Transarterial chemoembolization as initial treatment for unresectable hepatocellular carcinoma in southern China

AIM:To identify prognostic factors from pretreatment variables of the initial transarterial chemoembolization(TACE)procedure in unresectable hepatocellular carcinoma(HCC). METHODS:One thousand and five hundred and sixtynine patients with unresectable HCC underwent TACE as initial treatment were retrospectively studied.Pretreatment variables of the initial TACE procedure with a P value less than 0.05 by univariate analysis were subjected to Cox proportional hazards model. RESULTS:The median overall survival time and 1-, 5-,10-year survival rates were 10.37 mo,47%,10%, and 7%,respectively.A Cox proportional hazard model showed that 8 pretreatment factors of regional lymphnodes metastasis,Child-Pugh class,macrovascular invasion,greatest dimension,α-fetoprotein(AFP), Hepatitis virus B,tumor capsule,and nodules were independent prognostic factors.Patients with multimodality therapy have better survival than those with TACE treatment only. CONCLUSION:Tumor status,hepatic function reserve,AFP,and hepatitis virus B status were independent prognostic factors for unresectable HCC.Distant metastasis might not be a contraindication to TACE. Multimodality therapy might improve survival.