Results of Transarterial Chemoembolization in Treatment of Primary and Metastatic Liver Cancer: Clinical Assessment

Introduction. Hepatocellular carcinoma is the third leading cause of cancer death worldwide with an extremely low five-year survival rate (20.3%) and colorectal cancer liver metastases accounting for significant 10–20% of all secondary tumors. Transarterial chemoembolization (TACE) represents a standard method of local palliative treatment; however, after the procedure, a stable hypoxic environment is formed contributing to aggressive relapses and further progression of the disease. The present study aims to assess the clinical efficacy and safety of TACE in patients with primary and metastatic liver cancer. Materials and methods. A retrospective analysis is conducted for 333 patients (181 men, 152 women) aged 19 to 83 years (mean age of 60.1 ± 0.55 years) treated at the National Medical Research Center for Oncology (Rostov-on-Don, Russian Federation). A total of 93 patients are diagnosed with hepatocellular carcinoma (ICD-10 C22.0); 240 have colorectal cancer metastases to the liver (ICD-10 C78.7). All underwent the TACE procedure. Two-year survival is analyzed using life tables, Kaplan-Meier method and Cox regression analysis to examine risk factors. Statistical analysis is performed using the Statistica 10 software. Results and discussion. During two years of observation, 61.9% of patients died; the overall survival rate is 38.1%. The highest risk of death was observed in the first two months after TACE, remaining high until the eighth month. A Kaplan-Meier analysis shows a significant reduction in survival after five months. Risk factors include disease stage, tumor morphology and patient gender: metastatic disease and male gender were associated with lower survival. Conclusion. Overall survival after TACE remains low, especially in the first months. The identified risk factors can be used for more accurate identification of high-risk groups to optimize combined therapy and develop more effective treatment strategies.

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