Efficacy of Postoperative Transarterial Chemoembolization and Portal Vein Chemotherapy for Patients with Hepatocellular Carcinoma Complicated by Portal Vein Tumor Thrombosis—a Randomized Study

Objectives The aim of this single, randomized study was to explore the efficacy of postoperative transarterial chemoembolization (TACE) and portal vein chemotherapy (PVC) for patients with hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombosis (PVTT) and to evaluate prognostic fa...

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Bibliographic Details
Published in:World journal of surgery 2006-11, Vol.30 (11), p.2004-2011
Main Authors: Li, Q., Wang, J., Sun, Y., Cui, Y.L., Juzi, J.T., Li, H.X., Qian, B.Y., Hao, X.S.
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - secondary
Chemoembolization, Therapeutic - methods
Disease-Free Survival
Female
Hepatic Arterial Infusion Chemotherapy
Humans
Left Branch
Liver Neoplasms - pathology
Male
Middle Aged
Neoplastic Cells, Circulating
Portal Vein
Postoperative Care
Prognosis
Single-Blind Method
Tace
Tumor Thrombus
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Summary:Objectives The aim of this single, randomized study was to explore the efficacy of postoperative transarterial chemoembolization (TACE) and portal vein chemotherapy (PVC) for patients with hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombosis (PVTT) and to evaluate prognostic factors. Methods The study cohort consisted of 112 patients with HCC and PVTT randomly divided into three groups: Group A (37 patients), operation only; Group B (35 patients), operation plus TACE; Group C (40 patients), operation plus TACE and PVC. Disease‐free survival rates and prognostic factors were analyzed. Results Most of the side effects and complications were related to the operation, catheters, and local chemotherapy and included liver decompensation (15.0%), catheter obstruction (11.6%), and nausea and loss of appetite (22.1%). The disease‐free survival curve was significantly different among the three groups, as estimated by the Kaplan‐Meier method (both P < 0.05). Group C showed a significantly higher disease‐free survival rate than Group A (P < 0.05), but no statistical differences were found between group A and group B, and group B and group C (both P > 0.05). Tumor size, tumor number, PVTT location, and treatment modalities were independent prognostic factors (P < 0.05). Conclusion Postoperative TACE combined with PVC may benefit the survival of patients with HCC complicated by PVTT in the short‐term (less than 60 months), but long‐term efficacy is not yet certain and needs to be confirmed by further studies.
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-006-0271-6