Predictive Factors for Complete Response and Recurrence after Transarterial Chemoembolization in Hepatocellular Carcinoma

Abstract

Background/Aims: To investigate the predictive factors for complete response (CR) and recurrence after CR in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). Methods: Among 691 newly diagnosed HCC patients, 287 were treated with TACE as a first therapy. We analyzed the predictive factors for CR, recurrence after CR, and overall survival (OS). Results: Eighty-one patients (28.2%) achieved CR after TACE, and recurrence after CR was detected in 35 patients (43.2%). In multivariate analyses, tumor size (<= 5 cm) and single nodularity were predictive factors for CR, with hazard ratios (HRs) of 0.35 (p=0.002) and 0.41 (p < 0.001), respectively. Elevated serum a-fetoprotein (AFP) (> 20 ng/mL) level and multinodularity exhibited significant relationships with recurrence after CR, with HRs of 2.220 (p=0.026) and 3.887 (p < 0.001), respectively. Tumor size (> 5 cm), multinodularity, elevated serum AFP (> 20 ng/mL) level, Child-Turcotte-Pugh score (B and C), and portal vein thrombosis were significant factors for OS. Conclusions: In patients treated with TACE as a first therapy, tumor size (<= 5 cm) and single nodularity were predictive factors for CR, and multinodularity and elevated serum AFP (> 20 ng/mL) levels were predictive factors for recurrence after CR. These factors were also significant for OS.