Safety and efficacy of GSMs-TACE plus liver transplantation for hepatocellularcarcinoma with type Ⅱ/Ⅲ portal vein tumor thrombus / 中华器官移植杂志

ABSTRACT

Objective:To explore the safety and clinical efficacy of orthotopic liver transplantation after treatment with gelatin sponge microparticles by transcatheter arterial chemoembolization (GSMs-TACE) for hepatocellular carcinoma with type II/III portal vein tumor thrombus.Methods:For this retrospective study, patients with hepatocellular carcinoma with portal vein tumor thrombosis undergoing GSMs-TACE before liver transplantation from January 2018 to June 2018. The clinical efficacy and safety were evaluated by alpha feto-protein (AFP), imaging changes, postoperative complications and survival time.Results:The median follow-up period was 24 months. The average number of GSMs-TACE was 1.5. No postoperative complications such as biliary fistula, abdominal hemorrhage, liver and kidney failure, arterial stenosis and biliary stricture occurred. After GSMs-TACE, there were varying degrees of tumor necrosis or thrombus, AFP decreased (n=5) and PIVKAII declined (n=7). The 1-year survival rate was 100% and the 1-year disease-free survival rate 71.4%. For two cases of lung metastasis, the recurrent time was 4 and 10 months respectively.Conclusions:GSMs-TACE plus liver transplantation offer good safety and clinical efficacy for hepatocellular carcinoma patients with portal vein cancer thrombus.