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. 2017 Aug 10;17(1):98.
doi: 10.1186/s12876-017-0656-z.

Survival benefit of transarterial chemoembolization in patients with metastatic hepatocellular carcinoma: a single center experience

Dominik Bettinger  1   2 , Renan Spode  3 , Nicolas Glaser  3 , Nico Buettner  3 , Tobias Boettler  3 , Christoph Neumann-Haefelin  3 , Thomas Baptist Brunner  4 , Eleni Gkika  4 , Lars Maruschke  5 , Robert Thimme  3 , Michael Schultheiss  3
Affiliations

Survival benefit of transarterial chemoembolization in patients with metastatic hepatocellular carcinoma: a single center experience

Dominik Bettinger et al. BMC Gastroenterol. .

Abstract

Background: As prognosis of patients with metastatic hepatocellular carcinoma (HCC) is mainly determined by intrahepatic HCC progression, local treatment with TACE may result in improved OS, although it is not recommended. The purpose of this study was to analyze retrospectively the efficacy of TACE and its impact on OS in patients with metastatic hepatocellular carcinoma (HCC).

Methods: Two hundred and fifteen patients with metastatic HCC who were treated at our Liver Center between 2003 and 2014 were included in this retrospective analysis. Medical records, laboratory parameters and imaging studies were analyzed. Treatment of metastatic HCC and OS were assessed RESULTS: One hundred and two patients (47.4%) did not receive any HCC specific treatment while 48 patients (22.3%) were treated with sorafenib, 42 patients (19.5%) with TACE and 23 patients (10.7%) received treatment with TACE and sorafenib in combination. Survival analyses and Cox regression models revealed that TACE and a combination therapy of TACE and sorafenib were significant prognostic factors in metastatic HCC. However, further analyses revealed that there was no additional prognostic effect of adding sorafenib to TACE treatment in this patient cohort.

Conclusions: In metastatic HCC, treatment of intrahepatic tumor by TACE may be associated with improved survival. These results support the prognostic importance of treating intrahepatic HCC even in patients with metastatic disease. Therefore, we suggest evaluating the technical feasibility of TACE in all metastatic patients.

Keywords: Hepatocellular carcinoma; Metastases; Prognosis; Sorafenib; Transarterial chemoembolization.

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Conflict of interest statement

Ethics approval and consent to participate

All patients provided written informed consent for TACE and for data collection. This study was performed in accordance with the Declaration of Helsinki and it has been approved by the local ethics committee of the University Hospital of Freiburg (no. EK 62/14).

Consent for publication

Not applicable.

Competing interests

DB receives teaching and speaking fees from Bayer HealthCare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Liver function assessed by the ALBI score in patients with no HCC specific treatment compared to patients with different treatment approaches. Patients who did not receive any HCC specific treatment had impaired liver function as shown by a higher ALBI grade. * The group “HCC treatment” includes all patients who received either sorafenib, TACE or a combination of both
Fig. 2
Fig. 2
Patients who did not receive any HCC specific treatment had worst median OS of 3 months compared to patients who were treated with sorafenib (6 months, p = 0.009), with TACE (9 months, p < 0.001) and to those treated with a combination of TACE and sorafenib (16 months, p = 0.002)
See this image and copyright information in PMC

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