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Japanese Journal of Clinical Oncology 32:455-460 (2002)
© 2002 Foundation for Promotion of Cancer Research

Prognostic Factors in Patients with Hepatocellular Carcinoma Treated by Transcatheter Arterial Embolization

Masafumi Ikeda1, Shuichi Okada1, Seiichiro Yamamoto2, Tosiya Sato3, Hideki Ueno1, Takuji Okusaka1, Hitoshi Kuriyama1, Kenichi Takayasu4, Hiroyoshi Furukawa4 and Ryoko Iwata4,+,§

Divisions of 1 Hepatobiliary and Pancreatic Oncology and 4 Diagnostic Radiology, National Cancer Center Hospital, Tokyo, 2 Cancer Information and Epidemiology Division, National Cancer Center Research Institute, Tokyo and 3 Department of Epidemiology and Biostatistics, Kyoto University School of Public Health, Kyoto, Japan

Background: Transcatheter arterial embolization induces marked antitumor response in patients with hepatocellular carcinoma, but the survival benefit of transcatheter arterial embolization remains to be determined. This study investigated prognostic factors in patients with advanced hepatocellular carcinoma treated by transcatheter arterial embolization.

Methods: A total of 128 consecutive patients with non-resectable hepatocellular carcinoma, who had undergone transcatheter arterial embolization between May 1990 and August 1998, were analyzed to investigate prognostic factors.

Results: Median survival time and survival proportions at 1, 3 and 5 years were 3.3 years, 92.0, 54.6 and 23.4%, respectively. By multivariate analysis using the accelerated failure time model, age <60 years, hepatitis C virus antibody positivity, serum albumin >3.5 g/dl, absence of portal vein invasion and serum {alpha}-fetoprotein level <400 ng/ml were significantly associated with favorable survival. For clinical application, we also propose a prognostic equation with combination of specific prognostic factors, by which survival curves of each patient could be predicted directly.

Conclusion: The findings of the current study may be helpful in predicting the life expectancy of hepatocellular carcinoma patients treated by transcatheter arterial embolization and in designing future clinical trials of transcatheter arterial embolization for hepatocellular carcinoma.

+ For reprints and all correspondence: Masafumi Ikeda, Hepatobiliary and Pancreatic Oncology Division, National Cancer Center Hospital, 5–1–1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. E-mail: sokada@ncc.go.jp

§ Abbreviations: TAE, transcatheter arterial embolization; HCC, hepatocellular carcinoma; CT, computed tomography; AFP, {alpha}-fetoprotein; HCV Ab, hepatitis C virus antibody; PV, portal vein; AFTM, accelerated failure time model


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