Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein
Background & Aims We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT. Methods From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as...
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| Veröffentlicht in: | Liver international 2018-09, Vol.38 (9), p.1646-1654 |
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| creator | Kim, Jin Hyoung Shim, Ju Hyun Yoon, Hyun‐Ki Ko, Heung‐Kyu Kim, Jong Woo Gwon, Dong Il |
| description | Background & Aims
We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT.
Methods
From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first‐line treatment for HCC with segmental PVTT.
Results
After TACE, the median survival of the whole cohort was 10.7 months, and the 1‐year, 3‐year and 5‐year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up‐to‐11 criteria, extrahepatic metastasis, Child–Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2‐4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30‐day mortality and major complications rates after TACE were 0.9% and 5.4% respectively.
Conclusions
TACE was well‐tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up‐to‐11 criteria out), extrahepatic spread, Child–Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2‐4 risk factors because of poor survival outcome. |
| doi_str_mv | 10.1111/liv.13719 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2001917849</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2001917849</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3539-551ca44525cc97c634a42f28abe652329550e882daf277da89c2def1399762d23</originalsourceid><addsrcrecordid>eNp1kctKAzEUhoMoWi8LX0ACbnTRNpdJZ7KU4g0KbtTtkGbOtJHMpCYzUyr47mZsdSGYzckhXz4O50fonJIRjWdsTTeiPKVyDw1okmZDzjjd_70zfoSOQ3gjhEop6CE6YjLhE0roAH1Ol1A5qObOmg_VGFdjD1Y1UODG4YVzBQ6t70ynLC6dxwEs6P51FWGom4DXplniJcTeabC2tcpjrbw2tasUNnWnClMv4sdFFfmoWTnflw5MfYoOSmUDnO3qCXq5u32ePgxnT_eP05vZUHPB5VAIqlWSCCa0lqme8EQlrGSZmsNEMM6kEASyjBWqZGlaqExqVkBJuZTphBWMn6CrrXfl3XsLockrE_ppVQ2uDTnrV0PTLJERvfyDvrnW13G6SElOGBGMROp6S2nvQvBQ5itvKuU3OSV5n0keM8m_M4nsxc7YzisofsmfECIw3gJrY2HzvymfPb5ulV_aRJeH</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2093020520</pqid></control><display><type>article</type><title>Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Jin Hyoung ; Shim, Ju Hyun ; Yoon, Hyun‐Ki ; Ko, Heung‐Kyu ; Kim, Jong Woo ; Gwon, Dong Il</creator><creatorcontrib>Kim, Jin Hyoung ; Shim, Ju Hyun ; Yoon, Hyun‐Ki ; Ko, Heung‐Kyu ; Kim, Jong Woo ; Gwon, Dong Il</creatorcontrib><description>Background & Aims
We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT.
Methods
From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first‐line treatment for HCC with segmental PVTT.
Results
After TACE, the median survival of the whole cohort was 10.7 months, and the 1‐year, 3‐year and 5‐year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up‐to‐11 criteria, extrahepatic metastasis, Child–Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2‐4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30‐day mortality and major complications rates after TACE were 0.9% and 5.4% respectively.
Conclusions
TACE was well‐tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up‐to‐11 criteria out), extrahepatic spread, Child–Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2‐4 risk factors because of poor survival outcome.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13719</identifier><identifier>PMID: 29436101</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Complications ; Hepatocellular carcinoma ; Liver ; Medical prognosis ; Metastases ; Patients ; Portal vein ; portal vein tumour thrombosis ; Regression analysis ; Risk analysis ; Risk factors ; Survival ; survival analysis ; transarterial chemoembolization ; Tumors</subject><ispartof>Liver international, 2018-09, Vol.38 (9), p.1646-1654</ispartof><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2018 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-551ca44525cc97c634a42f28abe652329550e882daf277da89c2def1399762d23</citedby><cites>FETCH-LOGICAL-c3539-551ca44525cc97c634a42f28abe652329550e882daf277da89c2def1399762d23</cites><orcidid>0000-0002-7336-1371 ; 0000-0002-7300-6396</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.13719$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.13719$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29436101$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Jin Hyoung</creatorcontrib><creatorcontrib>Shim, Ju Hyun</creatorcontrib><creatorcontrib>Yoon, Hyun‐Ki</creatorcontrib><creatorcontrib>Ko, Heung‐Kyu</creatorcontrib><creatorcontrib>Kim, Jong Woo</creatorcontrib><creatorcontrib>Gwon, Dong Il</creatorcontrib><title>Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background & Aims
We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT.
Methods
From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first‐line treatment for HCC with segmental PVTT.
Results
After TACE, the median survival of the whole cohort was 10.7 months, and the 1‐year, 3‐year and 5‐year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up‐to‐11 criteria, extrahepatic metastasis, Child–Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2‐4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30‐day mortality and major complications rates after TACE were 0.9% and 5.4% respectively.
Conclusions
TACE was well‐tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up‐to‐11 criteria out), extrahepatic spread, Child–Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2‐4 risk factors because of poor survival outcome.</description><subject>Complications</subject><subject>Hepatocellular carcinoma</subject><subject>Liver</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Patients</subject><subject>Portal vein</subject><subject>portal vein tumour thrombosis</subject><subject>Regression analysis</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Survival</subject><subject>survival analysis</subject><subject>transarterial chemoembolization</subject><subject>Tumors</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kctKAzEUhoMoWi8LX0ACbnTRNpdJZ7KU4g0KbtTtkGbOtJHMpCYzUyr47mZsdSGYzckhXz4O50fonJIRjWdsTTeiPKVyDw1okmZDzjjd_70zfoSOQ3gjhEop6CE6YjLhE0roAH1Ol1A5qObOmg_VGFdjD1Y1UODG4YVzBQ6t70ynLC6dxwEs6P51FWGom4DXplniJcTeabC2tcpjrbw2tasUNnWnClMv4sdFFfmoWTnflw5MfYoOSmUDnO3qCXq5u32ePgxnT_eP05vZUHPB5VAIqlWSCCa0lqme8EQlrGSZmsNEMM6kEASyjBWqZGlaqExqVkBJuZTphBWMn6CrrXfl3XsLockrE_ppVQ2uDTnrV0PTLJERvfyDvrnW13G6SElOGBGMROp6S2nvQvBQ5itvKuU3OSV5n0keM8m_M4nsxc7YzisofsmfECIw3gJrY2HzvymfPb5ulV_aRJeH</recordid><startdate>201809</startdate><enddate>201809</enddate><creator>Kim, Jin Hyoung</creator><creator>Shim, Ju Hyun</creator><creator>Yoon, Hyun‐Ki</creator><creator>Ko, Heung‐Kyu</creator><creator>Kim, Jong Woo</creator><creator>Gwon, Dong Il</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7336-1371</orcidid><orcidid>https://orcid.org/0000-0002-7300-6396</orcidid></search><sort><creationdate>201809</creationdate><title>Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein</title><author>Kim, Jin Hyoung ; Shim, Ju Hyun ; Yoon, Hyun‐Ki ; Ko, Heung‐Kyu ; Kim, Jong Woo ; Gwon, Dong Il</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-551ca44525cc97c634a42f28abe652329550e882daf277da89c2def1399762d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Complications</topic><topic>Hepatocellular carcinoma</topic><topic>Liver</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Patients</topic><topic>Portal vein</topic><topic>portal vein tumour thrombosis</topic><topic>Regression analysis</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Survival</topic><topic>survival analysis</topic><topic>transarterial chemoembolization</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Jin Hyoung</creatorcontrib><creatorcontrib>Shim, Ju Hyun</creatorcontrib><creatorcontrib>Yoon, Hyun‐Ki</creatorcontrib><creatorcontrib>Ko, Heung‐Kyu</creatorcontrib><creatorcontrib>Kim, Jong Woo</creatorcontrib><creatorcontrib>Gwon, Dong Il</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Jin Hyoung</au><au>Shim, Ju Hyun</au><au>Yoon, Hyun‐Ki</au><au>Ko, Heung‐Kyu</au><au>Kim, Jong Woo</au><au>Gwon, Dong Il</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2018-09</date><risdate>2018</risdate><volume>38</volume><issue>9</issue><spage>1646</spage><epage>1654</epage><pages>1646-1654</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background & Aims
We evaluated survival outcomes and prognostic factors associated with survival after TACE in a large cohort of 331 patients with HCC with segmental PVTT.
Methods
From 1997 to 2015, a total of 331 patients were included in this study from among 507 patients who underwent TACE as a first‐line treatment for HCC with segmental PVTT.
Results
After TACE, the median survival of the whole cohort was 10.7 months, and the 1‐year, 3‐year and 5‐year survival rates were 44.9%, 16% and 12% respectively. Objective tumour response after TACE was achieved in 53.8% of patients. Multivariable Cox regression analyses confirmed that up‐to‐11 criteria, extrahepatic metastasis, Child–Pugh class, and tumour response to TACE were independent prognostic factors for patient survival. The expected median survival times among patients with 0, 1 and 2‐4 risk factors were 29.1, 15.1 and 5.3 months respectively. The 30‐day mortality and major complications rates after TACE were 0.9% and 5.4% respectively.
Conclusions
TACE was well‐tolerated and effective in selected patients with HCC with segmental PVTT. We found that four risk factors were associated with decreased length of patient survival after TACE: a major tumour burden (up‐to‐11 criteria out), extrahepatic spread, Child–Pugh class B liver function and nonregression to TACE. TACE may not be recommended for HCC patients with segmental PVTT with 2‐4 risk factors because of poor survival outcome.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29436101</pmid><doi>10.1111/liv.13719</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-7336-1371</orcidid><orcidid>https://orcid.org/0000-0002-7300-6396</orcidid></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | Complications Hepatocellular carcinoma Liver Medical prognosis Metastases Patients Portal vein portal vein tumour thrombosis Regression analysis Risk analysis Risk factors Survival survival analysis transarterial chemoembolization Tumors |
| title | Chemoembolization related to good survival for selected patients with hepatocellular carcinoma invading segmental portal vein |
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