Early response to TACE predictive of survival, extrahepatic metastasis
Patients with hepatocellular carcinoma who experienced early response to treatment had significantly longer overall survival and time to extrahepatic metastasis development in a study presented at the International Liver Cancer Association Annual Conference in Washington, DC.
Researchers evaluated 136 patients with intermediate-stage hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE) at a hospital between January 2005 and May 2011. Overall survival and incidence of extrahepatic metastasis after the initial two TACE sessions was compared between patients with complete and partial response, and between those with stable and progressive disease, during a median follow-up of 23.2 months.
Patients developed extrahepatic metastasis in 33.1% of cases, with a median time to development of 20 months. Treatment-responsive patients had longer median time to development than those who were nonresponsive (25.5 months vs. 5.4 months; P=.02). Overall survival also was longer among treatment responders (32.9 months vs. 7.8 months; P<.0001).
Multivariate analysis indicated that early TACE response was predictive of extrahepatic metastasis (P=.028), as were alpha-fetoprotein levels (P=.022 for more than 200 ng/mL) and tumor size larger than 5 cm (P=.019). Early response to treatment (P=.001) and tumor size (P=.02) also were associated with overall survival.
“Early treatment response to TACE predicts the time to development of extrahepatic metastasis and patient survival times in intermediate-stage HCC patients,” the researchers concluded. “Therefore, if early treatment response is unsatisfactory, one may consider switching into other therapeutic modalities such as combination therapy with sorafenib, for better intrahepatic tumor control. Also, as time to extrahepatic metastasis is shorter in the no early treatment response group, evaluation for extrahepatic metastasis may be carried out in shorter, 6-month intervals in such cases.”
Disclosure: The researchers report no relevant financial disclosures.
For more information:
Lee SW. P-104: Early Treatment Response Predicts the Development of Extrahepatic Metastasis and Overall Survival in Intermediate Stage Hepatocellular Carcinoma. Presented at: The International Liver Cancer Association Annual Conference 2013; Sept. 13-15, Washington, DC.