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European Radiology
Published in: European Radiology 10/2016

Open Access 01-10-2016 | Hepatobiliary-Pancreas

Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: a retrospective matched cohort study

Authors: Mingsheng Huang, Qu Lin, Haofan Wang, Junwei Chen, Mingjun Bai, Long Wang, Kangshun Zhu, Zaibo Jiang, Shouhai Guan, Zhengran Li, Jiesheng Qian, Mingan Li, Pengfei Pang, Hong Shan

Published in: European Radiology | Issue 10/2016

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Abstract

Objectives

To investigate the survival benefit of transarterial chemoembolization (TACE) plus Iodine125 seed implantation (TACE-Iodine125) in hepatitis B-related HCC patients with portal vein tumour thrombus (PVTT) and the underlying prognostic factors.

Methods

A retrospective matched cohort study was performed on consecutive HCC patients with PVTT from January 2011 to June 2014. Seventy patients (TACE-Iodine125 group) who underwent TACE-Iodine125 were compared with a historical case-matched control group of 140 patients (TACE group) who received TACE alone. The survival of patients and the underlying prognostic factors were analysed.

Results

The median survival times of the TACE-Iodine125 and TACE groups were 11.0 and 7.5 months, respectively (p < 0.001). The survival probability at 12, 24, and 36 months was 50 %, 14.5 %, and 14.5 % vs. 25 %, 9 %, and 5 % in the TACE-Iodine125 and TACE groups, respectively (p < 0.001). The PVTT responders had better survival than the PVTT non-responders (p < 0.001). For the PVTT non-responders, there were no differences in the survival curves between the groups (p = 0.353). Multivariate analysis showed that type III PVTT (p < 0.001) and APS (p < 0.001) were independent predictors of poor prognosis. In contrast, the treatment modality of TACE-Iodine125 (p < 0.001) and PVTT response (p = 0.001) were favourable prognostic features.

Conclusions

TACE combined with Iodine125 seed implantation may be a good choice for selected HB-HCC patients with PVTT.

Key Points

• TACE-Iodine125 was more effective than TACE for patients with HCC-PVTT.
• The TACE-Iodine125 procedure was safe.
• TACE-Iodine125 was conditional for patients with HCC-PVTT.
• TACE-Iodine125 resulted in a better PVTT response compared to TACE alone.
• A good PVTT response is a favourable prognostic factor.
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Metadata
Title
Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: a retrospective matched cohort study
Authors
Mingsheng Huang
Qu Lin
Haofan Wang
Junwei Chen
Mingjun Bai
Long Wang
Kangshun Zhu
Zaibo Jiang
Shouhai Guan
Zhengran Li
Jiesheng Qian
Mingan Li
Pengfei Pang
Hong Shan
Publication date
01-10-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4198-x

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