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Clinical conditions and treatment requirements for long-term survival among hepatitis B-related hepatocellular carcinoma initially treated with chemoembolization.

Authors
  • Chen, Zhen-Xin1, 2, 3
  • Jian, Zhi-Wei1, 2, 3
  • Wu, Xi-Wen1, 2, 3
  • Wang, Jun-Cheng1, 2, 3
  • Peng, Jing-Yuan1, 2, 3
  • Lao, Xiang-Ming1, 2, 3
  • 1 Department of Hepatobiliary and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China. , (China)
  • 2 State Key Laboratory of Southern China, Guangzhou, P. R. China. , (China)
  • 3 Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China. , (China)
Type
Published Article
Journal
Cancer Medicine
Publisher
Wiley
Publication Date
Sep 01, 2019
Volume
8
Issue
11
Pages
5097–5107
Identifiers
DOI: 10.1002/cam4.2380
PMID: 31313476
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Transarterial chemoembolization (TACE) is recommended to treat intermediate/advanced stage of hepatocellular carcinoma (HCC). However, the overall survival among initially TACE-treated patients varies significantly. The clinical characterization of long-term survival following TACE remains uncertain. We sought to identify clinical parameters and treatment requirements for long-term survival among patients with hepatitis B-related HCC who were initially treated with TACE. The included patients with HCC were admitted to our cancer center between December 2009 and May 2015. Patients who survived for >3 years were compared with those who died within 3 years. The clinical and laboratory findings that were associated with the survival were also analyzed. One in six (17.9%) patients with HCC in this cohort survived for > 3 years after TACE. Body mass index (BMI) ≥ 23kg/m2 , aspartate aminotransferase levels ≤ 40 U/L, an activated partial thromboplastin time ≤ 34 seconds, α-fetoprotein (AFP) levels ≤ 25 ng/mL, antiviral therapy, tumor size ≤ 8 cm, solitary nodule, and the absence of vascular invasion were independently favorably associated with a 3-year survival. An absence of vascular invasion was the only independent factor associated with 3-year survival in patients who received resection and/or ablation after TACE. In this cohort, a 3-year survival was associated with BMI, antivirus treatment, tumor status, hepatic function, and AFP level. Distant metastasis did not negatively impact the long-term survival among patients with hepatitis B-related HCC initially treated with TACE. Vascular invasion was the single impediment to long-term survival in patients who received add-on resection and/or ablation after TACE. © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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