Transcatheter arterial chemoembolization after liver resection for hepatocellular carcinoma with portal vein tumor thrombus / 中华肝胆外科杂志

ABSTRACT

ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) after liver resection for hepatocellular carcinoma (HCC) with tumor thrombus in the main trunk and/or first branch of portal vein,and to clarify prognostic factors affecting survival.Methods From 2005 to 2009,there were 358 consecutive patients with HCC who underwent surgical resection in our Department.In 55 patients (15 ％),portal vein tumor thrombus (PVTT) was found intraoperatively or postoperatively during histopathological examinations to involve the first portal branch,main portal trunk,or contralateral portal branch.In this retrospective study,these 55 patients were divided into two groupsGroup A,29 patients received postoperative TACE,and Group B,26 patients who did not receive TACE.The clinical data and survivals were compared between the two groups.Prognostic factors were indentified using univariate analysis,followed by multivariate regression analysis using the Cox proportional hazards model.ResultsThere were no significant differences in the demographic clinical data between Group A and Group B.The overall 1-,2- and 3-year survivals for the 55 patients were 63.3 ％,51.4 ％ and 43.5 ％,respectively.The accumulative 1-,2- and 3-year survivals for group A were 71.4 ％,60.1 ％ and 50.1 ％,respectively.The corresponding figures for group B were 56.7％,21.7％ and 10.4％,respectively.Multiple tumors,intrahepatic metastases,hepatic vein thrombus,and invasive type of tumor thrombus were found to be risk factors for short-term survival on univariate analysis,while the latter 3 factors were further found to be significant prognostic factors in the Cox proportional hazards model.Postoperative TACE was shown to be a significant factor in both univariate and multivariate analyses.ConclusionLiver resection was beneficial for some patients with portal vein tumor thrombus.Postoperative TACE further improved the prognosis and prolonged survivals in these patients.