Traditional versus Microsphere Embolization for Hepatocellular Carcinoma: An Effectiveness Evaluation Using Data Mining.

ABSTRACT

Background: For hepatocellular carcinoma ("HCC"), the current standard of treatment is hepatic artery embolization, generally through trans-catheter arterial chemoembolization ("TACE"). There are two types traditional ("conventional" or "cTACE") and microsphere ("DC bead TACE"). Unfortunately, the literature comparing the relative effectiveness of cTACE versus DC bead TACE is inconclusive, partially due to the complexity of HCC and its response to treatment. Data mining is an excellent method to extract meaning from complex data sets. Purpose: Through the application of data mining techniques, to compare the relative effectiveness of cTACE and DC bead TACE using a large patient database and to use said comparison to establish usable guidelines for developing treatment plans for HCC patients. Materials and Methods: The data of 372 HCC patients who underwent TACE in Taichung Veterans General Hospital were analyzed. The chi-square test was used to compare the difference in the effectiveness of the two therapies was compared. Logistic regression was used to calculate the odds ratios. Furthermore, using the C4.5 decision tree, the two therapies were classified into applicable fields. Chi-square test, the t-test, and logistic regression were used to verify the classification results. Results: In Barcelona Clinic Stages A and B cancers, cTACE was found to be 22.7% more effective than DC bead TACE. By using the decision tree C4.5 as a classifier, the effectiveness of either treatment for small tumors was 8.475 times than that for large tumors. DC bead TACE was 3.39 times more successful in treating patients with a single tumor than with multiple tumors. For patients with a single tumor, the chi-square test showed that 100-300 µm microspheres were significantly more effective than 300-500 µm. While these findings provide a reference for the selection of an appropriate TACE approach, we noted that overall accuracy was somewhat low, possibly due to the limited population. Conclusions: We found that data mining could be applied to develop clear guidelines for physician and researcher use in the case of complex pathologies such as HCC. However, some of our results contradicted those elsewhere in the literature, possibly due to a relatively small sample size. Significantly larger data sets with appropriate levels of granularity could produce more accurate results.