Yong-Fa Zhang1, Wei Wei1, Zhi-Xing Guo2, Jia-Hong Wang1, Ming Shi1, Rong-Ping Guo3. 1. Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060. 2. State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060 Department of Ultrasonography, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China. 3. Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060 guorongp@mail.sysu.edu.cn.
Abstract
OBJECTIVE: To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus. METHODS: From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed. RESULTS: The 1-, 2- and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival. CONCLUSIONS: Hepatic resection provides a good prognosis for hepatocellular carcinoma patients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.
OBJECTIVE: To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus. METHODS: From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed. RESULTS: The 1-, 2- and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival. CONCLUSIONS: Hepatic resection provides a good prognosis for hepatocellular carcinomapatients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.
Authors: Aline Mähringer-Kunz; Franziska I Meyer; Felix Hahn; Lukas Müller; Christoph Düber; Daniel Pinto Dos Santos; Peter R Galle; Arndt Weinmann; Roman Kloeckner; Sebastian Schotten Journal: United European Gastroenterol J Date: 2021-06-02 Impact factor: 4.623