Shomeeta Mandhwani, Waseem Mehmood Nizamani, Ameet Jesrani.
Outcome of Trans Arterial Chemo Embolization (TACE) in patients with Unresectable Hepatocellular Carcinoma in a Subset of Pakistani Population.
Pak J Radiol May ;27(1):01-8.

PURPOSE: To evaluate the outcome following transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC) secondary to hepatitis B/C in a subset of Pakistani population. SUBJECT AND METHODS: After approval of institutional ethical review committee a prospective study of 81 patients having chronic liver disease secondary to Hepatitis B/C presented with unresectable HCC that referred to the department of interventional radiology of our hospital between January 2012 and December 2013 for TACE. The average age of the patients was 45.05±7.47 years. Out of 81 cases, 40 (49.39%) were male and 41 (50.62%) were female. 64.2% of patients had two tumors and 35.8% had single tumors. Hepatitis B infection was the most common etiological factor of HCC, seen in 59 (72.83%) patients. Regarding the type of Child Pugh?s classification, class A was observed in 49.38% patients and class B was observed in 50.52%. Single TACE was performed in 46 (56.79%) patients and twice in 35 (43.21%) cases. 35 (43.20%) patients have normal values (<20 ng/ml) of AFP. RESULTS: Response of TACE by using triphasic CT imaging in the patients of HCC is complete reduction was observed in 9.08% cases, partial reduction was 58.82% while in 32.1% cases disease was stable. According to operational definition of the study, satisfactory response was observed in 56.79% (46/81). Rate of satisfactory outcome was high in single tumor treatment as compare to multiple tumors (75.9% vs. 46.2%; 0.01). The overall survival rates at 1 and 2 years were 65% and 45%, respectively. Post TACE complications were recorded as postembolization syndrome, deranged renal parameters and hepatic failure in 17.28%, 14.8% and 4.8% respectively. CONCLUSION: TACE has been used extensively in the palliative treatment of unresectable HCC. In our study TACE showed favorable local outcome and the survival rates were comparable with those reported by other international studies.

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