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Transarterial chemoembolization for hepatocellular carcinoma combined with portal vein tumor thrombosis

Authors Lv WF, Liu KC, Lu D, Zhou CZ, Cheng DL, Xiao JK, Zhang XM, Zhang ZF

Received 22 May 2018

Accepted for publication 30 August 2018

Published 17 October 2018 Volume 2018:10 Pages 4719—4726

DOI https://doi.org/10.2147/CMAR.S166527

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Professor Nakshatri


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

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