Long-Term Survival of Taiwanese Patients with Hepatocellular Carcinoma after Combination Therapy with Transcatheter Arterial Chemoembolization and Percutaneous Ethanol Injection

肝細胞癌患者合併經導管動脈化學栓塞術與經皮酒精肴射療的長期存活情形

李育賢(Yu-Hsien Li) ； 王朝欣(Chaur-Shine Wang) ； 廖麗瑛(Li-Ying Liao) ； 王鐘貴(Chung-Kwe Wang) ； 施麗順(Li-Shun Shih) ； 陳潤秋(Ran-Chou Chen) ； 陳寶輝(Pao Huei Chen)

《Journal of the Formosan Medical Association》 102卷3期 (2003/03) Pp. 141-146

https://doi.org/10.29828/JFMA.200303.0002

並列摘要

Background and Purpose: Several studies have shown a superior effect of combination therapy with transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared with either monotherapy for the treatment of advanced hepatocellular carcinoma (HCC), but there have been no reports on combination
treatment from Taiwan. This study investigated the long-term survival and prognostic factors of HCC patients treated with TACE/PEI combination therapy.
Methods: A total of 153 consecutive HCC patients, with tumor sizes between 2 and 3 cm in 47 patients, between 3 and 5 cm in 66 patients, and between 5 and 13 cm in 40 patients, who received TACE/PEI combination therapy were included in this retrospective study. The mean follow-up duration was 23 ± 17 months (range, 1 to 78 months) .
Results: The 1-, 2-, 3-, 4-, 5-, and 6-year cumulative survival rates for the patients were 78%, 54%, 40%, 22%, 12%, and 5%, respectively. Multivariate analysis using Cox’s proportional hazards model showed that the stage of cirrhosis (Child’s class B or C vs class A) was the only factor that significantly affected the survival rate (p = 0.02) [relative risk,
2.10; 95% confidence interval, 1.12 to 3.96] . Univariate analysis showed that survival was poorer in patients with tumors greater than 5 cm than in patients with tumors 2 to 5 cm in largest dimension; this difference was not significant in the multivariate analysis. No serious complications were observed during or after treatment.
Conclusions: TACE combined with PEI is an alternative treatment for patients with larger HCC who are not suitable for surgical resection. A superior outcome can be expected in patients with Child’s lass A cirrhosis.

並列關鍵字

Carcinoma, hepatocellular ； Chemoembolization, therapeutic ； Injections, intralesional ； Ethanol, administration and dosage