Early evaluation of transcatheter arterial chemoembolization-refractory hepatocellular carcinoma

Background There is no standard therapy for patients with transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). This study examined whether evaluating the tumor effect (TE) at 1 week after TACE was useful for predicting refractoriness to TACE. Methods We performed a historical cohort study involving 54 patients and 119 tumors. TE was evaluated at 1 week and 3 months after TACE, and an overall evaluation was also performed at 3 months based on the response evaluation criteria in cancer of the liver. Results Among 45 tumors evaluated as TE2 at 1 week, 43 tumors (95.6%) were classified as TE1 or TE2 at 3 months. Of the 24 patients whose tumors were categorized as TE2 at 1 week, none achieved a complete or partial response. Conclusions Evaluating the TE at 1 week after TACE is useful for the early diagnosis of TACE-refractory HCC and allows alternative treatment options, such as sorafenib, to be employed before the disease progresses.