In a univariate analysis using Cox’s proportional hazards model, serum total bilirubin,

the serum level of protein induced by vitamin K absence/antagonist-II (≤100 vs ≥101 mAU/mL), tumor morphology (pattern 1 vs 2) and tumor number (≤3 vs ≥4) showed statistical significance (≤0.05). In a multivariate analysis of these factors, morphology and tumor number showed significance. According to Kaplan–Meier estimation, the cumulative disease-free survival rates were significantly lower in patients click here with four or more lesions than in those with three or less lesions and in patients showing pattern 2 than in those showing pattern 1. Patients with pattern 2 hepatocellular carcinoma and/or four or more lesions may have a relatively high recurrence rate after transarterial chemoembolization. HEPATOCELLULAR CARCINOMA (HCC) is the fifth and seventh most common

cause of cancer-related deaths in men and women, respectively, worldwide.[1] Therefore, establishing an effective treatment strategy is important. Currently, the main treatments for cure include hepatectomy and percutaneous radiofrequency ablation (RFA), and those for palliation in cases of incurable HCC include transarterial chemoembolization (TACE).[2] For advanced HCC, none of these treatments is indicated, but sorafenib, a small-molecule inhibitor of various kinases, has been Epacadostat datasheet reported to be effective.[3] TACE is indicated for moderately advanced HCC when hepatectomy or RFA is unlikely to be effective.[2, 4] The role of TACE in improving patient survival was initially debated; however, many subsequent randomized controlled trials

have proven its effectiveness. Thus, TACE is now commonly used in the clinical setting.[5, 6] However, because a 5-year survival rate of less than 50% is achieved with TACE, improvements in this methodology are definitely warranted.[4] One of the most common setbacks in achieving better HCC treatment outcomes are the high post-treatment recurrence rates. Post-treatment recurrence often requires retreatment, but repeating triclocarban TACE at short intervals is associated with a high risk of low hepatic functional reserve.[4-7] Therefore, identifying factors that contribute to high post-treatment recurrence rates is important for establishing an effective treatment strategy. In HCC, both treatment selection and patient outcomes are determined by tumor progression and hepatic functional reserve.[8-11] Hepatocellular carcinoma is known to demonstrate various morphological appearances.[12] Kanai et al.[13] classified the nodular type of HCC into three categories depending on gross appearance, in accordance with the clinicopathological features: simple nodular (SN) type, simple nodular type with extranodular growth (SNEG) and confluent multinodular (CM) type.