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Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design
Open accessAbstract
Background & Aims: Transarterial chemoembolisation (TACE) improves survival of properly selected patients with hepatocellular carcinoma (HCC). Drug eluting beads (DEB) provide a calibrated and homogenous procedure while increasing efficacy. Outcome data applying this technology is lacking, and this is instrumental for clinical decision-making and for trial design. We evaluated the survival of HCC patients treated with DEB-TACE following a strict selection (preserved liver function, absence of symptoms, extrahepatic spread or vascular invasion). Methods: We registered baseline characteristics, the development of treatment-related adverse events, and the overall survival of all HCC patients treated by DEB-TACE from February 2004 to June 2010. Results: One hundred and four patients were treated with DEB-TACE. All but one were cirrhotic, 62.5% HCV+, 95% Child-Pugh A, 41 BCLC-A and 63 BCLC-B. Causes of DEB-TACE treatment in BCLC-A patients were: 35 unfeasible ablation, and six post-treatment recurrences. After a median follow-up of 24.5 months, 38 patients had died, two patients had received transplantation and 24 had received sorafenib because of untreatable tumour progression. Median survival of the cohort was 48.6 months (95% CI: 36.9–61.2), while it was 54.2 months in BCLC stage A and 47.7 months in stage B. Median survival after censoring follow-up at time of transplant/sorafenib was 47.7 (95% CI: 37.9–57.5) months. Conclusions: These data validate the safety of DEB-TACE and show that the survival expectancy applying current selection criteria and technique is better than that previously reported. A 50% survival at 4 years should be considered when suggesting treatment for patients fitting into controversial scenarios such as expanded criteria for transplantation/resection for multifocal HCC.
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EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
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BCLC strategy for prognosis prediction and treatment recommendation: the 2022 update
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Metadata
- Authors
- Burrel, M., Reig, M., Forner, A., Barrufet, M., Lope, C. R. D., Tremosini, S., Ayuso, C., Llovet, J. M., Real, M. I., & Bruix, J.
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 56
- Issue
- 6
- Pages
- 1330-1335
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2059377623
- Cited by
- 485
- References
- 20
- FWCI
- 27.17
- Type
- journal article
- Language
- en
- Open access
- green
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- Burrel, M., Reig, M., Forner, A., Barrufet, M., Lope, C. R. D., Tremosini, S., Ayuso, C., Llovet, J. M., Real, M. I., & Bruix, J. (2012). Survival of patients with hepatocellular carcinoma treated by transarterial chemoembolisation (TACE) using Drug Eluting Beads. Implications for clinical practice and trial design. Journal of Hepatology. https://doi.org/10.1016/j.jhep.2012.01.008
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