Patient Demographics
The most common aetiology for liver cirrhosis is alcoholic liver disease followed by hepatitis. 83% of the patients were in the child A or B category. No significant difference in age, gender, aetiology , Child-Pugh status, performance status and the number of repeat TACE was demonstrated between the responder and non-responder group. (Figure 4)
Fig. 4
References: Department of Radiology, Queen Elizabeth University Hospital, Glasgow 2020
Tumour Necrosis
Patients were more likely to be responders (81%) compared to non-responders (19%). Individual response rates showed the most common response to be a partial success (60%) followed by complete success (21%) and then stable disease (12%). The least frequent response was progressive disease. (7%) (Figure 5)
Fig. 5
References: Department of Radiology, Queen Elizabeth University Hospital, Glasgow 2020
Survival Outcomes
Kaplan-Meier curves were constructed for both dichotomised and mRECIST criteria. Median survival was better in the responder group compared to the non-responder group (681 days versus 338 days, P < 0.001) (Figure 6)
Fig. 6
References: Department of Radiology, Queen Elizabeth University Hospital, Glasgow 2020
Patient survival varied greatly according to mRECIST criteria. Patients with a complete response had the longest median survival (822 days), followed by the partial response group (568 days). Stable disease response was third (518 days) and progressive disease was the worse survival (309 days). This was shown to be statistically significant in Kaplan Meier analysis (P = 0.001). (Figure 7)
Fig. 7
References: Department of Radiology, Queen Elizabeth University Hospital, Glasgow 2020
Multivariate analysis of patient and HCC tumour predictors showed higher Child-Pugh status and alpha-Feto Protein (AFP) >10 to be significantly associated with poorer post TACE survival. Poor performance status was associated with poorer survival but this was not statistically significant. (Figure 8)
Fig. 8
References: Department of Radiology, Queen Elizabeth University Hospital, Glasgow 2020