State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Eur Radiol. 2019 Nov;29(11):5752-5762. doi: 10.1007/s00330-019-06157-0. Epub 2019 Apr 16.
To study lipiodol deposition in portal vein tumour thrombus (PVTT) in predicting the treatment outcome of hepatocellular carcinoma (HCC) patients after transarterial chemoembolisation (TACE).
We retrospectively reviewed data from 379 HCC patients with PVTT who underwent TACE as the initial treatment at Sun Yat-Sen University Cancer Center from January 2008 to December 2015. Patients were grouped by positive and negative lipiodol deposition based on the extent of lipiodol deposition in PVTT. The overall survival (OS) and progression-free survival (PFS) were compared between negative and positive lipiodol deposition groups; furthermore, the value of the combinatorial evaluation of tumour responses and lipiodol deposition in PVTT in predicting prognosis was analysed in subgroup patients with stable disease (SD) after TACE.
Of the 379 patients, 264 (69.7%) had negative and 115 (30.3%) had positive lipiodol deposition in PVTT after TACE. Multivariate analysis identified positive lipiodol deposition in PVTT as an independent prognostic factor for favourable OS (p = 0.001). The median OS and PFS of negative and positive lipiodol deposition groups were 4.70 vs. 8.97 months (p = 0.001) and 3.1 months vs. 5.8 months (p < 0.001). In subgroup patients, the median OS and PFS of negative and positive lipiodol deposition groups were 4.7 months vs. 10.5 months (p < 0.001) and 3.5 months vs. 7.0 months (p < 0.001), respectively.
The patients with positive lipiodol deposition in PVTT had a longer OS than those with negative lipiodol deposition. Furthermore, the positive lipiodol deposition in PVTT can further differentiate HCC patients with favourable prognosis from SD patients.
• Lipiodol deposition in PVTT is a prognostic indicator for HCC patients after TACE treatment. • Positive lipiodol deposition in PVTT is associated with a better prognosis.
研究门静脉癌栓（PVTT）中的碘化油沉积在预测经动脉化疗栓塞（TACE）后肝细胞癌（HCC）患者治疗结局中的作用。
我们回顾性分析了 2008 年 1 月至 2015 年 12 月在中山大学肿瘤防治中心接受 TACE 作为初始治疗的 379 例伴有 PVTT 的 HCC 患者的数据。根据 PVTT 中碘化油沉积的程度，将患者分为碘化油沉积阳性和阴性组。比较两组患者的总生存期（OS）和无进展生存期（PFS）；此外，还分析了 TACE 后疾病稳定（SD）亚组患者中肿瘤反应和 PVTT 中碘化油沉积联合评估对预后的预测价值。
379 例患者中，264 例（69.7%）TACE 后 PVTT 碘化油沉积阴性，115 例（30.3%）TACE 后 PVTT 碘化油沉积阳性。多因素分析显示，PVTT 中碘化油沉积阳性是 OS 良好的独立预后因素（p=0.001）。碘化油沉积阴性和阳性组的中位 OS 和 PFS 分别为 4.70 个月和 8.97 个月（p=0.001）和 3.1 个月和 5.8 个月（p<0.001）。在亚组患者中，碘化油沉积阴性和阳性组的中位 OS 和 PFS 分别为 4.7 个月和 10.5 个月（p<0.001）和 3.5 个月和 7.0 个月（p<0.001）。
PVTT 中有碘化油沉积的患者 OS 长于无碘化油沉积的患者。此外，PVTT 中碘化油沉积阳性可进一步将预后良好的 HCC 患者与 SD 患者区分开来。
门静脉癌栓中的碘化油沉积是 TACE 治疗后 HCC 患者的预后指标。
PVTT 中碘化油沉积阳性与较好的预后相关。
