Portal hypertension is associated with poor outcome of transarterial chemoembolization in patients with hepatocellular carcinoma
- 131 Downloads
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).
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.
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.
Portal hypertension was significantly associated with poor outcome after TACE, and non-invasive CRPH grading may be a useful prognostic marker of TACE.
• 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.
KeywordsHepatocellular carcinoma Chemoembolization, therapeutic Portal hypertension Computed tomography, X-ray Survival
Barcelona Clinic Liver Cancer
Clinically relevant portal hypertension
Eastern Cooperative Oncology Group
Hepatic venous pressure gradient
Local tumour progression
Compliance with ethical standards
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.
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.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
No subjects / cohorts of this study have been previously reported.
• performed at one institution
- 13.American College of Radiology (2017) CT/MRI Liver Imaging Reporting and Data System (LI-RADS), version 2017. Available via https://www.acr.org/Quality-Safety/Resources/LIRADS/LIRADS-v2017. Accessed 24 June 2017
- 21.Miyayama S, Matsui O, Yamashiro M et al (2007) Ultraselective transcatheter arterial chemoembolization with a 2-f tip microcatheter for small hepatocellular carcinomas: relationship between local tumor recurrence and visualization of the portal vein with iodized oil. J Vasc Interv Radiol 18:365–376CrossRefPubMedGoogle Scholar
- 30.Julie Heimbach, Laura M Kulik, Richard Finn et al (2017) AASLD guidelines for the treatment of hepatocellular carcinoma. Available via https://www.aasld.org/publications/practice-guidelines-0. Accessed 24 June 2017.