Eleni A. Liapi MD, Presenter: Nothing to Disclose

Kwang-Hun Lee MD, Abstract Co-Author: Nothing to Disclose

Kelvin Hong MD, Abstract Co-Author: Speaker, Boston Scientific Corporation

Christos S. Georgiades MD, PhD, Abstract Co-Author: Nothing to Disclose

Ihab R. Kamel MD, PhD, Abstract Co-Author: Research grant, Bracco Group Research grant, Bayer AG

Jean-Francois H. Geschwind MD, Abstract Co-Author: Grant, Boston Scientific Corporation Grant, Genentech, Inc Grant, Biocompatibles International plc Grant, MDS Inc Consultant, Biocompatibles International plc Consultant, MDS Inc Consultant, Terumo Corporation Consultant, BioSphere Medical, Inc Patent holder, 3-BrPa for Targeting Tumor Metabolism

To report the outcome of the care of 347 patients with hepatocellular carcinoma (HCC) treated with transcatheter arterial chemomembolization (TACE) with a focus on tumor size change [Response Evaluation Criteria in Solid Tumors (RECIST) criteria], Child-Pugh (CP) class change over time and survival from 1996 to 2007.

TACE was performed on 347 patients in 979 sessions. According to a standardized protocol, all patients received imaging (MRI and/or CT) at baseline and at 4-6 weeks after each session and were clinically, biochemically and radiologically evaluated before each session. Disease status was evaluated before and at the end of the treatment period with the CP class system (nominal and categorical) and tumor size measurements according to the RECIST criteria. Three chemotherapeutic agents and lipiodol, followed by non-occlusive embolization were utilized during TACE. Complete vessel occlusion was avoided at all times. The Kaplan-Meier test was utilized to assess patient survival.

All patients (77% male, mean age: 65.6 years) received an average of 3 TACE sessions (range: 1-10 and average interval between sessions: 81 days). Sixty six percent of patients had 3 or more tumors, with a mean tumor size at presentation of 6.8 cm. There was a 20% decrease in tumor maximal diameter, corresponding to partial response according to RECIST (36 % mean overall response). Most patients had a CP class B (score of 6) at presentation, which did not significantly change over time (p=0.1). Median survival for the entire group was 20.25 months.

Patients treated with the aforementioned standardized TACE and follow-up protocol showed durable survival, stable liver disease and effective tumor control.

By reporting our significant experience with a standardized TACE protocol, we attempt to standardize the procedure worldwide and maximize clinical outcome

Liapi, E, Lee, K, Hong, K, Georgiades, C, Kamel, I, Geschwind, J, Chemoembolization of Hepatocellular Carcinoma with a Standardized Treatment and Follow-up Protocol: Survival, Clinical, and Tumor Control Outcome over 11 Years at a Single Center.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/7122110.html