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Radiological Response and Characteristics of Patients Diagnosed With Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: An Observational Study

Year: 2025

Type: article

Abstract: Introduction: Hepatocellular carcinoma (HCC), commonly associated with cirrhosis and factors such as viral hepatitis and metabolic disorders, is often diagnosed at advanced stages, influencing survival. Transarterial chemoembolization (TACE) is a primary therapeutic approach aimed at prolonging survival or serving as a link to liver transplantation. Objective: To identify factors associated with the response to TACE by modified Response Evaluation Criteria in Solid Tumors (mRECIST) in patients with HCC. Materials and Methods: This is a retrospective cohort study conducted at a Liver Institute in Brazil, including patients with HCC at Stages A and B treated with TACE from January 2011 to December 2021. Data were collected from electronic or digitized physical medical records and included demographic, clinical–laboratory, and tumor‐related variables. Radiological response was assessed using mRECIST criteria. Statistical analysis encompassed various tests, with a significance level of 5%. Results: Seventy‐six patients were evaluated, the majority being male (67.1%), with a median age of 62 years (57.0–70.0). Patients who responded to TACE showed a significant reduction in lesion size ( p < 0.001) compared to the nonresponding group, resulting in lesion enlargement ( p = 0.047). Only 38.2% of patients showed an objective response after the first TACE, with a trend towards a higher response in patients with stable disease ( p < 0.001). Hepatitis C virus (HCV) etiology was associated with a higher chance of treatment response ( p = 0.032). Initial disease staging was characterized by single tumors, while intermediate staging presented larger tumors after TACE. Conclusion: The association between HCV‐induced cirrhosis and a better response to TACE underscores the importance of assessing liver function status in determining therapeutic response. No association was identified between pre‐TACE alpha‐fetoprotein levels and a higher likelihood of radiological response.

Source: International Journal of Hepatology

DOI: 10.1155/ijh/5821839