Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma

Hideaki Kunugasa, Kazuhiro Nouso, Yasuto Takeuchi, Tetsuya Yasunaka, Hideki Ohnishi, Shin Ichiro Nakamura, Hidenori Shiraha, Kenji Kuwaki, Hiroaki Hagihara, Fusao Ikeda, Yasuhiro Miyake, Akinobu Takaki, Kazuhide Yamamoto

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC. Methods: Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model. Results: The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 10.2%, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence. Conclusions: Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalJournal of Gastroenterology
Volume47
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Hepatocellular Carcinoma
Recurrence
Ethiodized Oil
Neoplasms
Serum
Proportional Hazards Models
Therapeutics
Odds Ratio
Confidence Intervals

Keywords

  • Early-stage HCC
  • Hepatocellular carcinoma
  • Small HCC
  • TACE

ASJC Scopus subject areas

  • Gastroenterology

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Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma. / Kunugasa, Hideaki; Nouso, Kazuhiro; Takeuchi, Yasuto; Yasunaka, Tetsuya; Ohnishi, Hideki; Nakamura, Shin Ichiro; Shiraha, Hidenori; Kuwaki, Kenji; Hagihara, Hiroaki; Ikeda, Fusao; Miyake, Yasuhiro; Takaki, Akinobu; Yamamoto, Kazuhide.

In: Journal of Gastroenterology, Vol. 47, No. 4, 04.2012, p. 421-426.

Research output: Contribution to journalArticle

Kunugasa, Hideaki ; Nouso, Kazuhiro ; Takeuchi, Yasuto ; Yasunaka, Tetsuya ; Ohnishi, Hideki ; Nakamura, Shin Ichiro ; Shiraha, Hidenori ; Kuwaki, Kenji ; Hagihara, Hiroaki ; Ikeda, Fusao ; Miyake, Yasuhiro ; Takaki, Akinobu ; Yamamoto, Kazuhide. / Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma. In: Journal of Gastroenterology. 2012 ; Vol. 47, No. 4. pp. 421-426.
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abstract = "Background: Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC. Methods: Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model. Results: The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8{\%}, and 2.8, 2.8, and 10.2{\%}, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95{\%} confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence. Conclusions: Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.",
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T1 - Risk factors for recurrence after transarterial chemoembolization for early-stage hepatocellular carcinoma

AU - Kunugasa, Hideaki

AU - Nouso, Kazuhiro

AU - Takeuchi, Yasuto

AU - Yasunaka, Tetsuya

AU - Ohnishi, Hideki

AU - Nakamura, Shin Ichiro

AU - Shiraha, Hidenori

AU - Kuwaki, Kenji

AU - Hagihara, Hiroaki

AU - Ikeda, Fusao

AU - Miyake, Yasuhiro

AU - Takaki, Akinobu

AU - Yamamoto, Kazuhide

PY - 2012/4

Y1 - 2012/4

N2 - Background: Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC. Methods: Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model. Results: The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 10.2%, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence. Conclusions: Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.

AB - Background: Radiofrequency ablation (RFA) is a standard therapy for the treatment of hepatocellular carcinoma (HCC) with 3 or fewer tumors of up to 3 cm (early-stage HCC); when RFA is unsuccessful or unfeasible, transcatheter arterial chemoembolization (TACE) has often been performed. However, little information about the outcome of TACE for early-stage HCC has been reported and it is hard to decide whether to perform additional treatment following TACE in these difficult conditions. The aim of this study was to determine the risk factors for local or intrahepatic distant recurrence after TACE in early-stage HCC. Methods: Among 1,560 newly diagnosed HCC patients who were admitted to Okayama University Hospital, 43 patients with early-stage HCC who received only TACE in at least one nodule were enrolled in this study. We analyzed the risk factors for local and distant recurrence by the Cox proportional hazard model. Results: The local recurrence rates and intrahepatic distant recurrence rates at 3 months, 6 months, and 1 year were 18.6, 33.4, and 61.8%, and 2.8, 2.8, and 10.2%, respectively. Among 12 parameters examined as possible risk factors for recurrence, heterogeneous Lipiodol uptake (risk ratio 3.38; 95% confidence interval 1.14-10.60) and high serum des-gamma-carboxy prothrombin (DCP) (2.58; 1.03-7.14) were significantly correlated with local recurrence, and the presence of multiple tumors (10.64; 1.76-93.75) was significantly correlated with intrahepatic distant recurrence. Conclusions: Heterogeneous Lipiodol uptake, high serum DCP, and multiple tumors are risk factors for recurrence in patients with early-stage HCC who have undergone palliative TACE.

KW - Early-stage HCC

KW - Hepatocellular carcinoma

KW - Small HCC

KW - TACE

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