The efficacy and safety of postoperative adjuvant transarterial embolization and radiotherapy in hepatocellular carcinoma patients with portal vein tumor thrombus
Authors Bai T, Chen J, Xie Z, Wu F, Wang S, Liu J, Li L
Received 15 January 2016
Accepted for publication 9 April 2016
Published 27 June 2016 Volume 2016:9 Pages 3841—3848
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Ashok Kumar Pandurangan
Peer reviewer comments 4
Editor who approved publication: Dr William Cho
Tao Bai,1,2,* Jie Chen,1,2,* Zhi-Bo Xie,3 Fei-Xiang Wu,1,2 Si-Da Wang,2,4 Jun-Jie Liu,2,4 Le-Qun Li1,2
1Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, 2Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning, 3Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 4Department of Ultrasound Diagnosis, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People’s Republic of China
*These authors contributed equally to this work
Objective: This study aims to find out the safety and efficiency of postoperative adjuvant transarterial chemoembolization (TACE) and radiotherapy (RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT).
Methods: From 2009 to 2010, a total of 92 HCC patients with PVTT were enrolled in this retrospective study. Patients were divided into three groups according to their adjuvant therapies (conservative group, n=51; TACE group, n=31; RT group, n=10).
Results: In our analysis, median survival in patients with postoperative adjuvant TACE (21.91±3.60 months) or RT (14.53±1.61 months) was significantly longer than patients with hepatectomy alone (8.99±1.03 months). But the difference between adjuvant TACE and RT was of no significance (P=0.716). Also a similar result could be observed in median disease-free survival: conservative group (6.51±1.44 months), TACE group (13.98±3.38 months), and RT group (14.03±2.40 months). Treatment strategies (hazard ratio [HR] =0.411, P<0.001) and PVTT type (HR =4.636, P<0.001) were the independent prognostic factors for overall survival. Similarly, the risk factors were the same when multivariate analysis was conducted in disease-free survival (treatment strategies, HR =0.423, P<0.001; PVTT type, HR =4.351, P<0.001) and recurrence (treatment strategies, HR =0.459, P=0.030; PVTT type, HR =2.908, P=0.047). Patients with PVTT type I had longer overall survival than patients with PVTT type II (median survival: 18.43±2.88 months vs 11.59±1.45 months, P=0.035).
Conclusion: Postoperative adjuvant TACE and RT may be a choice for HCC patients with PVTT.
Keywords: HCC, portal vein tumor thrombus, transarterial chemoembolization, radiotherapy, surgery
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