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Published in: CardioVascular and Interventional Radiology 5/2012

01-10-2012 | Clinical Investigation

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

Authors: Katerina Malagari, Mary Pomoni, Hippocrates Moschouris, Evanthia Bouma, John Koskinas, Aspasia Stefaniotou, Athanasios Marinis, Alexios Kelekis, Efthymia Alexopoulou, Achilles Chatziioannou, Katerina Chatzimichael, Spyridon Dourakis, Nikolaos Kelekis, Spyros Rizos, Dimitrios Kelekis

Published in: CardioVascular and Interventional Radiology | Issue 5/2012

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Abstract

Purpose

The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand.

Materials and Methods

173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %).

Results

Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival.

Conclusion

DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.
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Metadata
Title
Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis
Authors
Katerina Malagari
Mary Pomoni
Hippocrates Moschouris
Evanthia Bouma
John Koskinas
Aspasia Stefaniotou
Athanasios Marinis
Alexios Kelekis
Efthymia Alexopoulou
Achilles Chatziioannou
Katerina Chatzimichael
Spyridon Dourakis
Nikolaos Kelekis
Spyros Rizos
Dimitrios Kelekis
Publication date
01-10-2012
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 5/2012
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-012-0394-0

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