Is there a survival benefit in interventional radiology for hepatocellular carcinoma in patients with Child-Pugh C liver cirrhosis?: A multicenter study

Aim: A lack of donors in liver transplantation (LT) for hepatocellular carcinoma (HCC) has become a big issue. There is no consensus regarding whether interventional radiology for HCC in patientswith Child-Pugh C liver cirrhosis will improve prognosis. To elucidate the effectiveness of such treatment, we evaluated the clinical features of affected patients. Methods: Patients with naive HCC of Child-Pugh C (n=236) were enrolled. Two of them were treated with LT after transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) were used as bridging treatments. After exclusion of a total of three patients who received LT, we evaluated clinical factors related to improved prognosis. Results: The percentage of all patients with total bilirubin of less than 3 mg/dL was 41.1%. The prognosis of patients who were received treatments (n=30; ablative therapy 10, TACE 20) was better than non-treated patients (n=18; mean survival time [ MST] 22.2 vs 13.8months, P=0.021, respectively) in patientswith up to 7 criteria and total bilirubin of less than 3 mg/dL (n=48). On the other hand, there was no difference in prognosis between those who underwent ablative therapies (n=10) and those who received TACE (n=20) (MST 22.2 vs 16.9 months, P=0.390). Conclusion: Therapy for HCC may prolong survival in patients with naive HCC, with up to 7 criteria and total bilirubin of less than 3 mg/dL.