Factors predicting overall response and overall survival in hepatocellular carcinoma patients undergoing balloon‐occluded transcatheter arterial chemoembolization: A retrospective cohort study

Aim This study aimed to investigate the factors predicting overall response and overall survival in hepatocellular carcinoma patients undergoing balloon‐occluded transcatheter arterial chemoembolization (B‐TACE). Methods Sixty‐six patients treated with B‐TACE at a Japanese tertiary referral hospital between January 2011 and August 2015 were included in this retrospective cohort study. Results The overall response was classified as complete response, partial response, stable disease, and progressive disease in 35 (53.0%), 7 (10.6%), 13 (19.7%), and 11 (16.7%) patients, respectively. The response rate was 63.6%, and the disease control rate was 83.3%. The number of tumors (hazard ratio [HR], 4.44; 95% confidence interval [CI], 1.26–15.7; P = 0.021) and α‐fetoprotein level (HR, 11.40; 95% CI, 2.75–46.9; P < 0.001) were significantly associated with the tumor response in a multivariate analysis. The 1‐, 2‐, and 3‐year survival rates were 76.8% (95% CI, 64.5–85.3%), 57.3% (95% CI, 42.3–69.7%), and 46.7% (95% CI, 30.7–61.2%), respectively. The median survival time was 902 days. Albumin (≥3.4 g/dL) (HR, 0.28; 95% CI, 0.12–0.63; P = 0.002) and overall response (complete response and partial response) (HR, 0.33; 95% CI, 0.16–0.71; P = 0.004) were factors significantly associated with overall survival in a multivariate analysis. No mortalities were observed, but biloma requiring percutaneous transhepatic biliary drainage occurred in one patient (1.5%). Conclusion Balloon‐occluded transcatheter arterial chemoembolization may exert a good antitumor effect and result in good overall survival in select hepatocellular carcinoma patients.