Koichiro Yamakado MD, PhD, Presenter: Nothing to Disclose

Shiro Miyayama, Abstract Co-Author: Nothing to Disclose

Shozo Hirota MD, Abstract Co-Author: Nothing to Disclose

Kimiyoshi I. Mizunuma MD, Abstract Co-Author: Nothing to Disclose

Kenji Nakamura MD, Abstract Co-Author: Nothing to Disclose

Yoshitaka Inaba MD, Abstract Co-Author: Nothing to Disclose

Takeshi Aramaki, Abstract Co-Author: Nothing to Disclose

Kunihiro Matsuo, Abstract Co-Author: Nothing to Disclose

Norifumi Nishida, Abstract Co-Author: Nothing to Disclose

Hiroshi Anai MD, PhD, Abstract Co-Author: Nothing to Disclose

Hideo Gobara MD, Abstract Co-Author: Nothing to Disclose

Shinichi Koura, Abstract Co-Author: Nothing to Disclose

Osamu Ikeda MD, Abstract Co-Author: Nothing to Disclose

Tetsuya Minami MD, Abstract Co-Author: Nothing to Disclose

Daisuke Abo MD, Abstract Co-Author: Nothing to Disclose

Keigo Osuga MD, Abstract Co-Author: Nothing to Disclose

Yoshito Takeuchi MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kotake, Abstract Co-Author: Nothing to Disclose

Hiroyuki Morishita MD, Abstract Co-Author: Nothing to Disclose

Yasuhiro Hata MD, Abstract Co-Author: Nothing to Disclose

Fumikiyo Ganaha MD, Abstract Co-Author: Nothing to Disclose

Shigeo Oikawa, Abstract Co-Author: Nothing to Disclose

Hitoshi Ito MD, Abstract Co-Author: Nothing to Disclose

Sachio Kuribayashi MD, Abstract Co-Author: Research grant, General Electric Company

Manabu Watanabe, Abstract Co-Author: Nothing to Disclose

Hiroki Okada MD, Abstract Co-Author: Nothing to Disclose

Kazuhiko Ueda MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Nobata, Abstract Co-Author: Nothing to Disclose

Takeshi Kobayashi, Abstract Co-Author: Nothing to Disclose

Mika Kamiya MD, Abstract Co-Author: Nothing to Disclose

Taku Yasumot, Abstract Co-Author: Nothing to Disclose

Michio Yamasaki MD, Abstract Co-Author: Nothing to Disclose

Masato Yamaguchi MD, PhD, Abstract Co-Author: Nothing to Disclose

Hideaki Kakizawa, Abstract Co-Author: Nothing to Disclose

Akira Naito MD, Abstract Co-Author: Nothing to Disclose

Takeshi Hashimoto MD, Abstract Co-Author: Nothing to Disclose

Norihisa Nitta MD, Abstract Co-Author: Nothing to Disclose

Yoichiro Kuwata MD, Abstract Co-Author: Nothing to Disclose

Yasutaka Baba MD, Abstract Co-Author: Nothing to Disclose

Hiromu Mori MD, Abstract Co-Author: Nothing to Disclose

To retrospectively evaluate whether technical factors of hepatic arterial embolization affects prognosis in patients with hepatocellular carcinoma (HCC).

An IRB-approval for this study was obtained in each institution. Inclusion criteria of this study were as follows; a) patients who received embolization as the initial treatment in 2003-2004, b) Child A or B liver profile, c) 7 or less HCCs with a maximum diameter of 10cm or smaller, and d) no extrahepatic metastases. Patients’ data were gathered from 34 training centers accredited by Japanese Society of Interventional Radiology. Prognostic factors were evaluated using univariate and multivariate analyses.

Seven-hundred and thirty-one patients were enrolled; there were 476 men (65.1%) and 255 women (34.9%) with a mean age of 68.9+/-8.4 years (range, 40-91 years). The mean maximum tumor diameter was 3.5cm +/- 1.9 (range, 0.5-10.0 cm). The tumor number was single in 377 patients (51.6%) and portal venous invasion was found in 34 patients (4.7%). Embolization was done using gelatin sponge in all patients (100%), anticancer drug in 724 patients (99.0%), and iodized-oil in 720 patients (98.5%). Selective embolization was performed in 607 patients (83.0%). During the mean follow-up of 37.0 months, 1798 embolization sessions were performed with a mean of 3.2 per patient (range, 1-10). The 1-, 3-, 5-, and 7-year overall survival rates were 90.9% (95%CI, 88.8-93.1%), 59.6% (95%CI, 55.6-63.6%), 36.9% (95%CI, 32.7-41.1%), and 25.8% (95%CI, 21.5-30.0%) in all patients. The univariate analysis showed Child-Pugh class-A, alpha-fetoprotein level lower than 100 ng/ml, tumor size of 3 cm or smaller, single tumor, one-lobe tumor distribution, nodular tumor-type, stage-1 or -2, no portal venous invasion, and selective embolization are better prognostic factors. In the multivariate Cox model, the survival benefit of selective embolization remained significant (hazard ratio, 0.77; 95%CI, 0.34-0.91, p=0.0327).

Selective embolization contributes to survival in patients with unresectable HCCs.

This study have shown that technical factor (selective embolization) maters to improve survival of patients with unresectable HCCs.

Yamakado, K, Miyayama, S, Hirota, S, Mizunuma, K, Nakamura, K, Inaba, Y, Aramaki, T, Matsuo, K, Nishida, N, Anai, H, Gobara, H, Koura, S, Ikeda, O, Minami, T, Abo, D, Osuga, K, Takeuchi, Y, Kotake, H, Morishita, H, Hata, Y, Ganaha, F, Oikawa, S, Ito, H, Kuribayashi, S, Watanabe, M, Okada, H, Ueda, K, Nobata, H, Kobayashi, T, Kamiya, M, Yasumot, T, Yamasaki, M, Yamaguchi, M, Kakizawa, H, Naito, A, Hashimoto, T, Nitta, N, Kuwata, Y, Baba, Y, Mori, H, Hepatic Arterial Embolization for Unresectable Hepatocellular Carcinomas: Do Technical Factors Affect Patients' Survival?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11020036.html