TACE FOR ADVANCED HEPATOCELLULAR CARCINOMA 

Radiology. 2012 May;263(2):590-599. Epub 2012 Mar 21.

Advanced-Stage Hepatocellular Carcinoma: Transarterial Chemoembolization versus Sorafenib.

Pinter M, Hucke F, Graziadei I, Vogel W, Maieron A, Königsberg R, Stauber R, Grünberger B, Müller C, Kölblinger C, Peck-Radosavljevic M, Sieghart W.

Source

Departments of Gastroenterology and Hepatology, Klinik Innere Medizin III, and Radiology, AKH & Medizinische Universität Wien, Währinger Gürtel 18-20, A-1090 Vienna, Austria; Department of Gastroenterology and Hepatology, Medizinische Universität Innsbruck, Innsbruck, Austria; Fourth Medical Department, KH Elisabethinen Linz, Linz, Austria; Kaiser Franz Josef-Spital, Third Medical Department, Centre for Oncology and Hematology, CEADDP, Applied Cancer Research, Institution for Translational Research Vienna, and Ludwig Boltzmann-Institute for Applied Cancer Research, Vienna, Austria; Department of Gastroenterology and Hepatology, LKH & Medizinische Universität Graz, Graz, Austria.

Abstract

Purpose: To compare the efficacies of transarterial chemoembolization (TACE) and sorafenib in patients with advanced-stage hepatocellular carcinoma (HCC). Materials and Methods: The retrospective analysis of the data was approved by the institutional review board; the requirement to obtain informed consent was waived. Three hundred seventy-two patients with HCC were treated between January 1999 and December 2009. Patients with advanced HCC according to the Barcelona Clinic Liver Cancer (BCLC) staging classification (Child-Pugh class A or B, Eastern Cooperative Oncology Group performance status of 1-2, and/or macrovascular invasion or extrahepatic metastasis) were included in the study (n = 97). Thirty-four patients underwent conventional TACE with doxorubicin plus lipiodol or TACE with drug-eluting beads; 63 patients were treated with sorafenib. Results: The median duration of sorafenib treatment was 4.6 months (95% confidence interval [CI]: 3.2, 6.0 months). The median number of TACE sessions per patient was 3 ± 2. Side effects of TACE and sorafenib were comparable to those reported in the literature. The median time to progression was similar between the two treatment groups (P = .737). The median overall survival was 9.2 months (95% CI: 6.1, 12.3 months) for patients treated with TACE and 7.4 months (95% CI: 5.6, 9.2 months) for those treated with sorafenib (P = .377). Only Child-Pugh class was associated with a better overall survival at uni- and multivariate analysis. Conclusion: TACE achieved a promising outcome in select patients with advanced HCC (BCLC stage C