TY - JOUR
T1 - Experience from a real-life cohort: outcome of 606 patients with hepatocellular carcinoma following transarterial chemoembolization
AU - Kirstein, Martha M.
AU - Schweitzer, Nora
AU - Ay, Nazli
AU - Boeck, Christina
AU - Lappas, Katerina
AU - Hinrichs, Jan B.
AU - Voigtländer, Torsten
AU - Wacker, Frank
AU - Manns, Michael P.
AU - Rodt, Thomas
AU - Vogel, Arndt
N1 - Publisher Copyright:
© 2016 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2017/1/2
Y1 - 2017/1/2
N2 - Background: Hepatocellular carcinoma (HCC) is one of the most lethal cancers. Transarterial chemoembolization (TACE) has been accepted as the standard care for intermediate stage disease. Methods: In this study, we characterized 606 with HCC patients from Hannover Medical School treated with TACE. Results: 606 with HCC patients treated with TACE were identified between 2000 and 2015. Most patients (59.8%) were at intermediate stage. Following TACE, most patients subsequently received systemic therapy or best supportive care (BSC), whereas 227 (37.5%) patients were bridged to potentially curative local treatments. Depending on subsequent therapies, median post-TACE survival ranged from 7 to 162 months. Ascites, cholinesterase, c-reactive and alpha-feto protein and tumor size were identified as prognostic factors. These factors as well as the HAP, mHAP-II and STATE score also determined post-TACE survival independent of subsequent therapies. Hepatic function progressively deteriorated with repeated TACE sessions. Despite that, post-TACE survival was not shortened in frequently treated patients (≥5 times) as compared to patients treated 4 times or less (p = not significant [n.s.]). Patients treated ≥5 times with TACE received significantly more often systemic therapy following TACE (37.3%) as compared to patients with 3–4 (30.1%), 2 (27.4%) and 1 (21.8%) sessions (p <.05). Conclusion: TACE is performed in a heterogeneous population as bridging therapy to other local treatments and palliative therapy. The long-term survival following TACE is determined by baseline tumor, patient-related factors and by subsequent therapies. Post-TACE survival is not shorter in patients with frequent treatments (≥5), and the rate of subsequent systemic treatments is higher compared to less frequently treated patients.
AB - Background: Hepatocellular carcinoma (HCC) is one of the most lethal cancers. Transarterial chemoembolization (TACE) has been accepted as the standard care for intermediate stage disease. Methods: In this study, we characterized 606 with HCC patients from Hannover Medical School treated with TACE. Results: 606 with HCC patients treated with TACE were identified between 2000 and 2015. Most patients (59.8%) were at intermediate stage. Following TACE, most patients subsequently received systemic therapy or best supportive care (BSC), whereas 227 (37.5%) patients were bridged to potentially curative local treatments. Depending on subsequent therapies, median post-TACE survival ranged from 7 to 162 months. Ascites, cholinesterase, c-reactive and alpha-feto protein and tumor size were identified as prognostic factors. These factors as well as the HAP, mHAP-II and STATE score also determined post-TACE survival independent of subsequent therapies. Hepatic function progressively deteriorated with repeated TACE sessions. Despite that, post-TACE survival was not shortened in frequently treated patients (≥5 times) as compared to patients treated 4 times or less (p = not significant [n.s.]). Patients treated ≥5 times with TACE received significantly more often systemic therapy following TACE (37.3%) as compared to patients with 3–4 (30.1%), 2 (27.4%) and 1 (21.8%) sessions (p <.05). Conclusion: TACE is performed in a heterogeneous population as bridging therapy to other local treatments and palliative therapy. The long-term survival following TACE is determined by baseline tumor, patient-related factors and by subsequent therapies. Post-TACE survival is not shorter in patients with frequent treatments (≥5), and the rate of subsequent systemic treatments is higher compared to less frequently treated patients.
UR - http://www.scopus.com/inward/record.url?scp=84988661479&partnerID=8YFLogxK
U2 - 10.1080/00365521.2016.1233579
DO - 10.1080/00365521.2016.1233579
M3 - Journal articles
C2 - 27598949
AN - SCOPUS:84988661479
SN - 0036-5521
VL - 52
SP - 116
EP - 124
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 1
ER -