4 Efficacy

4 Efficacy

This section describes efficacy outcomes from the published literature that the Committee considered as part of the evidence about this procedure. For more detailed information on the evidence, see the interventional procedure overview.

4.1 A case series of 25 patients with advanced hepatocellular carcinoma (HCC) treated by chemosaturation via percutaneous hepatic artery perfusion and hepatic vein isolation (hepatic chemosaturation) reported 1-year and 5-year survival rates of 86% and 47% respectively (n=22). A case series of 28 patients with HCC treated by hepatic chemosaturation (included in a report of 46 patients with different types of cancer) reported 1-year and 5-year survival rates of 68% and 40% respectively. Median survival for these patients was 16 months. A case series of 10 patients with metastatic melanoma or sarcoma reported that median overall survival from time of first hepatic chemosaturation treatment was 8.7 months. At a median follow-up of 11.5 months, 40% (4/10) of patients were still alive.

4.2 A case series of 28 patients with primary or metastatic liver cancer treated by hepatic chemosaturation reported an overall radiographic response rate of 30% (8/27): this included 2 complete responses (both in patients with metastatic ocular melanoma) and 6 partial responses. The case series of 25 patients with advanced HCC reported complete remission in 45% (10/22) of patients, partial response in 41% (9/22), stable disease in 9% (2/22) and progressive disease in 5% (1/22). The median duration of response was 16 months (range 4–93 months). A case series of 46 patients reported tumour response for 28 patients with HCC: 19% (5/27) of patients had a complete response, 44% (12/27) had a partial response, 26% (7/27) had stable disease and 11% (3/27) had progressive disease. A case series of 23 patients with primary or metastatic liver cancer reported a 'significant response' in 10% (2/21) of patients, stable disease in 10% (2/21) and progression of hepatic tumours in 81% (17/21). The case series of 10 patients reported that 90% (9/10) patients had stable disease or a partial response to treatment and the median hepatic progression free survival was 240 days.

4.3 The specialist advisers listed key efficacy outcomes as progression-free and overall survival, and time to disease progression.

  • National Institute for Health and Care Excellence (NICE)