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Is there a survival benefit in interventional radiology for hepatocellular carcinoma in patients with Child–Pugh C liver cirrhosis?: A multicenter study
Author(s) -
Hiraoka Atsushi,
Kumada Takashi,
Michitaka Kojiro,
Toyoda Hidenori,
Tada Toshifumi,
Ishikawa Toru,
Itobayashi Ei,
Shimada Noritomo,
Takaguchi Koichi,
Takizawa Daichi,
Tsuji Kunihiko
Publication year - 2016
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12583
Subject(s) - medicine , hepatocellular carcinoma , liver transplantation , cirrhosis , gastroenterology , radiofrequency ablation , transcatheter arterial chemoembolization , bilirubin , transplantation , ablation
Aim A lack of donors in liver transplantation (LT) for hepatocellular carcinoma (HCC) has become a big issue. There is no consensus regarding whether interventional radiology for HCC in patients with Child–Pugh C liver cirrhosis will improve prognosis. To elucidate the effectiveness of such treatment, we evaluated the clinical features of affected patients. Methods Patients with naive HCC of Child–Pugh C ( n = 236) were enrolled. Two of them were treated with LT after transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were used as bridging treatments. After exclusion of a total of three patients who received LT, we evaluated clinical factors related to improved prognosis. Results The percentage of all patients with total bilirubin of less than 3 mg/dL was 41.1%. The prognosis of patients who were received treatments ( n = 30; ablative therapy 10, TACE 20) was better than non‐treated patients ( n = 18; mean survival time [MST] 22.2 vs 13.8 months, P = 0.021, respectively) in patients with up to 7 criteria and total bilirubin of less than 3 mg/dL ( n = 48). On the other hand, there was no difference in prognosis between those who underwent ablative therapies ( n = 10) and those who received TACE ( n = 20) (MST 22.2 vs 16.9 months, P = 0.390). Conclusion Therapy for HCC may prolong survival in patients with naive HCC, with up to 7 criteria and total bilirubin of less than 3 mg/dL.