Chemoembolization for hepatocellular carcinoma: Multivariate analysis of predicting factors for tumor response and survival in a 362-patient cohort

Hong Tao Hu, Jin Hyoung Kim, Lim Sick Lee, Kyung Ah Kim, Gi Young Ko, Hyun Ki Yoon, Kyu Bo Sung, Dong Il Gwon, Ji Hoon Shin, Ho Young Song

Research output: Contribution to journalArticle

62 Scopus citations

Abstract

Purpose: To evaluate the factors associated with tumor response and survival after chemoembolization in 362 patients with hepatocellular carcinoma (HCC). Materials and Methods: Between January 2006 and August 2006, 362 patients who underwent chemoembolization for unresectable HCC were evaluated. The endpoints were tumor response and patient survival. Factors associated with tumor response were evaluated using multivariate logistic regression analysis. Factors associated with patient survival were evaluated using multivariate Cox regression analysis. Results: After chemoembolization, 69% of the study patients showed a tumor response. On multivariate analysis, tumor size (centimeter) (odds ratio [OR] 2.85, P = .002), tumor number (OR 4.58, P < .001), tumor vascularity (OR 11.97, P < .001), and portal vein invasion (OR 4.24, P < .001) were significant factors for tumor response. The median survival was 23 months. On multivariate analysis, Child-Pugh class (hazard ratio [HR] 2.43, P < .001), maximal tumor size (HR 1.66, P = .002), tumor vascularity (HR 2.13, P = .001), portal vein invasion (HR 2.39, P < .001), tumor number (HR, 1.92, P < .001), and alpha fetoprotein (AFP) value (HR 1.54, P = .003) were significant factors associated with patient survival after chemoembolization. Conclusions: Tumor size, tumor vascularity, tumor number, and portal vein invasion are significant independent predictors of tumor response after chemoembolization in patients with unresectable HCC. Child-Pugh class B or C, large tumor size (< 4 cm), multiple tumors (five or more), portal vein invasion, and a high AFP value (> 83 ng/mL) indicated poor prognosis for overall patient survival after chemoembolization.

Original languageEnglish (US)
Pages (from-to)917-923
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

Keywords

  • AFP
  • alpha fetoprotein
  • hazard ratio
  • HCC
  • hepatocellular carcinoma
  • HR
  • odds ratio
  • OR
  • RECIST
  • Response Evaluation Criteria in Solid Tumors

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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