Prospective Multi-Center Korean Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolics for Nodular Hepatocellular Carcinoma: A Two-Year Outcome Analysis.

Abstract

OBJECTIVE:

To assess the two-year treatment outcomes of chemoembolization with drug-eluting embolics (DEE) for nodular hepatocellular carcinoma (HCC).

MATERIALS AND METHODS:

This study was a prospective, multicenter, registry-based, single-arm trial conducted at five university hospitals in Korea. Patients were recruited between May 2011 and April 2013, with a target population of 200. A DC Bead loaded with doxorubicin was used as the DEE agent. Patients were followed up for two years. Per-patient and per-lesion tumor response analysis, per-patient overall survival (OS) and progression-free survival (PFS) analysis, and per-lesion tumor control analysis were performed.

RESULTS:

The final study population included 152 patients, with 207 target lesions for the per-lesion analysis. At one-month, six-month, one-year, and two-year per-patient assessments, complete response (CR) rates were 40.1%, 43.0%, 33.3%, and 19.6%, respectively. The objective response (OR) rates were 91.4%, 55.4%, 35.1%, and 19.6%, respectively. The cumulative two-year OS rate was 79.7%. The cumulative two-year PFS rate was 22.4% and the median survival was 9.3 months. In multivariable analysis, the Child-Pugh score (p = 0.019) was an independent predictor of OS, and tumor multiplicity (p < 0.001), tumor size (p = 0.020), and Child-Pugh score (p = 0.006) were independent predictors of PFS. In per-lesion analysis, one-month, six-month, one-year and two-year CR rates were 57.5%, 58.5%, 45.2%, and 33.3%, respectively, and the OR rates were 84.1%, 65.2%, 46.6%, and 33.3%, respectively. The cumulative two-year per-lesion tumor control rate was 36.2%, and the median time was 14.1 months. The Child-Pugh score (p < 0.001) was the only independent predictor of tumor control. Serious adverse events were reported in 11 patients (7.2%).

CONCLUSION:

DEE chemoembolization for nodular HCCs in the Korean population showed acceptable survival, tumor response, and safety profiles after a two-year follow-up. Good liver function (Child-Pugh score A5) was a key predictor of per-patient OS, PFS, and per-lesion tumor control.

• Authors: Myungsu Lee, Jin Wook Chung, Kwang-Hun Lee, Jong Yun Won, Ho Jong Chun, Han Chu Lee, Jin Hyoung Kim, In Joon Lee, Saebeom Hur, Hyo-Cheol Kim, Yoon Jun Kim, Gyoung Min Kim, Seung-Moon Joo, Jung Suk Oh
• Journal: Korean journal of radiology (Korean J Radiol) Vol. 22 Issue 10 Pg. 1658-1670 (Oct 2021) ISSN: 2005-8330 [Electronic] Korea (South)
• PMID: 34132079 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 The Korean Society of Radiology.

Chemical References

• Pharmaceutical Preparations
• Doxorubicin

Topics

• Carcinoma, Hepatocellular (drug therapy)
• Chemoembolization, Therapeutic
• Doxorubicin
• Humans
• Liver Neoplasms (drug therapy)
• Pharmaceutical Preparations
• Prospective Studies
• Registries
• Republic of Korea (epidemiology)
• Retrospective Studies
• Treatment Outcome