Journal
JAPANESE JOURNAL OF RADIOLOGY
Volume 30, Issue 7, Pages 560-566Publisher
SPRINGER
DOI: 10.1007/s11604-012-0088-1
Keywords
Hepatocellular carcinoma; Arterial embolization; Prognosis
Funding
- Okitama Public General Hospital, Department of Radiology
- Toho University Omori Hospital, Department of Department of Gastroenterology and Hepatology
- National Center for Global Health and Medicine, Department of Radiology
- Tokai University, Department of Radiology
- Yamanashi University, Department of Radiology
- Shinshu University, Department of Radiology
- Kouseiren Takaoka Hospital, Department of Radiology
- Ishikawa Prefectural Central Hospital, Department of Radiology
- Hamamatsu University School of Medicine, Department of Radiology
- Nagoya City University, Department of Radiology
- Aichi Medical University, Department of Radiology
- Shiga University of Medical Science, Department of Radiology
- Kohka Public Hospital, Department of Radiology
- Japanese Red Cross Kobe Hospital, Department of Radiology
- Nishi-Kobe Medical Center, Department of Radiology
- Wakayama Medical University, Department of Radiology
- Hiroshima University, Department of Radiology
- Chugoku Rosai Hospital, Department of Radiology
- Tottori University, Department of Radiology
- Shimane University, Department of Radiology
- Oita University, Department of Radiology
- Kumamoto University, Department of Radiology
- Kagoshima University, Department of Radiology
- Kanazawa University, Department of Radiology
- Hokkaido University, Department of Radiology
- Okayama University, Department of Radiology
- Osaka University, Department of Radiology
- National Cancer Center, Department of Radiology
- Teikyo University, Department of Radiology
- Japan Red Cross Kyoto Daiichi Hospital, Department of Radiology
- Kochi Health Science Center, Department of Radiology
- Nanbu Medical Center, Department of Radiology
- Keio University, Department of Diagnostic Radiology
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To evaluate retrospectively whether technical factors of hepatic arterial embolization affect the prognosis of patients with hepatocellular carcinoma (HCC). Inclusion criteria of this study were the following: (1) patients received embolization as the initial treatment during 2003-2004, (2) Child A or B liver profile, (3) five or fewer HCCs with maximum diameter of 7 cm or smaller, and (4) no extrahepatic metastasis. Patient data were gathered from 43 centers. Prognostic factors were evaluated using univariate and multivariate analyses. Eight hundred fifteen patients were enrolled. The 1-, 3-, 5-, and 7-year overall survival rates were 92.0 % (95 % CI 90.1-93.9), 62.9 % (95 % CI 59.3-66.6), 39.0 % (95 % CI 35.1-43.0), and 26.7 % (95 % CI 22.6-30.8) in all patients. Univariate analysis showed a Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, tumor number of 3 or fewer, one-lobe tumor distribution, nodular tumor type, within the Milan criteria, stage I or II, no portal venous invasion, use of iodized oil, and selective embolization were significantly better prognostic factors. In the multivariate Cox model, the benefit to survival of selective embolization remained significant (hazard ratio 0.68; 95 % CI 0.48-0.97; p = 0.033). Selective embolization contributes to survival in patients with HCCs.
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