Efficacy and Safety of Transarterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma Associated with Bile Duct Tumor Thrombus: A Real-World Retrospective Cohort Study

The occurrence of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of the study was to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) for patients with unresectable HCC with BDTT. This retrospective study was conducted on newly dia...

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Bibliographic Details
Published in:Cancer management and research 2021-01, Vol.13, p.3551-3560
Main Authors: Feng, Jin-Kai, Sun, Ju-Xian, Liu, Zong-Han, Gu, Jing-Wen, Chen, Zhen-Hua, Liu, Chang, Guo, Wei-Xing, Shi, Jie, Cheng, Shu-Qun
Format: Article
Language:English
Subjects:
Antigens
Bile
bile duct tumor thrombus
Bilirubin
Blood clot
Blood clots
Cancer therapies
Chemoembolization
Cohort analysis
Comparative analysis
conservative management
Drug therapy
Endoscopy
Health aspects
Hepatitis
hepatocellular carcinoma
Hepatoma
Hospitals
Liver cancer
Magnetic resonance imaging
Medical prognosis
Medical research
Medicine, Experimental
Original Research
overall survival
Patients
Surveillance
Thrombosis
transarterial chemoembolization
Veins & arteries
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Summary:The occurrence of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of the study was to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) for patients with unresectable HCC with BDTT. This retrospective study was conducted on newly diagnosed HCC and BDTT patients who were initially treated with TACE or conservative management (CM) from 2009 to 2018. Survival outcomes of patients treated with TACE were compared with those of patients given CM. Multivariate analyses were performed to identify independent prognostic factors related to survival. Out of 100 patients included in this study, 40 patients underwent TACE, while the remaining 60 received CM. The median survival time of the TACE group was 8.0 months longer than that of the CM group (13.0 versus 5.0 months, < 0.001). The 6-, 12-, 18-, 24-month overall survival (OS) rates were 90.0%, 52.5%, 22.5%, and 12.5%, respectively, for the TACE group compared with 26.7%, 8.3%, 5.0%, and 3.3%, respectively, for the CM group. Multivariate analyses showed that treatment allocation (hazard ratio [HR], 0.421; 95% confidence interval [CI], 0.243-0.730; = 0.002), Child-Pugh status (HR, 2.529; 95% CI, 1.300-4.920; = 0.006) and total bilirubin level (HR, 1.007; 95% CI, 1.004-1.009; < 0.001) on first admission were independent predictors of OS. There was no procedure-related mortality within one month after TACE treatment. TACE is a safe and effective treatment method that may improve the OS of patients with unresectable HCC with BDTT.
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S307065