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Prospective Multi-Center Korean Registry of Transcatheter Arterial Chemoembolization with Drug-Eluting Embolics for Nodular Hepatocellular Carcinoma: A Two-Year Outcome Analysis

 Myungsu Lee  ;  Jin Wook Chung  ;  Kwang-Hun Lee  ;  Jong Yun Won  ;  Ho Jong Chun  ;  Han Chu Lee  ;  Jin Hyoung Kim  ;  In Joon Lee  ;  Saebeom Hur  ;  Hyo-Cheol Kim  ;  Yoon Jun Kim  ;  Gyoung Min Kim  ;  Seung-Moon Joo  ;  Jung Suk Oh 
 KOREAN JOURNAL OF RADIOLOGY, Vol.22(10) : 1658-1670, 2021-10 
Journal Title
Issue Date
Carcinoma, Hepatocellular* / drug therapy ; Chemoembolization, Therapeutic* ; Doxorubicin ; Humans ; Liver Neoplasms* / drug therapy ; Pharmaceutical Preparations* ; Prospective Studies ; Registries ; Republic of Korea / epidemiology ; Retrospective Studies ; Treatment Outcome
Chemoembolization ; Drug-eluting beads ; Drug-eluting embolics ; Hepatocellular carcinoma
Objective: To assess the two-year treatment outcomes of chemoembolization with drug-eluting embolics (DEE) for nodular hepatocellular carcinoma (HCC).

Materials and methods: This study was a prospective, multicenter, registry-based, single-arm trial conducted at five university hospitals in Korea. Patients were recruited between May 2011 and April 2013, with a target population of 200. A DC Bead loaded with doxorubicin was used as the DEE agent. Patients were followed up for two years. Per-patient and per-lesion tumor response analysis, per-patient overall survival (OS) and progression-free survival (PFS) analysis, and per-lesion tumor control analysis were performed.

Results: The final study population included 152 patients, with 207 target lesions for the per-lesion analysis. At one-month, six-month, one-year, and two-year per-patient assessments, complete response (CR) rates were 40.1%, 43.0%, 33.3%, and 19.6%, respectively. The objective response (OR) rates were 91.4%, 55.4%, 35.1%, and 19.6%, respectively. The cumulative two-year OS rate was 79.7%. The cumulative two-year PFS rate was 22.4% and the median survival was 9.3 months. In multivariable analysis, the Child-Pugh score (p = 0.019) was an independent predictor of OS, and tumor multiplicity (p < 0.001), tumor size (p = 0.020), and Child-Pugh score (p = 0.006) were independent predictors of PFS. In per-lesion analysis, one-month, six-month, one-year and two-year CR rates were 57.5%, 58.5%, 45.2%, and 33.3%, respectively, and the OR rates were 84.1%, 65.2%, 46.6%, and 33.3%, respectively. The cumulative two-year per-lesion tumor control rate was 36.2%, and the median time was 14.1 months. The Child-Pugh score (p < 0.001) was the only independent predictor of tumor control. Serious adverse events were reported in 11 patients (7.2%).

Conclusion: DEE chemoembolization for nodular HCCs in the Korean population showed acceptable survival, tumor response, and safety profiles after a two-year follow-up. Good liver function (Child-Pugh score A5) was a key predictor of per-patient OS, PFS, and per-lesion tumor control.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Joo, Seung Moon(주승문) ORCID logo https://orcid.org/0000-0002-0647-2880
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