Hepatic Cancer
Conditions
Brief summary
Hepatic dysfunction limits the therapeutic options for hepatocellular carcinoma (HCC), which is closely associated with patient prognosis. Established practice guidelines for patients with HCC and impaired liver function are lacking. The treatment allocation in these populations is heterogeneous and remains controversial. This study compared the survival benefits of liver resection (LR) and transarterial chemoembolisation (TACE) in patients with HCC and impaired liver function.
Interventions
Before TACE, hepatic arteriography was performed to evaluate the vascular anatomy and tumour vascularity. During TACE, a vascular catheter was selectively inserted into the tumour-feeding artery with an injection containing a mixture of doxorubicin (10-50 mg) and lipiodol (2-20 mL), followed by embolisation using gelatin sponge particles. TACE was repeated when residual viable tumours were confirmed or new lesions developed in patients with adequate liver function. Laboratory assessments were performed every four to six weeks. Radiological evaluation using contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) was recommended during weeks 4 and 8 after treatment and every 8 weeks thereafter. However, in clinical practice, the intensity of follow-up depends on an individual's baseline characteristics and response to the last treatment.
Sponsors
Study design
Eligibility
Inclusion criteria
* patients with HCC who received conventional LR or TACE
Exclusion criteria
* (1) presence of portal vein tumour thrombosis (PVTT), hepatic artery, biliary duct or inferior vena cava invasion * (2) extrahepatic spread (EHS) * (3) albumin-bilirubin grade 1 or 3 * (4) Eastern Cooperative Oncology Group Performance Status (ECOG-PS) \>1 * (5) tumour number \>3 * (6) other tumours or severe cardiac, cerebral, and renal insufficiency * (7)ascites, hepatic encephalopathy, and jaundice
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| overall survival | 5 year | The overall survival rate at 5 years |
Countries
China