Patients with hepatocellular carcinoma (HCC) have a wide range of results after transarterial chemoembolization (TACE).
The purpose of this study is to determine which factors influence the result of TACE for HCC.
Methods: We used Fisher's exact test and
Mann Whitney U test for univariate analysis and the Kaplan-Meier technique and
Cox proportional hazard models to assess survival in HCC patients treated with
TACE at the VA Medical Center in Gainesville, Florida, from January 2001 to
December 2010.
Results: A total of 82 patients were enrolled in the study, 45 of whom received
doxorubicin drug eluting beads (DEB TACE) and 37 of whom received conventional
(CON) TACE. With the exception of the CON TACE's higher MELD score, the two
TACE groups shared identical features. Survival was linked with TACE type (p=
0.022), Child-Pugh (CP) class (p= 0.038), MELD score (p= 0.028), AFPmax
(p=0.0002), and response after first TACE (p= 0.006) in univariate analysis.
The DEB TACE group had a substantial survival benefit (p=0.014) over the CON
TACE group (-26.4 months versus 15.8 months, respectively) and in patients with
lower MELD levels (p=0.005), according to Kaplan Meier analysis. A
multivariable analysis found a statistically significant interaction between
TACE type and MELD score (p=0.395), with DEB TACE patients outliving CON TACE
patients, but the effect lessening as MELD levels climbed. Furthermore, AFPmax
significantly increased the chance of death (hazard ratio 1.15, 95 percent CI=
[1.06, 1.26], p=0.0001).
Author (s) Details
Amitabh Suman
University of Florida, Gainesville and VA Medical Center, Gainesville, Florida, United States.
View Book :- https://stm.bookpi.org/HMMS-V15/article/view/2475
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