TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION IN THE TREATMENT OF PATIENTS WITH HEPATOCELLULAR CARCINOMA ON ADVANCED LIVER CIRRHOSIS

OBJECTIVE was to evaluate the results of transcatheter arterial chemoembolization (TACE) in the treatment of patients with hepatocellular carcinoma (HCC) on advanced liver cirrhosis (LC) and intermediate stage (B) according to BCLC classification (Barcelona Clinic Liver Cancer classification).

METHODS AND MATERIALS. We evaluated results of TACE in 54 patients. Of them, 12 (22 %) had stage A of cirrhosis and 42 (78 %) – stage B of cirrhosis according to the Child-Pugh score. Nine (17 %) patients matched stage A4 and 45 (83 %) – stage В according to BCLC classification. The TACEs was performed according to the conventional practice with using Lipiodol + gelfoam (n=40) and with a drug-eluting beads (n=14) from 1 to 16 (average 6) times. The Doxorubicin was used as a first-line therapy in all cases.

RESULTS. After TACE, two patients died of liver failure (3.7 %). According to the m-RECIST, complete response to treatment was observed in 9 (16.5 %), partial response – in 13 (24 %), stabilization – in 19 (35.5 %) and progression – in 13 (24 %) patients. At present, 22 (41 %) patients are alive for 1 to 51 (average 16.2) months. 32 patients (59 %) died between 2 to 62 months: 13 (24 %) – from HCC progression, 19 (35 %) – from liver failure. The 1– 2–3-year survival rate was 75–44–15 %; only one patient survived > 5 years. The median survival rate was (22.0±3.0) months, overall survival rate according to Kaplan – Meier was 26 months.

CONCLUSION. TACE is a relatively safe and effective treatment in patients with HCC on advanced LC and intermediate stage (B). 

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