ArticlePloS one2019
Hepatocellular carcinoma with extrahepatic metastasis: Are there still candidates for transarterial chemoembolization as an initial treatment?
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Clinical and molecular hepatology · 2022Guideline
- Low Tumor Burden Predicts Benefit from Transarterial Treatment in Hepatocellular Carcinoma with Extrahepatic Metastasis: A Nationwide Cohort Study.Liver cancer · 2026Article
- Combining Transarterial Chemoembolization with Sorafenib Improves Survival in Selected Patients with Hepatocellular Carcinoma and Extrahepatic Spread: A Multicenter Real-World Study.Journal of hepatocellular carcinoma · 2025Article
- Development and Validation of a Radiomics Nomogram Based on Magnetic Resonance Imaging and Clinicoradiological Factors to Predict HCC TACE Refractoriness.Cancer management and research · 2025Article
- Role of transarterial chemoembolization for hepatocellular carcinoma with extrahepatic metastases in the era of advancing systemic therapy.Journal of liver cancer · 2024Article
- Anticancer Potential of Natural Chalcones: In Vitro and In Vivo Evidence.International journal of molecular sciences · 2023Review
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Journal of liver cancer · 2023Review
- Restratification of Advanced Hepatocellular Carcinoma to Identify Patients Sensitive to Transarterial Chemoembolization.Radiology · 2023Article
- 2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma.Korean journal of radiology · 2022Review
- Transarterial chemoembolization failure/refractoriness: A scientific concept or pseudo-proposition.World journal of gastrointestinal surgery · 2022Review
- Plasma arginase-1 as a predictive marker for early transarterial chemoembolization refractoriness in unresectable hepatocellular carcinoma.Frontiers in oncology · 2022Article
- Emerging Trends in the Treatment of Advanced Hepatocellular Carcinoma: A Radiological Perspective.Korean journal of radiology · 2021Review
- Efficacy of Local Therapy for Oligometastatic Hepatocellular Carcinoma: A Propensity Score Matched Analysis.Journal of hepatocellular carcinoma · 2021Article
- Article
- Role of VEGFs/VEGFR-1 Signaling and its Inhibition in Modulating Tumor Invasion: Experimental Evidence in Different Metastatic Cancer Models.International journal of molecular sciences · 2020Review
- Fairly rare small-diameter hepatocellular carcinoma with right adrenal gland metastasis having an inferior vena cava tumor thrombus: a case report.Surgical case reports · 2019Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimCurrently, sorafenib is indicated for hepatocellular carcinoma (HCC) with extrahepatic metastasis (EHM), and many other systemic agents are becoming available. However, a few HCC patients with EHM still undergo transarterial chemoembolization (TACE) for intrahepatic tumor control. We aimed to investigate whether TACE is appropriate for patients with EHM, and if so, which subgroup may benefit from TACE.
methodsA total of 186 consecutive HCC patients (median: 55 years, male: 86.0%, hepatitis B virus: 81.7%, Child-Pugh Class A: 83.3%) with EHM (nodal metastasis: 60.8%, distant metastasis: 39.2%) between 2010 and 2014 were analyzed. Initial treatment included sorafenib in 69 patients, and TACE in 117 patients.
resultsDuring a median follow-up of 6.6 months (range: 0.2-94.6 months), mortality was observed in 90.3% (168/186). The median survival was better for patients who received TACE than those treated with sorafenib (8.2 months vs. 4.6 months, p < 0.001). However, baseline characteristics varied between patients initially treated with TACE and sorafenib, and the treatment modality was not an independent factor associated with overall survival (hazard ratio: 1.19, 95% confidence interval: 0.81-1.75, p = 0.36). In sub-group analysis, TACE was associated with better survival only among younger patients and those with segmental/lobar portal vein invasion.
conclusionIn HCC patients with EHM, TACE was not an independent favorable prognostic factor compared to sorafenib. The concept of intrahepatic control in HCC patients with EHM may need to be reevaluated in the era of promising systemic therapies, although there can be specific subgroups who still benefit from TACE.
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