Selective Versus Non-selective Transarterial Chemoembolization via the Intercostal Artery for the Treatment of Hepatocellular Carcinoma

Purpose To report the 1-month tumor response and safety of selective transarterial chemoembolization (TACE) via the intercostal artery (ICA) for the treatment of hepatocellular carcinoma (HCC) in comparison with those of non-selective TACE. Methods This retrospective study included 79 HCC patients who underwent TACE via the ICA selectively (selective TACE group; n = 26) or non-selectively (non-selective TACE group; n = 53) between January 2001 and December 2016. Selective TACE was defined when TACE was performed with selective catheterization of the tumor feeding branch of the ICA. TACE performed without selective catheterization of the tumor feeding branch was defined as non-selective TACE. One-month target and overall tumor responses and complications of the two groups were compared. Univariate and multivariate analyses were performed to identify prognostic factors. Results Selective TACE group showed better 1-month target and overall tumor responses and lower frequency of complications than non-selective TACE group ( P = .007, P = .018, and P 200 ng/mL and non-selective TACE were statistically significant. However, multivariate analysis showed that performing non-selective TACE was the only significant risk factor (odds ratio 13.56; 95% confidence interval 3.51–52.5; P