Is transarterial chemoembolization beneficial for patients with diffuse infiltrative hepatocellular carcinoma?

Abstract

Purpose: Diffuse infiltrative hepatocellular carcinoma (D-HCC) is an incurable disease with short survival time. Transarterial chemoembolization (TACE) was often used to alleviate patient's symptoms and reduce tumor burden. However, it remains unknown if the TACE benefits the survival of D-HCC patients.

Methods: A hospital-based retrospective study was conducted at a large referral hospital in Taiwan for a 9-year period (2000-2008).

Results: Of the 150 D-HCC patients, 106 patients were related to hepatitis B virus (HBV), 17 to hepatitis C virus (HCV), 3 to both HBV and HCV, and 24 not to HBV or HCV. Multivariate Cox regression analysis showed treatment strategy, serum alpha-fetoprotein level, model for end-stage liver disease (MELD) score, serum gamma glutamyl transferase, and serum lactic acid dehydrogenase were associated with survival time. Compared to supportive treatment, the adjusted hazard ratios of transarterial chemoembolization (TACE) and chemotherapy including oral or systemic chemotherapy were 0.383 (p < 0.001) and 0.711 (p = 0.289), respectively.

Conclusion: TACE is a preferred therapy for D-HCC patients.

Keywords: Diffuse infiltrative type; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Transarterial chemoembolization.