Comparison of Overall Survival between Transarterial Chemoembolization and Best Supportive Care in Intermediate- Stage Hepatocellular Carcinoma

Document Type : Research Articles


1 Division of Gastroenterology, Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.

2 Department of Internal Medicine, Hatyai Hospital, Songkhla, Thailand.

3 Division of Intervention Radiology, Department of Radiology, Hatyai Hospital, Songkhla, Thailand.


Objective: The Thailand management guideline allows the use of transarterial chemoembolization (TACE) for the treatment of intermediate-stage hepatocellular carcinoma (HCC) in patients with decompensated cirrhosis, whereas other guidelines do not. The aim of this study was to compare the overall survival between TACE and the best supportive care (BSC) in HCC patients with Child–Pugh score 5–8 cirrhosis and in subgroups with compensated cirrhosis (Child–Pugh score 5–6) and early decompensated cirrhosis (Child–Pugh score 7–8). Methods: This retrospective study comprised 118 patients with intermediate-stage HCC. The overall survival was compared between TACE and BSC using the Kaplan–Meier method. Results: The median overall survival time for all patients was 21.4 months in the TACE group and 8.2 months in the BSC group (P <0.001). In the subgroup analyses, the overall survival times for TACE and BSC were 26 months and 9 months, respectively, for compensated cirrhosis (P <0.001), and 14.5 months and 6.9 months, respectively, for early decompensated cirrhosis (P <0.001). In the Cox proportional-hazards model, TACE was an independent prognostic factor for prolonged overall survival in all patients [hazard ratio (HR) 0.29; 95% confidence interval (CI), 0.17–0.49; P <0.001], patients with compensated cirrhosis (HR, 0.31; 95% CI, 0.16–0.62; P <0.001), and patients with early decompensated cirrhosis (HR, 0.16; 95% CI, 0.061–0.44; P <0.001). Conclusion: TACE improves the overall survival in patients with intermediate-stage HCC and compensated or early decompensated cirrhosis.


Main Subjects

Volume 23, Issue 9
September 2022
Pages 3173-3178
  • Receive Date: 14 May 2022
  • Revise Date: 08 July 2022
  • Accept Date: 26 September 2022
  • First Publish Date: 26 September 2022