Jin Hyoung Kim1, Ju Hyun Shim2, Hyun-Ki Yoon1, Heung-Kyu Ko1, Jong Woo Kim1, Dong Il Gwon1. 1. Department of Radiology and Research Institute of Radiology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 2. Department of Gastroenterology, Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
BACKGROUND & AIMS: We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT. METHODS: From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first-line treatment for HCC with segmental PVTT. RESULTS: After TACE, the median survival of the whole cohort was 10.7 months, and the 1-year, 3-year and 5-year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up-to-11 criteria, extrahepatic metastasis, Child-Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2-4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30-day mortality and major complications rates after TACE were 0.9% and 5.4% respectively. CONCLUSIONS: TACE was well-tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up-to-11 criteria out), extrahepatic spread, Child-Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2-4 risk factors because of poor survival outcome.
BACKGROUND & AIMS: We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT. METHODS: From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first-line treatment for HCC with segmental PVTT. RESULTS: After TACE, the median survival of the whole cohort was 10.7 months, and the 1-year, 3-year and 5-year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up-to-11 criteria, extrahepatic metastasis, Child-Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2-4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30-day mortality and major complications rates after TACE were 0.9% and 5.4% respectively. CONCLUSIONS:TACE was well-tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up-to-11 criteria out), extrahepatic spread, Child-Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2-4 risk factors because of poor survival outcome.
Authors: Hee Ho Chu; Jin Hyoung Kim; Ju Hyun Shim; Sang Min Yoon; Pyeong Hwa Kim; Ibrahim Alrashidi Journal: Cancers (Basel) Date: 2020-04-29 Impact factor: 6.639
Authors: Jonggi Choi; Danbi Lee; Ju Hyun Shim; Kang Mo Kim; Young-Suk Lim; Yung Sang Lee; Han Chu Lee Journal: PLoS One Date: 2020-03-04 Impact factor: 3.240
Authors: Chan Park; Jin Hyoung Kim; Pyeong Hwa Kim; So Yeon Kim; Dong Il Gwon; Hee Ho Chu; Minho Park; Joonho Hur; Jin Young Kim; Dong Joon Kim Journal: Korean J Radiol Date: 2020-08-28 Impact factor: 3.500