Simple method with tumor markers for predicting prognosis following transcatheter arterial chemo-embolization for switching to next therapy in intermediate hepatocellular carcinoma: Multi-center analysis

Abstract

Background/Aim: Although definition of transcatheter arterial chemo-emblization (TACE) refractory in hepatocellular carcinoma (HCC) has been proposed, a criterion for switching TACE to next therapy has not been established clinically. We estimate tumor marker score, which has been proposed for predicting prognosis of HCC treated with TACE. Method: From 2000 to 2015, 183 naïve intermediate-stage HCC patients with Child-Pugh A were enrolled. AFP (≥100 ng/mL; HR 1.515; P=0.033), AFP-L3 (≥10%; HR 1.510; P=0.039), and PIVKA-II (≥100 mAU/mL; HR 1.676; P=0.009) for the score were significant prognostic factors by Cox-hazard multivariate analysis. Median survival time (MST) of patients with score 2 or more were shorter than the others (19.4 vs. 48.8 months, P<0.001). MST after twice TACE was shorter in patients, who showed PR or SD by imaging evaluation, with score 2 or more than the others (14.0 vs. 43.0 months, P<0.001). Conclusion: In patients with score 2 or more, next therapy should be considered even if therapeutic response is thought to be PR or SD after twice TACE.