Transarterial chemoembolization in the intermediate stage of hepatocellular carcinoma: survival analysis

Hepatocellular carcinoma is the most common primary tumor pathology of the liver (> 85%), an aggressive course with an unfavorable prognosis. Objective: to elucidate the survival of various categories of patients with hepatocellular carcinoma in stage B hepatocellular carcinoma after transarterial chemoembolization.
The study was conducted on the basis of the JSC “National Scientific Center of Surgery” named after A.N. Syzganov in the period 2013-2018. When analyzing survival, patients were divided into the following categories: gender, age, degree of liver function damage according to Child-Pugh scale, the presence of viral hepatitis B and C, and the level of alpha-fetoprotein.
The average age of the patients was 60.4 years. The follow-up period was 2-64 months. The average length of stay of the patients studied in the hospital was 7.2 days. In patients older than 60 and 70 years, the 3-years and 5-years survival rates were 0%, the 1-year survival rate of the subjects studied in the group over 70 years of age was 14.3%. The one-year survival after transarterial chemoembolization in the total cohort left 42%, 2-years - 15% and 3-years - 5%, respectively. The survival rate among patients with
cirrhosis of stage B on the Chile-Pugh scale was significantly lower than that of stage A patients (82% vs 56% for 6 months and 50% vs 31% for a year, respectively). In the group, a substantial increase of alphafetoprotein (>1000 IU/ml), the Kaplan-Meier survival curve showed a survival rate of 0% 18 months after the first transarterial chemoembolization.
Transarterial chemoembolization showed good results in the group among women, and the life expectancy was higher in the middle-age group (50-59 years). Adult age, a high degree of liver dysfunction, as well as high alpha-fetoprotein values are additional factors that dramatically reduce the life expectancy of patients after transarterial chemoembolization with hepatocellular carcinoma hepatocellular carcinoma in stage B.