Jeong Il Yu1, Jae Won Park2, Hee Chul Park3, Sang Min Yoon4, Do Hoon Lim1, Joon Hyeok Lee5, Han Chu Lee6, Seon Woo Kim7, Jong Hoon Kim2. 1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea. Electronic address: hee.ro.park@samsung.com. 4. Department of Radiation Oncology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address: drsmyoon@amc.seoul.kr. 5. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 7. Biostatistics Team, Samsung Biomedical Research Institute, Seoul, Republic of Korea.
Abstract
PURPOSE: To evaluate the relationship between portal vein tumor thrombosis (PVTT) response and clinical outcomes in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization followed by radiotherapy (TACE-RT). MATERIALS AND METHODS: The study enrolled 329 patients in the training set and 179 patients in the validation set. All patients who were treated with TACE-RT from 2002 to 2008 and satisfied the inclusion criteria were enrolled in the study. The median follow-up period was 11.7 months (range, 1.6-108.6) in the training set and 11.9 months (range, 1.7-105.1) in the validation set. RESULTS: After TACE-RT, PVTT response was complete or partial in 32 (9.7%) and 134 (40.7%) patients of the training set and in 18 (10.1%) and 96 (53.6%) patients in the validation set, respectively. Failure to obtain PVTT response was significantly related with elevated post-treatment Child-Pugh score (P<0.001). Furthermore, progression-free survival was significantly related with PVTT response (P<0.001, hazard ratio 0.33, 95% confidence interval 0.25-0.42) in multivariate analysis. In receiver-operating characteristics analysis of 1-year progression prediction, the PVTT response showed an area under the curve of 0.74. Most of the findings were successfully reproduced in the independent external validation set. CONCLUSIONS: Positive PVTT response was closely associated with favorable clinical outcomes. The PVTT response to TACE-RT reduces metastasis and makes it possible to maintain normal liver function and achieve longer survival.
PURPOSE: To evaluate the relationship between portal vein tumor thrombosis (PVTT) response and clinical outcomes in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization followed by radiotherapy (TACE-RT). MATERIALS AND METHODS: The study enrolled 329 patients in the training set and 179 patients in the validation set. All patients who were treated with TACE-RT from 2002 to 2008 and satisfied the inclusion criteria were enrolled in the study. The median follow-up period was 11.7 months (range, 1.6-108.6) in the training set and 11.9 months (range, 1.7-105.1) in the validation set. RESULTS: After TACE-RT, PVTT response was complete or partial in 32 (9.7%) and 134 (40.7%) patients of the training set and in 18 (10.1%) and 96 (53.6%) patients in the validation set, respectively. Failure to obtain PVTT response was significantly related with elevated post-treatment Child-Pugh score (P<0.001). Furthermore, progression-free survival was significantly related with PVTT response (P<0.001, hazard ratio 0.33, 95% confidence interval 0.25-0.42) in multivariate analysis. In receiver-operating characteristics analysis of 1-year progression prediction, the PVTT response showed an area under the curve of 0.74. Most of the findings were successfully reproduced in the independent external validation set. CONCLUSIONS: Positive PVTT response was closely associated with favorable clinical outcomes. The PVTT response to TACE-RT reduces metastasis and makes it possible to maintain normal liver function and achieve longer survival.
Authors: Jinhong Jung; Ji Hyeon Joo; So Yeon Kim; Jin Hyoung Kim; Jonggi Choi; Danbi Lee; Ju Hyun Shim; Kang Mo Kim; Young-Suk Lim; Han Chu Lee; Jin-Hong Park; Sang Min Yoon Journal: Liver Cancer Date: 2021-12-07 Impact factor: 12.430
Authors: Sang Min Yoon; Baek-Yeol Ryoo; So Jung Lee; Jong Hoon Kim; Ji Hoon Shin; Ji Hyun An; Han Chu Lee; Young-Suk Lim Journal: JAMA Oncol Date: 2018-05-01 Impact factor: 31.777
Authors: Diego A S Toesca; Bulat Ibragimov; Amanda J Koong; Lei Xing; Albert C Koong; Daniel T Chang Journal: J Radiat Res Date: 2018-03-01 Impact factor: 2.724