Source Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University at Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany.

PURPOSE: To assess the survival time of patients with HCC following transarterial chemoembolization performed in a highly selective and sequential way.

PATIENTS AND METHODS: 124 HCC patients (102 male, 22 female; mean age 63±11 years) treated with selective and sequential chemoembolization at a single center were included. Selective chemoembolization was performed through a coaxially introduced microcatheter in a segmental or subsegmental hepatic artery. Treatment was stopped after complete stasis of the blood flow in the tumor-feeding vessel. The primary endpoint of the study was overall survival.

RESULTS: The median overall survival of the entire patient population was 27.2 months (mo) (±8.9mo, 95% CI 9.8mo, 44.6mo). When stratified according to liver function the median survival was 46.1mo (±9.0mo; 95% CI 28.5mo, 63.7mo) for Child-Pugh A and 11.1mo (±4.3mo; 95% CI 2.7mo, 19.5mo) for Child-Pugh B (p<.001). The median survival was 46.1mo (±16.6mo; 95% CI 13.5mo, 78.7mo) for BCLC stage A, 19.7mo (±2.6mo; 95% CI 14.6mo, 24.8mo) for BCLC stage B, and 14.4mo (±5.0mo; 95% CI 4.5mo, 24.3mo) for BCLC stage C (p<.01).

CONCLUSION: Selective and sequential chemoembolization offers long survival times in patients with HCC. Those patients with preserved liver function benefit more than patients with limited liver reserve.