Jin Woo Choi1, Hyo-Cheol Kim2, Jeong-Hoon Lee3, Su Jong Yu3, Yoon Jun Kim3, Jung-Hwan Yoon3, Hwan Jun Jae1, Saebeom Hur1, Myungsu Lee1, Jin Wook Chung1. 1. Section of Interventional Radiology, Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. 2. Section of Interventional Radiology, Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. angiointervention@gmail.com. 3. Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
OBJECTIVES: To evaluate the clinical outcome and safety of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with segmental or subsegmental portal vein tumour thrombus (sPVTT) in patients with preserved hepatic function, and to address the efficacy of additional chemoinfusion after TACE (TACE+CI). METHODS: From January 2003 to December 2012, TACE was conducted on 81 patients with Child-Pugh score ≤7 who had HCC with sPVTT. Thirty-one of them underwent TACE+CI. The overall survival (OS) and serious adverse events (SAEs) were evaluated. The efficacy of TACE+CI was appraised after adjustment with inverse probability of treatment weighting (IPTW). RESULTS: The OS after TACE (median, 15.5 months) was significantly related with aspartate aminotransferase (hazard ratio [HR], 1.011), modified Barcelona Clinic Liver Cancer (BCLC) stage D (HR, 2.841), extrahepatic spread (HR, 4.862), and TACE+CI (HR, .367). The SAE incidence was significantly associated with modified BCLC stages (HR, 10.174 [proper-C] and 24.000 [D]). After IPTW adjustment, TACE+CI significantly improved OS (p = .028; HR, .511), but the SAE incidence was not significantly altered (p = .737; HR, .819). CONCLUSIONS: TACE can be an effective and safe treatment option for HCC with sPVTT in patients with preserved hepatic function. Furthermore, additional chemoinfusion can enhance the therapeutic efficacy while maintaining the safety. KEY POINTS: • TACE is effective and safe for treating HCC with sPVTT. • Modified BCLC stages can stratify the risk and benefit of TACE. • Additional chemoinfusion can enhance the therapeutic efficacy while maintaining the safety.
OBJECTIVES: To evaluate the clinical outcome and safety of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with segmental or subsegmental portal vein tumour thrombus (sPVTT) in patients with preserved hepatic function, and to address the efficacy of additional chemoinfusion after TACE (TACE+CI). METHODS: From January 2003 to December 2012, TACE was conducted on 81 patients with Child-Pugh score ≤7 who had HCC with sPVTT. Thirty-one of them underwent TACE+CI. The overall survival (OS) and serious adverse events (SAEs) were evaluated. The efficacy of TACE+CI was appraised after adjustment with inverse probability of treatment weighting (IPTW). RESULTS: The OS after TACE (median, 15.5 months) was significantly related with aspartate aminotransferase (hazard ratio [HR], 1.011), modified Barcelona Clinic Liver Cancer (BCLC) stage D (HR, 2.841), extrahepatic spread (HR, 4.862), and TACE+CI (HR, .367). The SAE incidence was significantly associated with modified BCLC stages (HR, 10.174 [proper-C] and 24.000 [D]). After IPTW adjustment, TACE+CI significantly improved OS (p = .028; HR, .511), but the SAE incidence was not significantly altered (p = .737; HR, .819). CONCLUSIONS:TACE can be an effective and safe treatment option for HCC with sPVTT in patients with preserved hepatic function. Furthermore, additional chemoinfusion can enhance the therapeutic efficacy while maintaining the safety. KEY POINTS: • TACE is effective and safe for treating HCC with sPVTT. • Modified BCLC stages can stratify the risk and benefit of TACE. • Additional chemoinfusion can enhance the therapeutic efficacy while maintaining the safety.
Entities:
Keywords:
Barcelona Clinic Liver Cancer Stage; Chemoinfusion; Hepatocellular carcinoma; Portal vein tumour thrombus; Transarterial chemoembolization
Authors: Andrew Kennedy; Daniel B Brown; Jonas Feilchenfeldt; John Marshall; Harpreet Wasan; Marwan Fakih; Peter Gibbs; Alexander Knuth; Bruno Sangro; Michael C Soulen; Gianfranco Pittari; Ricky A Sharma Journal: J Gastrointest Oncol Date: 2017-12
Authors: Sung Won Chung; Min Kyung Park; Young Youn Cho; Youngsu Park; Cheol-Hyung Lee; Hyunwoo Oh; Heejoon Jang; Minseok Albert Kim; Sun Woong Kim; Joon Yeul Nam; Yun Bin Lee; Eun Ju Cho; Su Jong Yu; Hyo-Cheol Kim; Yoon Jun Kim; Jin Wook Chung; Jung-Hwan Yoon; Jeong-Hoon Lee Journal: J Hepatocell Carcinoma Date: 2021-06-15