Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma

D. Y. Kim, H. J. Ryu, J. Y. Choi, J. Y. Park, D. Y. Lee, B. K. Kim, S. U. Kim, S. H. Ahn, C. Y. Chon, K. H. Han

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Abstract

Background It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC). Aim To reveal the clinical relevance of compact lipiodolisation after TACE. Methods We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not. Results Of the 490 patients, 409 (83.5%) were in Child-Pugh class A and 81 (16.5%) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7% vs. 14.6%, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours â‰5, 5-10 and >10 cm was 46.6%, 13.6%, and 0% respectively. The 1-, 3- and 5-year survival rates of patients with compact uptake were 92.7%, 70.7% and 52.4% compared to 60.8%, 28.0% and 16.9% in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child-Pugh class, alpha-fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival. Conclusions Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.

Original languageEnglish
Pages (from-to)1343-1350
Number of pages8
JournalAlimentary Pharmacology and Therapeutics
Volume35
Issue number11
DOIs
Publication statusPublished - 2012 Jun 1

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Hepatocellular Carcinoma
Survival
Ethiodized Oil
alpha-Fetoproteins
Portal Vein
Neoplasms
Thrombosis
Multivariate Analysis
Survival Rate
Tomography
Neoplasm Metastasis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

Cite this

@article{fada72668e07474c819daf5ecaa9c9c9,
title = "Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma",
abstract = "Background It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC). Aim To reveal the clinical relevance of compact lipiodolisation after TACE. Methods We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not. Results Of the 490 patients, 409 (83.5{\%}) were in Child-Pugh class A and 81 (16.5{\%}) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7{\%} vs. 14.6{\%}, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours {\^a}‰5, 5-10 and >10 cm was 46.6{\%}, 13.6{\%}, and 0{\%} respectively. The 1-, 3- and 5-year survival rates of patients with compact uptake were 92.7{\%}, 70.7{\%} and 52.4{\%} compared to 60.8{\%}, 28.0{\%} and 16.9{\%} in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child-Pugh class, alpha-fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival. Conclusions Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.",
author = "Kim, {D. Y.} and Ryu, {H. J.} and Choi, {J. Y.} and Park, {J. Y.} and Lee, {D. Y.} and Kim, {B. K.} and Kim, {S. U.} and Ahn, {S. H.} and Chon, {C. Y.} and Han, {K. H.}",
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language = "English",
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Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma. / Kim, D. Y.; Ryu, H. J.; Choi, J. Y.; Park, J. Y.; Lee, D. Y.; Kim, B. K.; Kim, S. U.; Ahn, S. H.; Chon, C. Y.; Han, K. H.

In: Alimentary Pharmacology and Therapeutics, Vol. 35, No. 11, 01.06.2012, p. 1343-1350.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Radiological response predicts survival following transarterial chemoembolisation in patients with unresectable hepatocellular carcinoma

AU - Kim, D. Y.

AU - Ryu, H. J.

AU - Choi, J. Y.

AU - Park, J. Y.

AU - Lee, D. Y.

AU - Kim, B. K.

AU - Kim, S. U.

AU - Ahn, S. H.

AU - Chon, C. Y.

AU - Han, K. H.

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Background It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC). Aim To reveal the clinical relevance of compact lipiodolisation after TACE. Methods We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not. Results Of the 490 patients, 409 (83.5%) were in Child-Pugh class A and 81 (16.5%) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7% vs. 14.6%, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours â‰5, 5-10 and >10 cm was 46.6%, 13.6%, and 0% respectively. The 1-, 3- and 5-year survival rates of patients with compact uptake were 92.7%, 70.7% and 52.4% compared to 60.8%, 28.0% and 16.9% in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child-Pugh class, alpha-fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival. Conclusions Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.

AB - Background It remains unclear whether initial compact lipiodol uptake after transarterial chemoembolisation (TACE) is associated with improved survival in patients with hepatocellular carcinoma (HCC). Aim To reveal the clinical relevance of compact lipiodolisation after TACE. Methods We studied 490 patients with unresectable HCC who had first been treated with TACE. Compact lipiodolisation was defined as the absence of an arterial enhancing lesion, reflecting complete lipiodol uptake, as assessed by dynamic computed tomography (CT) 1 month after treatment. The rate of initial compact lipiodolisation was analysed according to multiplicity and size of tumour, and survival of patients who achieved compact lipiodolisation was compared to that of patients who did not. Results Of the 490 patients, 409 (83.5%) were in Child-Pugh class A and 81 (16.5%) in class B. The rate of initial compact lipiodolisation in single HCCs was higher than that in multinodular HCCs (33.7% vs. 14.6%, P < 0.001). Among single HCCs, the rate of compact lipiodolisation in tumours â‰5, 5-10 and >10 cm was 46.6%, 13.6%, and 0% respectively. The 1-, 3- and 5-year survival rates of patients with compact uptake were 92.7%, 70.7% and 52.4% compared to 60.8%, 28.0% and 16.9% in patients with noncompact lipiodolisation. Multivariate analysis revealed that Child-Pugh class, alpha-fetoprotein level, tumour node metastasis stage, portal vein thrombosis and initial compact lipiodolisation were independent predictors of survival. Conclusions Initial compact lipiodol uptake after transarterial chemoembolisation is associated with improved survival in patients with unresectable hepatocellular carcinoma. Accordingly, initial complete lipiodolisation should be considered a relevant therapeutic target.

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U2 - 10.1111/j.1365-2036.2012.05089.x

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