Clinical

Prognostic factors identified for localized chemotherapy in advanced liver cancer

Last Updated: 2004-08-30 11:33:02 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Hepatic arterial infusion chemotherapy may be useful in certain patients with advanced hepatocellular carcinoma (HCC). Various tumor and patient characteristics predict response to treatment, according to a report in the August Journal of Vascular and Interventional Radiology.

Hepatic arterial infusion chemotherapy has previously been reported to offer palliation for patients with advanced HCC, the authors explain, but few studies have evaluated prognostic factors in such patients.

To investigate this issue, Dr. Ayumi Hamada and colleagues from Mie University School of Medicine in Japan studied 88 patients with advanced HCC who received arterial infusion chemotherapy.

One patient experienced a complete response, and 14 patients experienced partial responses, for a tumor response rate of 17%, the authors report. No tumors showed progression.

Estimated overall survival was 55% at 1 year, 36% at 2 years, and 24% at 3 years, and the mean survival was 19.5 months.

Three factors proved to be significant, independent prognostic factors in a multivariate analysis: CLIP (Cancer of the Liver Italian Program) score, Okuda stage (2 tumor staging systems) and therapeutic effect.

Fourteen patients (16%) had major complications related to the chemotherapy reservoir system, the researchers note. These and other complications were controllable by removal or replacement of the reservoir system, medical treatment, and suspension of hepatic arterial infusion chemotherapy.

"Before giving patients hepatic arterial infusion chemotherapy, we can predict their prognosis," Dr. Hamada told Reuters Health. "As a result, we can discuss if patients could undergo additional therapy, including hepatic arterial infusion therapy, and we can select the best treatment from many kinds of therapies." In this way, he pointed out, futile procedures can be avoided.

J Vasc Interv Radiol 2004;15:835-841.