Transarterial chemoembolization for hepatocellular carcinoma combined with portal vein tumor thrombosis

• Published in: Cancer Management and Research
• Main Authors: Lv WF, Liu KC, Lu D, Zhou CZ, Cheng DL, Xiao JK, Zhang XM, Zhang ZF
• Format: Article
• Language: English
• Published: Dove Medical Press 2018-10-01
• Subjects: Hepatocellular carcinoma; Transarterial chemoembolization; Portal vein tumor thrombus; Survival analysis
• Online Access: https://www.dovepress.com/transarterial-chemoembolization-for-hepatocellular-carcinoma-combined--peer-reviewed-article-CMAR
• ISSN: 1179-1322

Wei-Fu Lv, Kai-Cai Liu, Dong Lu, Chun-Ze Zhou, De-Lei Cheng, Jing-Kun Xiao, Xing-Ming Zhang, Zheng-Feng Zhang Department of Interventional Radiology, Anhui Provincial Hospital, The First Affiliated Hospital of University of Science and Technology of China (USTC), Hefei 230001, Anhui Province, China Objectives: To explore the efficacy and influencing factors of transarterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT).Materials and methods: The clinical data of 3,126 consecutive patients who suffered from advanced HCC and underwent TACE were retrospectively analyzed. A total of 685 patients had a combination of HCC and PVTT. Of these patients, 475 were treated with TACE (Group A) and 210 were given a supportive care (Group B). The local response and overall survival of the two groups were observed and compared, and the influencing factors were examined through Cox regression analysis.Results: The median survival time and cumulative survival rate at 6, 12, and 24 months of Group A were higher than those of Group B (P=0.002). Multiple Cox regression analysis revealed that Child–Pugh classes and PVTT grades were the independent prognostic factors affecting a patient’s survival. Stratified analysis demonstrated that the survival time of patients diagnosed with grades I/II PVTT and treated with TACE was superior to that of patients provided with supportive care (P=0.001), but the survival time of patients with grades III/IV PVTT with or without TACE did not significantly differ (P=0.662).Conclusion: TACE can significantly improve local response, increase cumulative survival rate, and prolong the survival duration of patients with HCC and grades I/II PVTT, whereas the efficacy of TACE for patients with grades III/IV PVTT should be further verified, although their local responses were improved. Child–Pugh classes and PVTT grades are essential factors influencing patient prognosis. Keywords: HCC, TACE, portal vein tumor thrombus, survival analysis