Department of Postgraduate, Guangxi Medical University, Tumor Hospital of Guangxi Autonomous Region, Nanning, Guangxi Province, People's Republic of China.
Med Oncol. 2012 Dec;29(4):2992-7. doi: 10.1007/s12032-011-0145-0. Epub 2011 Dec 27.
We aimed to compare the survival benefit of transarterial chemoembolization (TACE) with conservative treatment for patients with advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT), furthermore, to reveal which PVTT types benefit from TACE treatment. From August 2007 to January 2010, a prospective controlled study was performed on consecutive patients with advanced HCC and PVTT. Of a total of 150 patients, 115 were treated with TACE (lipiodol and anticancer agents ± gelatin sponge embolization), and 35 who refused to accept the procedure were treated with conservative treatment. We performed survival analysis of the two treatment groups and then stratified by a new classification of PVTT that was divided into four types. Overall survival was significantly better in the TACE group than in the conservative group (8.67 months vs. 1.4 months, P<0.001). The overall median survival for types I-IV PVTT were 12.0, 8.3, 5.0, and 2.43 months (P<0.01). On subgroup analysis of PVTT, the median survival in the TACE group compared with conservative group for type I, II, III, and IV PVTT was 19.0 months versus 4.0 months, 11.0 months versus 1.43 months, 7.1 months versus 1.3 months, and 4.0 months versus 1.0 months, respectively (P<0.01). The TACE group had significantly better survival than the conservative group for different extent of PVTT. TACE is an effective treatment mode compared with conservative treatment for HCC and PVTT and may provide a significantly better survival benefit for different extent of PVTT.
我们旨在比较经导管动脉化疗栓塞（TACE）与保守治疗对晚期肝细胞癌（HCC）伴门静脉癌栓（PVTT）患者的生存获益，并揭示哪些 PVTT 类型从 TACE 治疗中获益。从 2007 年 8 月至 2010 年 1 月，我们对连续的晚期 HCC 伴 PVTT 患者进行了前瞻性对照研究。在总共 150 例患者中，115 例接受 TACE（碘化油和抗癌药物±明胶海绵栓塞）治疗，35 例拒绝接受该治疗的患者接受保守治疗。我们对两组患者进行了生存分析，并根据一种新的 PVTT 分类进行分层，该分类将 PVTT 分为四型。TACE 组的总生存明显优于保守组（8.67 个月比 1.4 个月，P<0.001）。I-IV 型 PVTT 的总中位生存时间分别为 12.0、8.3、5.0 和 2.43 个月（P<0.01）。在 PVTT 的亚组分析中，TACE 组与保守组相比，I 型、II 型、III 型和 IV 型 PVTT 的中位生存时间分别为 19.0 个月比 4.0 个月，11.0 个月比 1.43 个月，7.1 个月比 1.3 个月，4.0 个月比 1.0 个月（P<0.01）。对于不同程度的 PVTT，TACE 组的生存明显优于保守组。与保守治疗相比，TACE 是 HCC 和 PVTT 的一种有效治疗模式，可能为不同程度的 PVTT 提供更好的生存获益。
