Unresectable hepatocellular carcinoma: analysis of prognostic factors in transcatheter management.

PURPOSE: To evaluate the effect of transcatheter management of hepatocellular carcinoma (HCC) on survival. MATERIALS AND METHODS: A prospective trial of transcatheter arterial embolization (TAE) was performed in patients with unresectable HCC. Three hundred twenty-two patients (265 men, 57 women; age range, 30-83 years) underwent TAE alone: 60 patients underwent TAE with gelatin sponge (GS) that contained anticancer agents (protocol 1); 78, TAE with GS and iodized oil mixed with anticancer agents (protocol 2); and 159, TAE with iodized oil with anticancer agents (protocol 3). A Cox proportional hazard model was used to analyze prognostic factors. RESULTS: In the randomized group (n = 272), survival rates for protocols 1, 2, and 3 were 80.4%, 86.3%, and 65.9%, respectively, at 1 year. Findings of analysis of prognostic factors showed that extrahepatic metastases, ascites, tumor extension, and icterus were the important factors. CONCLUSION: TAE with GS was superior to TAE without GS. Patient characteristics were important factors for survival.