Lipiodol deposition in portal vein tumour thrombus predicts treatment outcome in HCC patients after transarterial chemoembolisation
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To study lipiodol deposition in portal vein tumour thrombus (PVTT) in predicting the treatment outcome of hepatocellular carcinoma (HCC) patients after transarterial chemoembolisation (TACE).
We retrospectively reviewed data from 379 HCC patients with PVTT who underwent TACE as the initial treatment at Sun Yat-Sen University Cancer Center from January 2008 to December 2015. Patients were grouped by positive and negative lipiodol deposition based on the extent of lipiodol deposition in PVTT. The overall survival (OS) and progression-free survival (PFS) were compared between negative and positive lipiodol deposition groups; furthermore, the value of the combinatorial evaluation of tumour responses and lipiodol deposition in PVTT in predicting prognosis was analysed in subgroup patients with stable disease (SD) after TACE.
Of the 379 patients, 264 (69.7%) had negative and 115 (30.3%) had positive lipiodol deposition in PVTT after TACE. Multivariate analysis identified positive lipiodol deposition in PVTT as an independent prognostic factor for favourable OS (p = 0.001). The median OS and PFS of negative and positive lipiodol deposition groups were 4.70 vs. 8.97 months (p = 0.001) and 3.1 months vs. 5.8 months (p < 0.001). In subgroup patients, the median OS and PFS of negative and positive lipiodol deposition groups were 4.7 months vs. 10.5 months (p < 0.001) and 3.5 months vs. 7.0 months (p < 0.001), respectively.
The patients with positive lipiodol deposition in PVTT had a longer OS than those with negative lipiodol deposition. Furthermore, the positive lipiodol deposition in PVTT can further differentiate HCC patients with favourable prognosis from SD patients.
• Lipiodol deposition in PVTT is a prognostic indicator for HCC patients after TACE treatment.
• Positive lipiodol deposition in PVTT is associated with a better prognosis.
KeywordsHepatocellular carcinoma Lipiodol Chemoembolisation Prognosis
Eastern Cooperative Oncology Group
The Modified Response Evaluation Criteria in Solid Tumors
Portal vein tumour thrombus
We thank Mr. Filip Ivkovic from European Society of Radiology for his help with the editing of the language.
This study has received funding from the National Natural Science Foundation of China (No. 81372571), the State “973 Program” of China (No. 2014CB542005), the Sun Yat-Sen University Clinical Research 5010 Program (No. 2012010), and the Fundamental Research Funds for the Central Universities (No. 17ykzd34).
Compliance with ethical standards
The scientific guarantor of this publication is Yunfei Yuan.
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.
Statistics and biometry
No complex statistical methods were necessary for this paper.
Written informed consent was obtained from patients in this study.
Institutional Review Board approval was obtained.
• Diagnostic or prognostic study
• Performed at one institution
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