As Barcelona Clinic Liver Cancer (BCLC) staging classification was not

yet standard at the time that several patients had their treatment, we didn’t have all the information to be able to use it as a prognostic score in this study. Values for aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, albumin, International Normalized Ratio (INR) were documented before and after treatment. Patients We identified a cohort of patients at our institution that had a TACE treatment between May 2005 and December 2009. Inclusion criteria were: Inhibitors,research,lifescience,medical age ≥18 years, diagnosis of HCC either proven by biopsy or supported by its radiological features PLX-4720 manufacturer according to American Association for the Study of Liver Disease Inhibitors,research,lifescience,medical (AASLD) guidelines valid at that time (14) and completion of a treatment of chemoembolization.

Exclusion criteria were as follows: a tumour type other than HCC, simultaneous systemic treatment, embolization without chemotherapy, lack of information Inhibitors,research,lifescience,medical about lesion size prior to treatment, lack of biochemical data prior or within five days following treatment. Our cohort included patients for whom TACE had a curative or palliative intent. Chemoembolization was performed by two radiologists (P.P, L.B) trained in interventional radiology and consisted in the infusion of a chemotherapeutic agent following selective catheterisation of a branch Inhibitors,research,lifescience,medical of the hepatic artery feeding the tumour. A larger territory was targeted when the tumour burden was extensive. At no moment treatment aimed both liver lobes Contraindications for the procedure at our institution are: Child-Pugh C, presence of portal vein thrombosis, presence of a large portovenal shunt, Inhibitors,research,lifescience,medical hepatofugal flow and presence of arterioportal fistulae (without prior coil embolization). The chemotherapeutic agent most often

used was cisplatin mixed with lipiodol followed by a embolization with GelFoam particles (Pfizer, Canada). The dose of the chemotherapeutic agent was decided according to the size of the tumour to embolize. Follow-up and response to treatment Measurement of liver biochemistry was performed the day before the chemoembolization and then daily until discharge. At our institution, a contrast enhanced abdominal computed tomography (CT) below scan or liver magnetic resonance imaging (MRI) with gadolinium are performed two months after TACE to evaluate the response to treatment. Accordingly, treatment can be repeated or the patient followed-up with a repeated imaging every 3 months if the initial response was satisfactory. Decision to repeat the treatment is taken in a multidisciplinary tumour board comprised of interventional radiologists, hepatobiliary surgeons and hepatologists.