Transcatheter arterial embolisation versus no treatment in cirrhotic patients with hepatocellular carcinoma: a retrospective comparative study

To evaluate the effectiveness of transcatheter arterial embolisation (TAE) as a treatment of hepatocellular carcinoma (HCC) complicating cirrhosis, the survival of 27 untreated patients and 57 TAE-treated patients was compared. Clinical features, laboratory findings and tumour stage were comparable in the two groups of patients. TAE was undertaken with epirubicin, iodised oil and gelatine esponge. Cumulative survival rates at 6, 12, 24 and 36 months were 0.59, 0.47, 0.17 and 0.08 in the untreated group, and 0.87, 0.75, 0.40 and 0.19 in the TAE-treated group (P = 0.01). Patients with Child's grade B cirrhosis and patients with tumour smaller than 25% of the liver volume responded better to TAE. Twenty-four untreated patients and 25 TAE-treated patients died during the follow-up. The complication rate and mortality rate of TAE were 28% and 1.7% respectively. TAE prolongs the survival of patients with HCC complicating cirrhosis; prognosis depends on tumour stage and the degree of hepatic function impairment.