Abstract:
BACKGROUND/AIM:There is no definite consensus regarding management of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). This study aimed to compare clinical outcomes according to initial treatment modality for treatment of naïve HCC combined with subsegmental (Vp1)/ segmental (Vp2) PVTT with liver resection (LR) versus trans-arterial chemoembolization (TACE) followed by radiotherapy (RT). MATERIALS AND METHODS:From our institutional registry, we enrolled 78 patients diagnosed with HCC combined with Vp1 or Vp2 PVTT and treated with LR or TACE followed by RT (TACE-RT) as a primary treatment. RESULTS:LR was more frequently applied for younger, nodular tumor morphology, or solitary tumor. Overall, LR yielded significantly better progression-free survival (PFS) (p=0.02, 41.9% vs. 15.7% at 2-years), and marginally higher overall survival (OS) (p=0.09, 75.8% vs. 61.5% at 2-years). There was an interaction effect between primary treatment and tumor morphology, and a significantly higher PFS was observed after LR in nodular morphology, in contrast with the lower PFS that was achieved after LR in infiltrative or massive morphology. CONCLUSION:Although LR yielded higher PFS than TACE-RT in HCC with Vp1 or Vp2 PVTT with similar acute complications, the difference in PFS between the LR and TACE-RT groups was significantly affected by tumor morphology.
journal_name
Anticancer Resjournal_title
Anticancer researchauthors
Yu JI,Choi GS,Lim DH,Lee E,Joh JW,Kwon CHD,Kim JM,Kim S,Woo SY,Paik SW,Park HCdoi
10.21873/anticanres.12808subject
Has Abstractpub_date
2018-08-01 00:00:00pages
4919-4925issue
8eissn
0250-7005issn
1791-7530pii
38/8/4919journal_volume
38pub_type
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