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Transarterial chemoembolization compared with conservative treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus: using a new classification

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Abstract

We aimed to compare the survival benefit of transarterial chemoembolization (TACE) with conservative treatment for patients with advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT), furthermore, to reveal which PVTT types benefit from TACE treatment. From August 2007 to January 2010, a prospective controlled study was performed on consecutive patients with advanced HCC and PVTT. Of a total of 150 patients, 115 were treated with TACE (lipiodol and anticancer agents ± gelatin sponge embolization), and 35 who refused to accept the procedure were treated with conservative treatment. We performed survival analysis of the two treatment groups and then stratified by a new classification of PVTT that was divided into four types. Overall survival was significantly better in the TACE group than in the conservative group (8.67 months vs. 1.4 months, P < 0.001). The overall median survival for types I–IV PVTT were 12.0, 8.3, 5.0, and 2.43 months (P < 0.01). On subgroup analysis of PVTT, the median survival in the TACE group compared with conservative group for type I, II, III, and IV PVTT was 19.0 months versus 4.0 months, 11.0 months versus 1.43 months, 7.1 months versus 1.3 months, and 4.0 months versus 1.0 months, respectively (P < 0.01). The TACE group had significantly better survival than the conservative group for different extent of PVTT. TACE is an effective treatment mode compared with conservative treatment for HCC and PVTT and may provide a significantly better survival benefit for different extent of PVTT.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Postgraduate, Guangxi Medical University, Nanning, People’s Republic of China

    Zhi-Jie Niu

  2. Tumor Hospital of Guangxi Autonomous Region, No. 22 Shuangyong Road, Nanning, Guangxi Province, People’s Republic of China

    Yi-Long Ma, Ping Kang, Sheng-Qiu Ou, Zhi-Bin Meng, Zhi-Kun Li, Feng Qi & Chang Zhao

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  1. Zhi-Jie Niu
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Correspondence to Yi-Long Ma.

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Niu, ZJ., Ma, YL., Kang, P. et al. Transarterial chemoembolization compared with conservative treatment for advanced hepatocellular carcinoma with portal vein tumor thrombus: using a new classification. Med Oncol 29, 2992–2997 (2012). https://doi.org/10.1007/s12032-011-0145-0

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  • DOI: https://doi.org/10.1007/s12032-011-0145-0

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