Transarterial chemoembolization for hepatocellular carcinoma combined with portal vein tumor thrombosis
| Autor: | Dong Lu, Xing-Ming Zhang, Zheng-Feng Zhang, Kai-Cai Liu, Wei-Fu Lv, Chun-Ze Zhou, Jing-Kun Xiao, De-Lei Cheng |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Portal vein Gastroenterology portal vein tumor thrombus Group B survival analysis Stratified analysis 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine HCC Survival analysis Original Research TACE business.industry Proportional hazards model medicine.disease Thrombosis Oncology Cancer Management and Research 030220 oncology & carcinogenesis Hepatocellular carcinoma 030211 gastroenterology & hepatology business Median survival |
| Zdroj: | Cancer Management and Research |
| ISSN: | 1179-1322 |
| DOI: | 10.2147/cmar.s166527 |
| Popis: | 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 |
| Databáze: | OpenAIRE |
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