous enhancement versus HCC with heterogeneous enhancement. RESULTS: Sixty-seven DEB-TACE procedures were performed in 25 patients (average: 2.7 ± 1.4 sessions per patient). The mean lesion size was 9.9 ± 4.5 cm. Of 25 patients, 13 (52%) had multifocal HCC. Unilobar disease was seen in 15 patients (60%). The mean duration of follow-up was 24.4 months. OR at 6 and 12 months were 56% and 48%, respectively, with well-defined lesions showing better OR. The median OS was 28 months (95% confidence interval, 12.3-43.6). OS rate at 12 and 24 months was 92% and 57%, respectively. OS was seen to be superior in well-defined HCC and unilobar disease. CONCLUSION: In this study, DEB-TACE has shown to have a good response in patients having large/multifocal HCC with preserved liver functions. Well-defined HCC and unilobar disease have a better response and survival.
BACKGROUND/AIMS: This study aimed to study the outcome and survival of patients with large hepatocellular carcinoma (HCC) receiving drug-eluting beads (DEBs) transarterial chemoembolization (TACE). In addition, tumor morphologies were correlated with the response and survival to analyze the association of morphology with the outcome. METHODS: Patients with large HCC (>5 cm) who underwent DEB-TACE for palliation were analyzed retrospectively. Patients were assessed for objective response (OR) and overall survival (OS), which was calculated from the first session of DEB-TACE to the last follow-up/death. OR and OS were calculated for the entire study group and were compared among the subgroups consisting of solitary versus multifocal HCC, unilobar versus bilobar disease, well-defined versus ill-defined HCC, and HCC with homogeneous enhancement versus HCC with heterogeneous enhancement. RESULTS: Sixty-seven DEB-TACE procedures were performed in 25 patients (average: 2.7 ± 1.4 sessions per patient). The mean lesion size was 9.9 ± 4.5 cm. Of 25 patients, 13 (52%) had multifocal HCC. Unilobar disease was seen in 15 patients (60%). The mean duration of follow-up was 24.4 months. OR at 6 and 12 months were 56% and 48%, respectively, with well-defined lesions showing better OR. The median OS was 28 months (95% confidence interval, 12.3-43.6). OS rate at 12 and 24 months was 92% and 57%, respectively. OS was seen to be superior in well-defined HCC and unilobar disease. CONCLUSION: In this study, DEB-TACE has shown to have a good response in patients having large/multifocal HCC with preserved liver functions. Well-defined HCC and unilobar disease have a better response and survival.
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