Interventional therapy for primary hepatic carcinoma associated with IVC-RA tumor thrombus:initial experience in 17 cases / 介入放射学杂志

ABSTRACT

Objective To evaluate the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) in treating primary hepatic carcinoma (PHC) complicated by tumor thrombus in inferior vena cava and right atrium (IVC-RA).Methods A total of 17 patients with PHC complicated by tumor thrombus in IVC-RA were included in this study.After the tumor-feeding arteries were confirmed with selective arteriography,TACE was carried out.The used embolization materials included chemotherapy drug-lipiodol emulsion and particle type embolic materials,and the target arteries included branches of hepatic artery,right inferior phrenic artery,branches of left gastric artery,etc.All patients were periodically followed up,and further treatment would be conducted if it was necessary.Results A total of 45 interventional procedures were performed in the 17 patients and all procedures were successful without any significant complication.Explicit blood supply arteries of IVC-RA tumor thrombus were observed in all the 17 patients,including hepatic artery branches (n=12) and extra-hepatic arteries (n=9),which included left gastric artery (n=1) and right inferior phrenic artery (n=8).CT reexamination showed that lipiodol deposition in IVC-RA tumor thrombus was found in 15 patients.In the 17 patients,the median survival time was 12 months,and the one-year and 2-year overall survival rates were 52.9％ and 29.4％ respectively.Conclusion IVC-RA tumor thrombus has rich blood supply,and its main blood supply arteries include hepatic artery and right inferior phrenic artery.For the treatment of PHC associated with IVC-RA tumor thrombus,TACE is safe and effective.