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Microwave ablation of hepatocellular carcinoma with portal vein tumor thrombosis after transarterial chemoembolization: a prospective study

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Abstract

Aims

To prospectively assess the use of microwave ablation (MWA) to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) after transarterial chemoembolization (TACE), and to evaluate factors that significantly affect treatment outcomes.

Methods

Sixty patients with HCC [55 male, 5 female; mean age, 54.1 ± 10.2 (range 36–77) years] + PVTT were enrolled. Patients were treated with MWA after TACE. Results were compared with those of 54 patients treated by TACE alone in another retrospective study. Data analyzed included patient demographics, Eastern Cooperative Oncology Group performance status, liver cirrhosis, liver volume, Child-Pugh class, Cancer of the Liver Italian Program (CLIP) score, and imaging findings. Survival time (from occurrence of PVTT to last follow-up) and predictive factors and their correlation with survival were statistically evaluated.

Results

The median 3-year overall survival (OS) duration was 13.5 months, and the 1- and 3-year OS rates were 48 and 23 %, respectively. Cox hazards regression analysis revealed that change in the neutrophil-to-lymphocyte ratio, CLIP score, and treatment efficacy were the only independent predictive factors for outcome (p = 0.035, 0.024, and 0.000, respectively).

Conclusions

Combination therapy with MWA after TACE may provide a substantial benefit for patients with HCC + PVTT type I, II, or partial III and Child-Pugh class A or B by reducing the tumor burden.

Trial registration number

Chinese Clinical Trial Register (ChiCTR): ChiCTR-ONC-12002689.

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Abbreviations

HCC:

Hepatocellular carcinoma

CLIP:

Cancer of the Liver Italian Program

TACE:

Transarterial chemoembolization

CT:

Computerized tomography

MWA:

Microwave ablation

PVTT:

Portal vein tumor thrombosis

RLV:

Remnant liver volume

FRLV:

Functional remnant liver volume

TLV:

Total liver volume

CR:

Complete response

PR:

Partial response

BCLC:

Barcelona Clinic Liver Cancer Group

OS:

Overall survival

HAIC:

Hepatic arterial infusion chemotherapy

TTV:

Total tumor volume

NLR:

Neutrophil-to-lymphocyte ratio

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Acknowledgments

Dr. Jia-sheng Zheng received a grant from the National Science and Technology Support Project (2010-2015).

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Authors and Affiliations

  1. Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China

    Jiang Long, Jia-sheng Zheng, Bin Sun & Ningning Lu

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  1. Jiang Long
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  2. Jia-sheng Zheng
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  3. Bin Sun
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Corresponding author

Correspondence to Jia-sheng Zheng.

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Conflict of interest

Jiang Long, Jia-sheng Zheng, Bin Sun, Ningning Lu declare that they have no conflicts of interest.

Ethical standards

The study complied with the standards of the Declaration of Helsinki and current ethical guidelines, and was approved by our institutional ethics board.

Informed Consent

Patient consent was obtained

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Long, J., Zheng, Js., Sun, B. et al. Microwave ablation of hepatocellular carcinoma with portal vein tumor thrombosis after transarterial chemoembolization: a prospective study. Hepatol Int 10, 175–184 (2016). https://doi.org/10.1007/s12072-015-9673-6

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  • DOI: https://doi.org/10.1007/s12072-015-9673-6

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