Impact of Gross Classification on Outcomes of Chemoembolization for Hepatocellular Carcinoma
Abstract
Objective: This study investigated the effect of gross morphological classification, adhering to the Korean Liver Cancer Association (KLCA) guidelines, on chemoembolization efficacy in HCC patients.
Material and Methods: A retrospective analysis was conducted on HCC patients treated with TACE at HRH Princess Maha Chakri Sirindhorn Medical Center between January 2011 and August 2021. Gross morphology was categorized into six types, adapted from the KLCA guidelines: vague nodular (VN), expanding nodular (EN), multinodular confluent (MC), nodular with peri-nodular extension (NP), infiltrative (INF), and cirrhotomimetic (CM). For analysis, these were grouped into three categories: Group 1 (VN and EN), Group 2 (MC and NP), and Group 3 (INF and CM).
Results: A total of 132 patients were included in the study, with 41 (31.0%) in Group 1, 62 (47.0%) in Group 2, and 29 (22.0%) in Group 3. Patients with INF and CM morphology demonstrated the poorest prognosis, with a median survival of 0.87 years and a five-year survival rate of only 6.3%. Univariate analysis and multivariate analysis identified several prognostic factors associated with overall survival, including gross morphology, serum albumin level, and tumor burden.
Conclusion: Gross morphology and tumor burden are key prognostic indicators in patients undergoing TACE for HCC. Assessing gross morphology and tumor burden is essential for determining the suitability of TACE as a treatment option.
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