Transcatheter arterial infusion chemotherapy with cisplatin-lipiodol suspension in patients with hepatocellular carcinoma

• Published in: Journal of gastroenterology 2010, Vol.45 (1), p.60-67
• Main Authors: Ikeda, Masafumi, Maeda, Seishi, Ashihara, Hiroshi, Nagahama, Hiroyasu, Tanaka, Motohiko, Sasaki, Yutaka
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Biliary Tract; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - physiopathology; Cisplatin - administration & dosage; Cisplatin - therapeutic use; Colorectal Surgery; Female; Follow-Up Studies; Gastroenterology; Hepatology; Humans; Infusions, Intra-Arterial; Iodized Oil - chemistry; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Original Article—Liver; Pancreas; Prognosis; Surgical Oncology; Survival Rate; Treatment Outcome
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-009-0109-8

Purpose The aim of this study was to investigate the antitumor efficacy of treatment, identify prognostic factors, and construct a prognostic index in patients with hepatocellular carcinoma treated by transcatheter arterial infusion chemotherapy (TAI) using cisplatin suspended in lipiodol. Methods We analyzed the outcomes in a total of 94 consecutive patients with previously untreated hepatocellular carcinoma who were treated by TAI using cisplatin suspended in lipiodol. Results Twenty-seven patients (29%) showed complete response and 21 patients (22%) showed partial response, with an overall response rate of 51% (95% confidence interval, 41-61%). The median survival time was 2.5 years and the proportions of survivors at 1, 2, and 5 years were 81.6, 65.2, and 18.3%, respectively. The results of multivariate analysis indicated a significant association of serum albumin ≥3.0 g/dL, maximum tumor size ≤3.0 cm, absence of ascites, and unilateral distribution of the tumors with a favorable survival. For clinical application, we also propose a prognostic index based on a combination of these prognostic factors. Based on this index, the patients were classified into three groups: those with good, intermediate, and poor prognosis. The median survival times in these three groups were 4.3, 2.7, and 1.1 years, respectively (p < 0.01). Conclusions TAI with cisplatin suspended in lipiodol exhibited favorable tumor efficacy and survival in patients with hepatocellular carcinoma. The prognostic factors identified and the index proposed based on these factors may be useful for predicting life expectancy, determining treatment strategies, and designing future clinical trials.