• Man Fung Yuen, Annie On-On Chan, Benjamin Chun-Yu Wong, Chee Kin Hui, Gaik Cheng Ooi, Wai Kuen Tso, He Jun Yuan, Danny Ka-Ho Wong, and Ching Lung Lai.
• Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
• Am. J. Gastroenterol. 2003 May 1; 98 (5): 1181-5.

ObjectiveThe efficacy of transarterial chemoembolization (TACE) in prolongation of survival is controversial. We conducted a comparative study to determine whether TACE treatment had any survival benefit for patients with unresectable hepatocellular carcinoma (HCC) and with relatively preserved liver function.MethodsIn all, 96 patients with unresectable HCC of Okuda stage I or II and Child-Pugh grade A or B were recruited. A total of 80 patients (group 1) who received TACE were compared to 16 patients (group 2) who were treated conservatively.ResultsThe median survival time of group 1 patients was significantly longer than that of group 2 patients (31.2 vs 14.1 months respectively, p = 0.0126). The cumulative survival rates at 6 months, 1 yr, 2 yr, 3 yr, and 4 yr of group 1 compared to group 2 were as follows: 93.8% versus 62.5% (p = 0.002); 86.3% versus 62.5% (p = 0.023); 78.8% versus 50% (p = 0.017); 57.5% versus 50% (p = ns); and 51.3% versus 43.8% (p = ns), respectively. Tumor response was observed in 28% of patients receiving TACE. Patients with higher pretreatment albumin levels, lower pretreatment alpha-fetoprotein levels, and Okuda stage I disease were associated with a favorable response to TACE.ConclusionTACE treatment improved survival in patients with unresectable HCC in the early stages and with relatively preserved liver function.

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