Objective Transcatheter arterial chemoembolization (TACE) is an essential therapy for patients with hepatocellular carcinoma (HCC) in whom administering other treatments such as liver transplantation, resection or local therapy is not feasible. The purpose of our study was to determine the independent risk factors for one-year recurrence and two-year mortality in patients treated solely with TACE.
Methods We conducted a retrospective cohort study of 34 consecutive patients (Group 1) with incident HCC who were treated solely with epirubicin-based TACE between April 2004 and March 2009. A subgroup analysis was performed among 24 patients (Group 2) who underwent complete TACE confirmed with abdominal computed tomography (CT) one month later. Tumor recurrence was evaluated using contrast CT every three months after the initial TACE. We calculated Kaplan-Meier estimates and performed a multiple regression analysis using a Cox-proportional hazard model.
Results The patients in Group 1 (men, 59%), all of whom had liver cirrhosis, underwent TACE as the sole therapy for HCC. Kaplan-Meier estimates revealed a two-year survival rate [95% CI] of 70% [48-84%]. For the non-Child A patients, the adjusted hazard ratio (HR) [95% CI] for two-year survival was 7.1 [1.06-51.7]. In Group 2, the Kaplan-Meier estimate of the one-year recurrence rate [95% CI] was 61% [42-81%]. The adjusted HRs [95% CIs] for one-year recurrence for age and indocyanine green (ICG) 15-min >30% were 1.1 [1.0-1.26] and 7.87 [1.94-45.1], respectively.
Conclusion Non-Child A cirrhosis is an independent risk factor for two-year mortality in patients treated solely with TACE. For ICG 15-min >30%, careful monitoring for HCC recurrence at one year, even after complete TACE, is warranted.