Evolving strategies for the management of intermediate-stage hepatocellular carcinoma: available evidence and expert opinion on the use of transarterial chemoembolization. EASL-EORTC Clinical Practice Guidelines: management of hepatocellular carcinoma.
2013 108:1252–1259.Įuropean Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer.
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A randomised phase II/III trial of 3-weekly cisplatin-based sequential transarterial chemoembolisation vs embolisation alone for hepatocellular carcinoma. Systematic review of randomized trials for unresectable hepatocellular carcinoma: Chemoembolization improves survival. Out of the four double-blind randomized clinical trials, one study showed no significant difference in clinical attachment level, CI or probing pocket depth with treatment with. The HAP score predicts outcomes in patients with HCC undergoing TACE/TAE and may help guide treatment selection, allow stratification in clinical trials and facilitate meaningful comparisons across reported series. The majority of clinical trials investigated the effect of propolis, and one of the clinical trials investigated the effect of raw honey in periodontitis treatment. The HAP score validated well with the independent dataset and performed better than other scoring systems in differentiating high- and low-risk groups. The median survival for the groups A, B, C and D was 27.6, 18.5, 9.0 and 3.6 months, respectively. Patients were divided into four risk groups based on their HAP scores HAP A, B, C and D (scores 0, 1, 2 and >2, respectively). The Hepatoma arterial-embolisation prognostic (HAP) score was calculated by summing these points. Patients were assigned one point if albumin 17 μmol/l, AFP >400 ng/ml or size of dominant tumour >7 cm. Low albumin, high bilirubin or α-fetoprotein (AFP) and large tumour size were associated with a two- to threefold increase in the risk of death. A simple prognostic score (PS) was developed, validated using an independent dataset of 167 patients and compared with Child-Pugh, CLIP, Okuda, Barcelona Clinic Liver Cancer (BCLC) and MELD. We carried out Cox regression analysis of prognostic factors using a training dataset of 114 patients treated with TACE/TAE. The prognosis for patients with hepatocellular cancer (HCC) undergoing transarterial therapy (TACE/TAE) is variable.
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