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Authors Lv WF, Liu KC, Lu D, Zhou CZ, Cheng DL, Xiao JK, Zhang XM, Zhang ZF
Received 22 May 2018
Accepted for publication 30 August 2018
Published 17 October 2018 Volume 2018:10 Pages 4719—4726
DOI https://doi.org/10.2147/CMAR.S166527
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Professor Nakshatri
Objectives: To explore the efficacy and influencing factors of transarterial
chemoembolization (TACE) in the treatment of hepatocellular carcinoma (HCC)
combined with portal vein tumor thrombosis (PVTT).
Materials and
methods: The clinical data of 3,126
consecutive patients who suffered from advanced HCC and underwent TACE were
retrospectively analyzed. A total of 685 patients had a combination of HCC and
PVTT. Of these patients, 475 were treated with TACE (Group A) and 210 were
given a supportive care (Group B). The local response and overall survival of
the two groups were observed and compared, and the influencing factors were
examined through Cox regression analysis.
Results: The median survival time and cumulative survival rate at 6, 12,
and 24 months of Group A were higher than those of Group B (P =0.002). Multiple Cox regression
analysis revealed that Child–Pugh classes and PVTT grades were the independent
prognostic factors affecting a patient’s survival. Stratified analysis
demonstrated that the survival time of patients diagnosed with grades I/II PVTT
and treated with TACE was superior to that of patients provided with supportive
care (P =0.001), but the survival time of
patients with grades III/IV PVTT with or without TACE did not significantly
differ (P =0.662).
Conclusion: TACE can significantly improve local response, increase cumulative
survival rate, and prolong the survival duration of patients with HCC and
grades I/II PVTT, whereas the efficacy of TACE for patients with grades III/IV
PVTT should be further verified, although their local responses were improved.
Child–Pugh classes and PVTT grades are essential factors influencing patient
prognosis.
Keywords: HCC, TACE, portal vein tumor thrombus, survival analysis