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European Radiology
Published in: European Radiology 7/2016

01-07-2016 | Oncology

Efficacy and safety of preoperative chemoembolization for resectable hepatocellular carcinoma with portal vein invasion: a prospective comparative study

Published in: European Radiology | Issue 7/2016

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Abstract

Objectives

To evaluate the outcomes of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC) with portal vein invasion.

Methods

From February 2006 to July 2011, 320 patients initially diagnosed with resectable HCC and portal vein invasion were prospectively non-randomized into two arms. In the immediate resection arm (Arm 1, n = 205) patients received immediate surgical resection. 115 patients were included in the preoperative TACE arm (Arm 2), and eventually 85 patients underwent TACE followed by surgical resection.

Results

The 1-, 3- and 5-year overall survival rates were 48.3 %, 18.7 % and 13.9 % for Arm 1 and 61.2 %, 31.7 % and 25.3 % for Arm 2 (P = 0.001), respectively. In the subgroup analysis of types I and II portal vein tumour thrombus (PVTT), the preoperative TACE arm demonstrated significantly better survival rates than the immediate resection arm (P I  = 0.001, P II  = 0.036). However, no significant difference was found for patients with type III PVTT (P III  = 0.684). No significant difference was found between the two arms in terms of complications and mortality.

Conclusions

Preoperative TACE seems to confer a survival benefit for resectable HCC with PVTT, especially for types I and II PVTT, and preoperative TACE should therefore be recommended as a routine procedure.

Key Points

• Preoperative TACE improves the clinical outcomes for patients with PVTT
• Preoperative TACE could significantly improve the rate of en bloc thrombectomy
• Preoperative TACE does not increase the related adverse events
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Metadata
Title
Efficacy and safety of preoperative chemoembolization for resectable hepatocellular carcinoma with portal vein invasion: a prospective comparative study
Publication date
01-07-2016
Published in
European Radiology / Issue 7/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4021-8

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