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

Purpose We aimed to elucidate the treatment outcomes of transcatheter arterial chemoembolization (TACE) and survival-associated factors in hepatocellular carcinoma (HCC) patients with hepatic vein (HV) and/or inferior vena cava (IVC) invasion. Methods The subjects were consecutively enrolled, newly...

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Published in:Cardiovascular and interventional radiology 2014-12, Vol.37 (6), p.1507-1515
Main Authors: Chung, Seong Min, Yoon, Chang Jin, Lee, Sang Soo, Hong, Sukho, Chung, Jung Wha, Yang, Sung Wook, Seong, Nak Jong, Jang, Eun Sun, Kim, Jin-Wook, Jeong, Sook-Hyang
Format: Article
Language:English
Subjects:
Antineoplastic Agents - administration & dosage
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - therapy
Cardiology
Chemoembolization, Therapeutic - methods
Cisplatin - administration & dosage
Clinical Investigation
Female
Gelatin Sponge, Absorbable - administration & dosage
Hepatic Veins - pathology
Humans
Imaging
Liver Neoplasms - pathology
Liver Neoplasms - therapy
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Invasiveness
Nuclear Medicine
Radiology
Survival Rate
Treatment Outcome
Ultrasound
Vena Cava, Inferior - pathology
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Summary:Purpose We aimed to elucidate the treatment outcomes of transcatheter arterial chemoembolization (TACE) and survival-associated factors in hepatocellular carcinoma (HCC) patients with hepatic vein (HV) and/or inferior vena cava (IVC) invasion. Methods The subjects were consecutively enrolled, newly diagnosed HCC patients with HV/IVC invasion who underwent TACE ( n  = 62) at the Seoul National University Bundang Hospital from May 2003 to October 2012. Clinical characteristics, treatment responses, overall survival, and survival-related factors were analyzed. Results The mean subject age was 56.6 years, 82.3 % were hepatitis B surface antigen-positive, and 76.2 % were classified as Child-Pugh class A. The tumor volume was ≥50 % of the liver in 64.5 % of patients, and 79, 41.9, and 9.7 % of patients had accompanying portal vein, IVC, and right atrial invasion, respectively. TACE response rates for primary tumors and tumor thrombi in HV or IVC were 55.6 and 13 %, respectively. Median overall survival was 10.9 months (range 0.1–23.0 months). Multivariate analysis showed that Child-Pugh class A (hazard ratio [HR] = 0.31; 95 % confidence interval [CI] 0.14–0.72; p  = 0.007), tumor volume 
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-014-0841-1