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Published in: Indian Journal of Gastroenterology 2/2018

01-03-2018 | Original Article

Outcome of transarterial chemoembolization in Egyptian patients with hepatocellular carcinoma and branch portal vein thrombosis

Authors: H. Abdella, M. K. Shaker, Iman Fawzy Montasser, M. Sobhi, H. Aly, A. Sayed, S. Saleh, A. El Dorry

Published in: Indian Journal of Gastroenterology | Issue 2/2018

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Abstract

Background/Aim

Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival.

Methods

Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE. Follow up was done at 1, 3, 6, and 12 months after first TACE. All patients underwent laboratory investigations including liver function tests to assess deterioration in liver functions and triphasic spiral computed tomography to assess radiological response according to modified response evaluation criteria in solid tumors (mRECIST) criteria, and survival analysis was recorded.

Results

TACE succeeded to achieve disease control in 93.3%, 86.3%, 57.7%, and 44.4% of patients after 1, 3, 6, and 12 months, respectively. Post-TACE liver decompensation occurred in the form of ascites in 30%, jaundice in 10%, and hepatic encephalopathy in 3.3% within 1 month of TACE. One month survival after TACE was 100%, 3 months was 96.6%, 6 months was 86.6%, and 1-year survival was 60%. Mean overall survival of the included patients was 17 months (SE = 1.59).

Conclusion

TACE seems an alternative option for patients with unrespectable HCC with portal vein thrombosis in patients with good liver function tests.
Literature
1.
go back to reference IARC: preventable exposures associated with human cancers. J Natl Cancer Inst 2011; 103:1–14. IARC: preventable exposures associated with human cancers. J Natl Cancer Inst 2011; 103:1–14.
2.
go back to reference Llovet J, Ducreux M, Lencioni R, et al. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer. 2012;48:599–641.CrossRef Llovet J, Ducreux M, Lencioni R, et al. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. Eur J Cancer. 2012;48:599–641.CrossRef
3.
4.
5.
go back to reference Yu J, Yoon S, Park H, et al. Multicenter validation study of a prognostic index for portal vein tumor thrombosis in hepatocellular carcinoma. Cancer Res Treat. 2014;46:348–57.CrossRefPubMedPubMedCentral Yu J, Yoon S, Park H, et al. Multicenter validation study of a prognostic index for portal vein tumor thrombosis in hepatocellular carcinoma. Cancer Res Treat. 2014;46:348–57.CrossRefPubMedPubMedCentral
6.
go back to reference Forner A, Reig M, de Lope C, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30:61–74.CrossRefPubMed Forner A, Reig M, de Lope C, Bruix J. Current strategy for staging and treatment: the BCLC update and future prospects. Semin Liver Dis. 2010;30:61–74.CrossRefPubMed
7.
go back to reference Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–2.CrossRefPubMedPubMedCentral Bruix J, Sherman M, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53:1020–2.CrossRefPubMedPubMedCentral
8.
go back to reference Lencioni R, Llovet J. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30:52–60.CrossRefPubMed Lencioni R, Llovet J. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30:52–60.CrossRefPubMed
9.
go back to reference Shaker M, Abdella H, Khalifa M, El Dorry A. Epidemiological characteristics of hepatocellular carcinoma in Egypt: a retrospective analysis of 1313 cases. Liver Int. 2013;33:1601–6.PubMed Shaker M, Abdella H, Khalifa M, El Dorry A. Epidemiological characteristics of hepatocellular carcinoma in Egypt: a retrospective analysis of 1313 cases. Liver Int. 2013;33:1601–6.PubMed
10.
go back to reference Song D, Nam S, Bae S, et al. Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma. World J Gastroenterol. 2015;21:2395–404.CrossRefPubMedPubMedCentral Song D, Nam S, Bae S, et al. Outcome of transarterial chemoembolization-based multi-modal treatment in patients with unresectable hepatocellular carcinoma. World J Gastroenterol. 2015;21:2395–404.CrossRefPubMedPubMedCentral
11.
go back to reference Kim K, Kim J, Park I, et al. Reappraisal of repeated transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein invasion. J Gastroenterol Hepatol. 2009;24:806–14.CrossRefPubMed Kim K, Kim J, Park I, et al. Reappraisal of repeated transarterial chemoembolization in the treatment of hepatocellular carcinoma with portal vein invasion. J Gastroenterol Hepatol. 2009;24:806–14.CrossRefPubMed
12.
go back to reference Leng JJ, Xu YZ, Dong JH. Efficacy of transarterial chemoembolization for hepatocellular carcinoma with portal vein thrombosis: a meta-analysis. ANZ J Surg. 2016;86:816–20.CrossRefPubMed Leng JJ, Xu YZ, Dong JH. Efficacy of transarterial chemoembolization for hepatocellular carcinoma with portal vein thrombosis: a meta-analysis. ANZ J Surg. 2016;86:816–20.CrossRefPubMed
13.
go back to reference Chung GE, Lee JH, Kim HY, Hwang SY, Kim JS, Chung JW, et al. Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival. Radiology. 2011;258:627–34.CrossRefPubMed Chung GE, Lee JH, Kim HY, Hwang SY, Kim JS, Chung JW, et al. Transarterial chemoembolization can be safely performed in patients with hepatocellular carcinoma invading the main portal vein and may improve the overall survival. Radiology. 2011;258:627–34.CrossRefPubMed
14.
go back to reference Jeon S, Park K, Kim Y, et al. Incidence and risk factors of acute hepatic failure after transcatheter arterial chemoembolization for hepatocellular carcinoma. Korean J Gastroenterol. 2007;50:176–82.PubMed Jeon S, Park K, Kim Y, et al. Incidence and risk factors of acute hepatic failure after transcatheter arterial chemoembolization for hepatocellular carcinoma. Korean J Gastroenterol. 2007;50:176–82.PubMed
15.
go back to reference Georgiades C, Hong K, D’Angelo M, Geschwind J. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol. 2005;16:1653–9.CrossRefPubMed Georgiades C, Hong K, D’Angelo M, Geschwind J. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis. J Vasc Interv Radiol. 2005;16:1653–9.CrossRefPubMed
16.
go back to reference Luo J, Guo RP, Lai EC, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a prospective comparative study. Ann Surg Oncol. 2011;18:413–20.CrossRefPubMed Luo J, Guo RP, Lai EC, et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis: a prospective comparative study. Ann Surg Oncol. 2011;18:413–20.CrossRefPubMed
Metadata
Title
Outcome of transarterial chemoembolization in Egyptian patients with hepatocellular carcinoma and branch portal vein thrombosis
Authors
H. Abdella
M. K. Shaker
Iman Fawzy Montasser
M. Sobhi
H. Aly
A. Sayed
S. Saleh
A. El Dorry
Publication date
01-03-2018
Publisher
Springer India
Published in
Indian Journal of Gastroenterology / Issue 2/2018
Print ISSN: 0254-8860
Electronic ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-018-0830-4

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