Trans-arterial chemoembolization and external beam radiation therapy for treatment of hepatocellular carcinoma with a tumor thrombus in the inferior vena cava and right atrium

Duan, Feng; Yu, Wei; Wang, Yan; Liu, Fengyong; Song, Peng; Wang, Zhijun; Yan, Jieyu; Yuan, Kai; Wang, Maoqiang

doi:10.1186/s40644-015-0043-3

Cited by 31 publications

(44 citation statements)

References 18 publications

(18 reference statements)

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“…In total 53 articles were collected , including 5 (9.4%) retrospective studies [3,11,23,50,53], 4 (7.5%) case series [1,21,43,49], and 44 (83.0%) case reports [2, 4-10, 12-20, 22, 24-42, 44-48, 51, 52], with 187 patients involved. Even though cohort studies, case-control studies and case series are considered to form a hierarchy of increasing risk of bias, these studies reflected closely a routine practice or the usual setting where the intervention would be implemented.…”

Section: Resultsmentioning

confidence: 99%

“…Wang et al [3] reported the median survival time of such patients was 4.6 months. Duan et al [11] retrospectively observed 11 cases of HCC with IVC/RA tumor thrombus treated with a combination of TACE and external beam radiation therapy and noted that all patients died of disease progression, and the median survival time was 21 months. The clinical effects of TACE in the treatment of HCC with IVC/RA tumor thrombus were heterogeneous and warrant further observations [3].…”

Section: Discussionmentioning

confidence: 99%

“…Chern MC, Chuang VP, Cheng T, Lin ZH, Lin YM. [3,20,22,26] 58 (53.7) Hepatitis B antigen positive [10, 13, 21, 23, 32-34, 46, 47, 50] 33 (30.6) Chronic hepatitis B [8,11,12,15,17,25,44] 17 (15.7) Hepatitis C 17 (9.1) Chronic hepatatis C [1,18,19,29,30,38,42,45,52] 10 (58.8) Hepatitis C virus antibody positive [5,27,31,50] 5 (29.4) Hepatitis C virus RNA very high [24] 1 (5.9) Hepatitis C virus-related end-stage liver disease [1] 1 (5.9) Chronic hepatitis, unspecified [39] 1 (0.5) Hepatitis, autoimmune [40] 1 (0.5) Cirrhosis [1,19,34,45,51] 7 (3.7) Hepatocellular carcinoma [1, 5, 15, 19, 20, 23, 30, 34, 36-38, 40, 45, 48, 51] 32 (17.1) Human immunodeficiency virus infection [44] 1 (0.5) Table II. 96 clinical symptoms in 36 patients Symptom n (%) Edema, lower extremity [5, 7-10, 14, 16, 34, 39, 42, 45, 46, 51] 13 (13.5) Ascites [1,5,8,19,21,<...>…”

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confidence: 99%

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Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of the pertinent literature published since 2000, 53 reports were collected with 187 patients recruited into this study. The quantitative data were expressed in mean±standard deviation with range and median values and were compared by independent samples t -test. The categorical variables were compared by Chi-square or Fisher exact test with continuity correction. Results: The survival rate of patients receiving transarterial chemoembolization was 33.3% and that of surgical patients was 41.9%. The survival time of patients with transarterial chemoembolization treatment was longer than that of surgical patients, but lack of a statistical significance. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patient prognoses were improved and survival time was elongated with the advances of active treatments such as transarterial chemoembolization and surgical treatments. Active treatments are advised to patients with hepatocellular carcinoma with right atrial tumor thrombus in order to improve patients’ survival.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Yuan

Guo²

2020

Preprint

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“…Authors are aware of a selection bias. Hepatitis B antigen positive [10, 13, 21, 23, 32-34, 46, 47, 50] 33 (30.6) Chronic hepatitis B [8,11,12,15,17,25,44] 17 (15.7)…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Yuan

Guo²

2020

Preprint

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Background: Hepatocellular carcinoma with right atrial tumor thrombus is uncommon but with a dismal prognosis. Methods: By comprehensive retrieval of literature published between 2000 and 2019, 53 reports were obtained with 187 patients recruited into this study. The extracted data included patient characteristics, tumor characteristics, treatment, follow-up and outcomes. Statistical analyses applied were student t , Fisher exact and I 2 tests. Patients were devided into 6 groups according to treatment of choices: transarterial chemoembolization (TACE), surgery, radiotherapy, chemotherapy, interventional treatment and supportive care. Results: The overall survival rate of this cohort was 40.8%. The survival rate of patients receiving TACE was 33.3% and that of surgical patients was 41.9%. The survival time of patients with TACE was longer than surgical patients, but lack of a statistical significance. Patients had a follow-up of 15.7±16.6 (median 10) months. The patients receiving radiotherapy had the longest follow-up among all groups. Intra- and/or extrahepatic recurrence of hepatocellular carcinoma was the major mobidity. The mortality rates in a decremental sequence for patients receiving different treatments were supportive care >radiotherapy >surgery >TACE >interventional treatment. No difference was found in mortality between patients reported from case reports and those from non-case reports. Conclusions: Even though advanced hepatocellular carcinoma with right atrial thrombus is an aggressive malignancy, the the present study showed that patients’ prognosis was improved and survival time elongated with active treatments such as TACE and surgery. The present systematic review reveals improved outcomes with active treatments against conservative treatments.

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“…In such cases, treatment options include TACE, SIRT, or local ablative techniques or systemic treatment with multi-kinase or checkpoint inhibitors [24]. While some reports have evaluated the efficacy of interventional methods in patients with HCC and CATT [25,26], the impact of systemic treatments is poorly described so far.…”

Section: Discussionmentioning

confidence: 99%

Pharmacological treatment of hepatocellular carcinoma with cavoatrial tumor thrombus – case series and literature review

et al. 2019

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Hepatocellular carcinomas (HCC) that extend into the vena cava and the right atrium have a poor prognosis. Surgical approaches including partial hepatectomy and thrombectomy are the most frequently reported treatment options. However, most patients with advanced HCC are not eligible for complex surgical interventions due to reduced liver function, comorbidities, and metastases. At the same time, systemic treatment options of HCC have expanded in recent years. Here, we report 3 cases of patients with advanced HCC who developed a cavoatrial tumor thrombus (CATT) after initial surgical or interventional therapy. The patients were consequently treated with sorafenib or nivolumab. In all cases, the tumor responded to systemic treatment with disease stabilization or partial regression. Overall survival after diagnosis of CATT was 3 and 17 months for sorafenib and 7 + months for nivolumab. Compared to survival rates of alternative treatment options, systemic therapies demonstrated comparable outcomes. In summary, pharmacotherapy is an efficient and well worth option to treat patients with HCC and CATT and should be an integral part of a multimodal therapy concept.

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Trans-arterial chemoembolization and external beam radiation therapy for treatment of hepatocellular carcinoma with a tumor thrombus in the inferior vena cava and right atrium

Cited by 31 publications

References 18 publications

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Hepatocellular carcinoma with right atrial tumor thrombus: a meta-analysis

Hepatocellular carcinoma with right atrial tumor thrombus: a systematic review

Pharmacological treatment of hepatocellular carcinoma with cavoatrial tumor thrombus – case series and literature review

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