Comparison of Chemoembolization with and without Radiation Therapy and Sorafenib for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Propensity Score Analysis

Kim, Gi Ae; Shim, Ju Hyun; Yoon, Sang Min; Jung, Jinhong; Kim, Jong Hoon; Ryu, Min Hee; Ryoo, Baek Yeol; Kang, Yoon Koo; Lee, Danbi; Kim, Kang Mo; Lim, Young Suk; Lee, Han Chu; Chung, Young Hwa; Lee, Yung Sang

doi:10.1016/j.jvir.2014.10.019

Cited by 80 publications

(84 citation statements)

References 37 publications

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“…In the matching analysis comparing 46 pairs of patients treated with TACE alone or sorafenib alone, the TACE-alone group had longer median time to progression (3.4 vs. 1.8 months; p < 0.001) and overall survival (5.9 vs. 4.4 months; p = 0.003). However, the difference in terms of overall survival was not persistent with the inverse probability of treatment-weighted outcomes approach [24]. …”

Section: Alternative Treatment Strategiesmentioning

confidence: 99%

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Costentin

Ferrone²,

Arellano

et al. 2017

Liver Cancer

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Background: Tumoral macrovascular invasion (MVI) of hepatic and/or portal vein branches is a common phenomenon in hepatocellular carcinoma (HCC) and is associated with poorer prognosis when compared to HCC without MVI. Summary: Current international guidelines for the management of HCC recommend sorafenib as the only treatment option in case of MVI. Despite guideline recommendations, several alternative options have been tested to manage HCC with MVI: surgery, transarterial chemoembolization, external or internal radiation, hepatic arterial infusion chemotherapy, percutaneous treatment, cryotherapy, or the combination of two or more of these strategies, with or without sorafenib. Here we will provide a comprehensive state-of-the-art review for the management of this challenging clinical entity based on the most recent available data. Key Messages: There is a growing body of evidence suggesting that alternative strategies to standard-of-care sorafenib might improve survival in patients with advanced HCC with MVI but the level of evidence remains weak. Randomized phase III trials are ongoing and will hopefully provide information leading towards a more personalized treatment algorithm.

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Section: Alternative Treatment Strategiesmentioning

confidence: 99%

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Costentin

Ferrone²,

Arellano

et al. 2017

Liver Cancer

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“…With only about 30% of patients able to undergo curative treatments, most HCC patients are referred for noncurative treatments (1,3). For intermediate-to-advanced-stage HCC patients without extrahepatic metastasis, transarterial chemoembolization (TACE) is the first-line treatment (1,4,5); however, diverse treatment modalities have been used to improve the treatment response and prognosis (6,7). Local radiotherapy has been effective in controlling HCC progression (8), and concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) has recently been considered as an attractive alternative treatment strategy for locally advanced HCC (9-11).…”

mentioning

confidence: 99%

Prognostic Significance of¹⁸F-FDG Uptake in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization or Concurrent Chemoradiotherapy: A Multicenter Retrospective Cohort Study

Lee

Chung

et al. 2016

J Nucl Med

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This study aimed to assess the prognostic value of 18 F-FDG uptake in hepatocellular carcinoma (HCC) patients who had transarterial chemoembolization (TACE) or concurrent intraarterial chemotherapy with external-beam radiotherapy (CCRT) and to compare the prognosis between patients treated with TACE and those with CCRT according to 18 F-FDG uptake. Methods: Two hundred fourteen intermediateto-advanced-stage HCC patients without extrahepatic metastasis who underwent staging 18 F-FDG PET/CT before TACE (153 patients) or CCRT (61 patients) were recruited from 7 hospitals. Progressionfree survival (PFS) and overall survival (OS) were compared using an optimal cutoff value for tumor-to-normal liver uptake ratio (TLR). Further, PFS and OS were compared according to treatment modalities (TACE vs. CCRT) using the same TLR cutoff value. Results: On multivariate analysis, age and TLR were independent prognostic factors for PFS (P , 0.050). For OS, Child-Pugh classification and TLR were independent prognostic factors (P , 0.050). When the TLR was greater than 2.0, patients treated with CCRT showed significantly better PFS and OS than those treated with TACE after adjusting for tumor size and number (P 5 0.014, for all). In contrast, there was no significant difference in PFS and OS between patients treated with TACE or CCRT when the TLR was 2.0 or less. Conclusion: 18 F-FDG uptake was an independent prognostic factor for PFS and OS in HCC patients treated with TACE or CCRT. Especially, in HCCs with high 18 F-FDG uptake, patients treated with CCRT showed better survival than those treated with TACE.

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“…Objective tumor response and OS were significantly better in the TACE-based multimodal treatment groups. Kim et al [105] compared the efficacy of TACE with and without radiotherapy (RT) vs sorafenib for advanced HCC with portal vein tumor thrombosis (PVTT). Of the 557 patients with HCC with PVTT, 295 received TACE, 196 received TACE with RT, and 66 received sorafenib.…”

Section: Advanced-stage Hccmentioning

confidence: 99%

Locoregional treatment for hepatocellular carcinoma: The best is yet to come

Kalra

Gupta

Chawla

et al. 2015

WJR

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Comparison of Chemoembolization with and without Radiation Therapy and Sorafenib for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Propensity Score Analysis

Cited by 80 publications

References 37 publications

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Prognostic Significance of¹⁸F-FDG Uptake in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization or Concurrent Chemoradiotherapy: A Multicenter Retrospective Cohort Study

Locoregional treatment for hepatocellular carcinoma: The best is yet to come

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Comparison of Chemoembolization with and without Radiation Therapy and Sorafenib for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Propensity Score Analysis

Cited by 80 publications

References 37 publications

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Hepatocellular Carcinoma with Macrovascular Invasion: Defining the Optimal Treatment Strategy

Prognostic Significance of18F-FDG Uptake in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization or Concurrent Chemoradiotherapy: A Multicenter Retrospective Cohort Study

Locoregional treatment for hepatocellular carcinoma: The best is yet to come

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Product

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Prognostic Significance of¹⁸F-FDG Uptake in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization or Concurrent Chemoradiotherapy: A Multicenter Retrospective Cohort Study