UCL logo

UCL Discovery

UCL home » Library Services » Electronic resources » UCL Discovery

Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies.

Marelli, L; Stigliano, R; Triantos, C; Senzolo, M; Cholongitas, E; Davies, N; Yu, D; (2006) Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies. Cancer Treat Rev , 32 (8) pp. 594-606. 10.1016/j.ctrv.2006.08.002.

Full text not available from this repository.

Abstract

BACKGROUND: Although transarterial chemoembolization (TACE) improves survival in patients with hepatocellular carcinoma (HCC), it is not known if TACE combined with other treatments is beneficial. AIM: To evaluate the evidence for improved outcomes in HCC with a multimodal treatment approach involving TACE. METHOD: PubMed search for all cohort and randomized trials (n=84) evaluating TACE combined with other therapies; meta-analysis performed where appropriate. RESULTS: A meta-analysis involving 4 RCTs showed a significant decrease in mortality favouring combination treatment (TACE plus percutaneous ablation) compared to monotherapy in patients with either small (<3cm) or large HCC nodules (>3cm) (OR, 0.534; 95% CI, 0.288-0.990; p=0.046). TACE combined with local radiotherapy improved survival in patients with tumour thrombosis of the portal vein in 7 non-randomized studies. Two RCTs and 13 non-randomized studies showed that TACE prior to hepatic resection does not improve survival nor tumour recurrence. Conversely, 2 RCTs and 5 comparative studies showed that transarterial injection of chemotherapeutic drugs mixed with lipiodol (TOCE) following hepatectomy confers survival benefit and less tumour recurrence. TACE before liver transplantation is safe and reduces drop-out rate from the waiting list, but there is no current evidence of improvement in subsequent survival or recurrence rate. CONCLUSIONS: A combined approach involving TACE and percutaneous ablation improves survival. Adjuvant TOCE improves outcome after hepatectomy. TACE is useful to control tumours burden while on the waiting list for OLT. Multimodal treatment seems to be the best way to optimize TACE outcomes in HCC.

Type: Article
Title: Treatment outcomes for hepatocellular carcinoma using chemoembolization in combination with other therapies.
Location: England
DOI: 10.1016/j.ctrv.2006.08.002
Keywords: Antineoplastic Combined Chemotherapy Protocols, Arteries, Carcinoma, Hepatocellular, Chemoembolization, Therapeutic, Chemotherapy, Adjuvant, Combined Modality Therapy, Humans, Liver Neoplasms, Radiotherapy, Adjuvant, Randomized Controlled Trials as Topic, Survival Analysis, Treatment Outcome
UCL classification: UCL > School of Life and Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Medicine (Division of)
URI: http://discovery.ucl.ac.uk/id/eprint/493670
Downloads since deposit
0Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item