Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: a retrospective matched cohort study.

Abstract:

OBJECTIVES:To investigate the survival benefit of transarterial chemoembolization (TACE) plus Iodine125 seed implantation (TACE-Iodine125) in hepatitis B-related HCC patients with portal vein tumour thrombus (PVTT) and the underlying prognostic factors. METHODS:A retrospective matched cohort study was performed on consecutive HCC patients with PVTT from January 2011 to June 2014. Seventy patients (TACE-Iodine125 group) who underwent TACE-Iodine125 were compared with a historical case-matched control group of 140 patients (TACE group) who received TACE alone. The survival of patients and the underlying prognostic factors were analysed. RESULTS:The median survival times of the TACE-Iodine125 and TACE groups were 11.0 and 7.5 months, respectively (p < 0.001). The survival probability at 12, 24, and 36 months was 50 %, 14.5 %, and 14.5 % vs. 25 %, 9 %, and 5 % in the TACE-Iodine125 and TACE groups, respectively (p < 0.001). The PVTT responders had better survival than the PVTT non-responders (p < 0.001). For the PVTT non-responders, there were no differences in the survival curves between the groups (p = 0.353). Multivariate analysis showed that type III PVTT (p < 0.001) and APS (p < 0.001) were independent predictors of poor prognosis. In contrast, the treatment modality of TACE-Iodine125 (p < 0.001) and PVTT response (p = 0.001) were favourable prognostic features. CONCLUSIONS:TACE combined with Iodine125 seed implantation may be a good choice for selected HB-HCC patients with PVTT. KEY POINTS:• TACE-Iodine125 was more effective than TACE for patients with HCC-PVTT. • The TACE-Iodine125 procedure was safe. • TACE-Iodine125 was conditional for patients with HCC-PVTT. • TACE-Iodine125 resulted in a better PVTT response compared to TACE alone. • A good PVTT response is a favourable prognostic factor.

journal_name

Eur Radiol

journal_title

European radiology

authors

Huang M,Lin Q,Wang H,Chen J,Bai M,Wang L,Zhu K,Jiang Z,Guan S,Li Z,Qian J,Li M,Pang P,Shan H

doi

10.1007/s00330-015-4198-x

subject

Has Abstract

pub_date

2016-10-01 00:00:00

pages

3428-36

issue

10

eissn

0938-7994

issn

1432-1084

pii

10.1007/s00330-015-4198-x

journal_volume

26

pub_type

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