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Portal hypertension is associated with poor outcome of transarterial chemoembolization in patients with hepatocellular carcinoma

  • Interventional
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine whether clinically relevant portal hypertension (CRPH) influences outcome and whether it may serve as a prognostic marker in patients treated with transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

Methods

One hundred and forty-seven patients underwent conventional TACE as a first-line treatment for a single HCC. CRPH was graded as 0, 1, or 2. The influence of CRPH, together with other factors, on local tumour progression (LTP) and overall survival (OS) were analysed using Cox proportional hazards regression.

Results

A higher CRPH grade (grade 1, p = 0.005, hazard ratio [HR] = 3.282; grade 2, p < 0.001, HR = 7.144) and less selective catheterization (p = 0.009, HR = 1.951) were significantly associated with early LTP. Regarding OS, older age, (p < 0.001, HR = 1.050), CRPH grade 2 (p = 0.024, HR = 2.058), and a larger tumour (p < 0.001, HR = 1.454) were significantly associated with early death.

Conclusions

Portal hypertension was significantly associated with poor outcome after TACE, and non-invasive CRPH grading may be a useful prognostic marker of TACE.

Key Points

• Portal hypertension was significantly associated with poor outcome after TACE.

• Grading portal hypertension non-invasively can help predict TACE outcome in HCC patients.

• CRPH grading can aid in selecting optimal candidates for TACE.

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Abbreviations

BCLC:

Barcelona Clinic Liver Cancer

CI:

Confidence interval

CR:

Complete response

CRPH:

Clinically relevant portal hypertension

CT:

Computed tomography

CTP:

Child-Turcotte-Pugh

ECOG:

Eastern Cooperative Oncology Group

HCC:

Hepatocellular carcinoma

HR:

Hazard ratio

HVPG:

Hepatic venous pressure gradient

LCOS:

LT-censored OS

LT:

Liver transplantation

LTP:

Local tumour progression

MR:

Magnetic resonance

OS:

Overall survival

PBP:

Peribiliary plexus

TACE:

Transarterial chemoembolization

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Authors and Affiliations

  1. Section of Interventional Radiology, Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Jin Woo Choi, Jin Wook Chung, Dong Ho Lee, Hyo-Cheol Kim, Saebeom Hur, Myungsu Lee & Hwan Jun Jae

Authors
  1. Jin Woo Choi
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  2. Jin Wook Chung
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  3. Dong Ho Lee
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  6. Myungsu Lee
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Corresponding author

Correspondence to Jin Wook Chung.

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Guarantor

The scientific guarantor of this publication is Jin Wook Chung, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by the Korean Health Industry Development Institute (KHIDI), supported by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI15C2797).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

No subjects / cohorts of this study have been previously reported.

Methodology

• retrospective

• observational

• performed at one institution

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Cite this article

Choi, J.W., Chung, J.W., Lee, D.H. et al. Portal hypertension is associated with poor outcome of transarterial chemoembolization in patients with hepatocellular carcinoma . Eur Radiol 28, 2184–2193 (2018). https://doi.org/10.1007/s00330-017-5145-9

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  • DOI: https://doi.org/10.1007/s00330-017-5145-9

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