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Transarterial embolization versus symptomatic treatment in patients with advanced hepatocellular carcinoma: Results of a randomized, controlled trial in a single institution
Author(s) -
Bruix Jordi,
Llovet Josep M.,
Castells Antoni,
Montañá Xavier,
Brú Concepció,
Ayuso Maria Del Carmen,
Vilana Ramon,
Rodés Joan
Publication year - 1998
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510270617
Subject(s) - medicine , hepatocellular carcinoma , stage (stratigraphy) , randomized controlled trial , embolization , chemotherapy , surgery , gastroenterology , liver function , carcinoma , paleontology , biology
This randomized, controlled trial assessed the effect of transarterial embolization (TAE) (without associated chemotherapy) on the survival of patients with nonsurgical hepatocellular carcinoma (HCC). Eighty consecutive patients were randomized to treatment with embolization (Group A, n = 40), or to symptomatic treatment (Group B, n = 40), there being no differences between both groups regarding the degree of liver function impairment and tumor stage. Eighty‐two percent of the patients presented a self‐limited postembolization syndrome, without treatment‐related mortality. Fifty‐five percent of the treated cases exhibited a partial response, which resulted in a lower probability of tumor progression during follow‐up (57% vs. 77% at 1 year; P < .005). However, after a median follow‐up of 24 months (30 deaths in each group), there are no differences in survival (Group A: 49% and 13%; Group B: 50% and 27%, at 2 and 4 years, respectively; P = .72). The absence of differences was maintained even when dividing patients according to Child‐Pugh's grade, Okuda stage, or performance status test (PST). Furthermore, there were no differences in the probability of complications or in the need of hospital admissions. In conclusion, TAE has a marked antitumoral effect associated to a slower growth of the tumor, but it does not improve the survival of patients with nonsurgical HCC.