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Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus

To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus. From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein...

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Published in:Japanese journal of clinical oncology 2015-09, Vol.45 (9), p.837-843
Main Authors: Zhang, Yong-Fa, Wei, Wei, Guo, Zhi-Xing, Wang, Jia-Hong, Shi, Ming, Guo, Rong-Ping
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container_title Japanese journal of clinical oncology
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creator Zhang, Yong-Fa
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Guo, Rong-Ping
description To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus. From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed. The 1-, 2- and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival. Hepatic resection provides a good prognosis for hepatocellular carcinoma patients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.
doi_str_mv 10.1093/jjco/hyv089
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From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed. The 1-, 2- and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival. Hepatic resection provides a good prognosis for hepatocellular carcinoma patients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.</description><identifier>ISSN: 0368-2811</identifier><identifier>EISSN: 1465-3621</identifier><identifier>DOI: 10.1093/jjco/hyv089</identifier><identifier>PMID: 26079139</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Aged ; Carcinoma, Hepatocellular - complications ; Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - therapy ; Case-Control Studies ; Chemoembolization, Therapeutic ; Female ; Follow-Up Studies ; Hepatectomy ; Hepatic Veins ; Humans ; Liver Neoplasms - complications ; Liver Neoplasms - mortality ; Liver Neoplasms - therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Portal Vein ; Risk Factors ; Survival Rate ; Venous Thrombosis - complications</subject><ispartof>Japanese journal of clinical oncology, 2015-09, Vol.45 (9), p.837-843</ispartof><rights>The Author 2015. 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source Oxford Journals Online
subjects Adult
Aged
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - therapy
Case-Control Studies
Chemoembolization, Therapeutic
Female
Follow-Up Studies
Hepatectomy
Hepatic Veins
Humans
Liver Neoplasms - complications
Liver Neoplasms - mortality
Liver Neoplasms - therapy
Male
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
Portal Vein
Risk Factors
Survival Rate
Venous Thrombosis - complications
title Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus
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