Risk factors for recurrence of large HCC in patients treated by combined TAE and PEI

Background/Aims: In this report, risk factors of intrahepatic recurrence of a large solitary hepatocellular carcinoma after combination therapy with t ran scatheter arterial embolization followed by percutaneous ethanol inject ion were studied. Methodology: The series included 61 patients with an unresectable large sol itary hepatocellular carcinoma, the largest size of which was greater than 3cm in diameter. All patients completely responded to combination therapy a nd recurrence rates were determined. The following parameters; age, sex, he patitis B virus surface antigen, hepatitis C virus antibodies, Child's clas sification, alcohol abuse, alanine aminotransferase, aspartate aminotransfe rase, alpha -fetaprotein, indocyanine green retention rate, hepatocellular carcinoma size, hepatocellular carcinoma capsule, total amount of injected ethanol and the alpha -fetoprotein 1 month after treatment were evaluated. Results: The 1-, 3-, and 5-year cancer-free survival rates of all patients were calculated to be 61%, 23%, and 13%, respectively. Among pretreatment p arameters, the log-rank test and subsequent Cox's proportional hazards mode l showed that a tuner size of more than 5cm in diameter was independently a ssociated with recurrence. The posttreatment parameters of total amount of injected ethanol was also shown to be significantly related to recurrence b y the log-rank test. Conclusions: Lesions more than 5cm in diameter and insufficient injected et hanol were associated with intrahepatic recurrence after this combination t herapy.