Survival in unresectable AJCC stage I and II HCC and the effect of DEB-TACE: SEER versus tertiary cancer center cohort study

J Comp Eff Res. 2016 Mar;5(2):141-54. doi: 10.2217/cer.15.54. Epub 2016 Mar 7.

Abstract

Aim: To evaluate overall survival (OS) in unresectable American Joint Committee on Cancer (AJCC) stage I/II hepatocellular carcinoma (HCC) treated with drug-eluting-bead transarterial chemoembolization (DEB-TACE) versus best supportive care.

Materials & methods: OS in consecutive patients with AJCC stage I/II unresectable HCC diagnosed in 2005-2010 who underwent DEB-TACE and similar patients from SEER with no surgery/radiation recommended/performed was evaluated.

Results: Median OS from HCC diagnosis was 28.9 months (DEB-TACE) versus 10.0 months (SEER), p < 0.0001. Median OS was 36.3 months (DEB-TACE) versus 12.0 months (SEER) in AJCC I, and 27.9 months (DEB-TACE) versus 10.0 months (SEER) in AJCC II, p < 0.0001. Significant independent prognostic factors for OS were single primary tumor, no vascular invasion, normal α-fetoprotein and DEB-TACE.

Conclusion: DEB-TACE in patients with unresectable AJCC stage I/II HCC was a significant independent prognostic factor for greater OS in a population-based study.

Keywords: AJCC staging; SEER; chemoembolization; drug-eluting-bead transarterial chemoembolization; hepatocellular carcinoma; locoregional therapy.

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods*
  • Cohort Studies
  • Female
  • Humans
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • SEER Program / statistics & numerical data*
  • Severity of Illness Index
  • Survival Analysis
  • Tertiary Care Centers / statistics & numerical data
  • Treatment Outcome
  • United States / epidemiology