Prognostic factors for portal vein tumor thrombosis in patients with hepatocellular carcinoma receiving transcatheter arterial chemoembolization therapy
CUI Peng1, LIU Xiao-xia1, DU Xiao-li1, ZHANG Jian-ming2, LU Zai-ming1
1. Department of Radiology, Shengjing Hospital of China Medical University, Shenyang 110004, China;2. Evidence-based Medicine Laboratory, First Affiliated Hospital, China Medical University, Shenyang 110001, China
Abstract:Objective: To evaluate the clinical prognosis and survival outcomes of hepatocellular carcinoma(HCC) patients with portal vein tumor thrombosis(PVTT). And to compare survival rate between groups of synchronous and asynchronous PVTT. Methods: A prognostic model was developed for 57 HCC patients with PVTT treated with transcatheter arterial chemoembolization(TACE) from 2007 January to 2013 March. Local tumor response was evaluated by modified response evaluation criteria in solid tumor. Clinical characteristics, prognosis, and patient survival were analyzed by the life table method, the Kaplan-Meier method and Cox’s proportional hazards model. Results: According to mRECIST, complete response, partial response, stable disease and progressive disease were found in 1 patient(1.5%), 14 patients(24.5%), 20 patients(35.5%) and 22 patients(38.5%), respectively. The 6-, 12-, 18- and 24-month overall survivals for the HCC patients with PVTT after TACE were 50.8%, 29.8%, 24.6% and 10.5%, respectively. The median survival was 6.8 months. In the multivariate analysis, pre-treatment prognostic factors for overall survival were AST, CHE, APS, complete portal vein occlusion and local tumor response. Conclusion: There are many factors affecting the survival outcomes of HCC patients with PVTT, and there is no difference in survival analysis study between synchronous and asynchronous portal vein tumor thrombosis.