Treatment Outcomes of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma that Invades Hepatic Vein or Inferior Vena Cava

Chung, Seong Min; Yoon, Chang Jin; Lee, Sang Soo; Hong, Sukho; Chung, Jung Wha; Yang, Sung Mo; Seong, Nak Jong; Jang, Eun Sun; Kim, Jin‐Wook; Jeong, Sook Hyang

doi:10.1007/s00270-014-0841-1

Cited by 18 publications

(15 citation statements)

References 14 publications

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“…Liver resection yielded an optimal survival outcome for this subgroup of patients because of the oncologically high‐risk condition of HVTT or IVCTT patients. Our study reported that TACE led to an OS rate of 10.8% at 3 years and 14.7 months median survival, consistent with other studies …”

Section: Discussionsupporting

confidence: 92%

“…Due to the paucity of data regarding the best management of HCC patients with HVTT or IVCTT, therapeutic options for this subgroup of patients are controversial. Currently, surgical resection of the primary tumor and the tumor thrombus and TACE with or without conformal radiotherapy have been reported, but there is no current credible evidence suggesting that these therapies offer benefits to patients, because all previous studies were either case reports or had a non‐control design . To our knowledge, this is the first large case series study to compare treatment outcomes among HCC patients with HVTT or IVCTT who were treated with LR or TACE using PSM analysis.…”

Section: Discussionmentioning

confidence: 99%

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Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Chen

Zhang

Wang

et al. 2019

Hepatology Research

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Aim: Because of the rarity of hepatic vein tumor thrombus (HVTT) in patients with hepatocellular carcinoma (HCC), little is known about HVTT. Thus, the survival benefit of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) for HCC patients with HVTT or inferior vena cava tumor thrombus (IVCTT) remains controversial. We aimed to explore the survival benefits of LR versus TACE for the treatment of these patients.Methods: From 2012 to 2016, a total of 276 patients with HVTT or IVCTT who underwent liver resection or TACE were enrolled in this study. Patients in the LR group were matched at a 1:1 ratio with patients treated with TACE as an initial treatment (TACE group). Clinical characteristics, overall survival, and diseasefree survival were analyzed. Results:The median survival time in the LR group was 4.7 months longer than that in the TACE group before PSM (19.4 vs. 14.7 months, P = 0.006) and 6.9 months longer than that in the TACE group after PSM (20.9 vs. 14.0 months, P = 0.019). The median disease-free survival time in the LR group was 3.2 months longer than that in the TACE group before PSM (12.3 vs. 9.1 months, P = 0.038) and 5.8 months longer than that in the TACE group after PSM (13.0 vs. 7.2 months, P = 0.011). Conclusion:Liver resection provides a good prognosis for HCC patients with HVTT or IVCTT compared with patients undergoing TACE, and coexistence with portal vein tumor thrombus is the most important factor related to survival. Figure 1 Flowchart of screening hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (HVTT) or inferior vena cava tumor thrombus (IVCTT) undergoing hepatic resection (HR) or transcatheter chemoembolization (TACE).

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Chen

Zhang

Wang

et al. 2019

Hepatology Research

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“…Our study may have yielded a better survival rate owing to the fact that previous research defined major vascular invasion contains involving the IVC (20) or PVTT (5,10,18). Our study reported that TACE led to an overall survival rate of 15.6% at 3 years, and 9.1 months of median survival, similar to previous findings (12,13). The patients with HVTT in the HR group achieved a better prognosis than the patients in the TACE group, as in previous similar studies on PVTT (26) or the IVC/RA (21) (P = 0.015).…”

Section: Discussionsupporting

confidence: 81%

Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

Zhang

Wei

Guo

et al. 2015

Jpn. J. Clin. Oncol.

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Objective: To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus. Methods: From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed. Results: The 1-, 2-and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival. Conclusions: Hepatic resection provides a good prognosis for hepatocellular carcinoma patients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.

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“…However, HCC patients after surgery have decreased immune function, damaged liver function, metastasis, and recurrence [2][3][4]. It has been reported that HCC can be treated by transcatheter arterial chemoembolization (TACE) via superselective segmental embolization [5]. However,the treatment strategy has some drawbacks [6]: incomplete embolism and tissue necrosis after surgery [7], collateral circulation quickly occurs after embolization of tumor supplying artery, which is not up to long-term blocking vascular [8], and multiple TACE treatment damages liver function and also leads to liver fibrosis [9].…”

Section: Introductionmentioning

confidence: 99%

Effect of Transcatheter Arterial Chemoembolization Combined with Argon–Helium Cryosurgery System on the Changes of NK Cells and T Cell Subsets in Peripheral Blood of Hepatocellular Carcinoma Patients

Huang¹,

Wang²,

Huang³

2015

Cell Biochem Biophys

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Hepatocellular carcinoma (HCC) is one of the most aggressive tumors in humans. T lymphocytes and natural killer (NK) cells are the body's first line of defense to prevent tumor cell growth. Previous studies have demonstrated that transcatheter arterial chemoembolization (TACE) combined with argon-helium cryosurgery system (AHCS) can effectively treat liver cancer. However, the mechanism of the treatment is unclear yet. In the current study, we investigated the effects of TACE combined with AHCS on the changes of T cell subsets and NK cells in peripheral blood of HCC. Our data show that alpha-fetoprotein (AFP) levels in peripheral blood were significantly up-regulated in HCC patients before treatment when compared with healthy people and reduced after TACE combined with AHCS treatment (P < 0.01). In addition, we found that CD4+ cells and NK cells decreased (P < 0.05) and CD8+ cells increased (P < 0.05) in HCC patients when compared with healthy people. After treatment, the CD4+ cells, CD4+/CD8+ ratio, and NK cells were dramatically increased in HCC patients (P < 0.05). In contrast, CD8+ cells were significantly decreased (P < 0.05). TACE combined with AHCS treatment significantly prolonged 1-year survival rate of HCC patients and did not show significant side effects. Taken together, our data indicate that TACE combined with AHCS treatment improves patients' immune system. It is a feasible and effective therapeutic method for HCC patients.

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Treatment Outcomes of Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma that Invades Hepatic Vein or Inferior Vena Cava

Abstract: TACE seems effective for HCC with HV/IVC invasion, especially in patients with preserved hepatic function, a treatment response for tumor thrombi, and an AFP response.

Cited by 18 publications

References 14 publications

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Liver resection versus transcatheter arterial chemoembolization for the treatment of patients with hepatocellular carcinoma and hepatic vein or inferior vena cava tumor thrombus: A propensity score matching analysis

Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

Effect of Transcatheter Arterial Chemoembolization Combined with Argon–Helium Cryosurgery System on the Changes of NK Cells and T Cell Subsets in Peripheral Blood of Hepatocellular Carcinoma Patients

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