Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma with Portal Vein Thrombosis: A Perspective on Survival

Yadav, Ajit; Hariprasad, Sudarsan; Gupta, SK; Agarwal, Abhishek; Redhu, Navneet; Piyush, Ranjan; Arora, Anil; Gupta, Arun

doi:10.5001/omj.2014.114

Cited by 21 publications

(12 citation statements)

References 13 publications

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“…The AEs rate was 28.9%, with gastrointestinal hemorrhage more frequent in the TACE group[66]. Another small study evidenced satisfying survival rates at 3-, 6- and 12-mo (82%, 71%, 47% respectively), with a median survival rate of 10 months and better OS in Child-Pugh A compared to Child B patients (15 mo vs 5 mo, respectively)[67]. Tawada et al [68] retrospectively analyzed the AEs in a group of patients with PVTT treated with TACE: The main grade 3 AEs were ALT and AST (Aspartate Aminotransferase) elevation (54.5% and 69.7%, respectively) whereas the occurrence of thrombocytopenia, hyponatremia, hyperbilirubinemia, leukopenia and anemia was rare.…”

Section: Treatment Options For Hcc With Pvtt: State Of the Art And Pomentioning

confidence: 99%

Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers

Cerrito

Annicchiarico

Iezzi

et al. 2019

WJG

105

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Hepatocellular carcinoma is one of the most frequent malignant tumors worldwide: Portal vein tumor thrombosis (PVTT) occurs in about 35%-50% of patients and represents a strong negative prognostic factor, due to the increased risk of tumor spread into the bloodstream, leading to a high recurrence risk. For this reason, it is a contraindication to liver transplantation and in several prognostic scores sorafenib represents its standard of care, due to its antiangiogenetic action, although it can grant only a poor prolongation of life expectancy. Recent scientific evidences lead to consider PVTT as a complex anatomical and clinical condition, including a wide range of patients with different prognosis and new treatment possibilities according to the degree of portal system involvement, tumor biological aggressiveness, complications caused by portal hypertension, patient’s clinical features and tolerance to antineoplastic treatments. The median survival has been reported to range between 2.7 and 4 mo in absence of therapy, but it can vary from 5 mo to 5 years, thus depicting an extremely variable scenario. For this reason, it is extremely important to focus on the most adequate strategy to be applied to each group of PVTT patients.

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Section: Treatment Options For Hcc With Pvtt: State Of the Art And Pomentioning

confidence: 99%

Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers

Cerrito

Annicchiarico

Iezzi

et al. 2019

WJG

105

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“…The patient survival rates decreased from 82% at 3-months to 71% at 6 months and 47% at 12 months, with a median survival of 10 months. Patients with Child-Pugh A liver function had better median survival when compared to patients with Child-Pugh B (15 months vs. 13 months) [ 33 ], and the complete remission rate (CR), partial remission rate (PR), and stable disease rate (SD) were reported to be 0, 19.5% to 26.3%, and 42.5% to 62.7%, respectively[ 34 , 35 , 36 ]. Lipiodol and gelatin sponge are common embolizing agents used in TACE [ 37 ].…”

Section: Nonsurgical Therapiesmentioning

confidence: 99%

Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition

2016

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Hepatocellular carcinoma is the fourth leading cause of cancer-related morbidity and mortality in China. Portal vein tumor thrombus (PVTT) is common and it worsens prognosis of hepatocellular carcinoma (HCC). There is no internationally accepted consensus or guideline for diagnosis and treatment of HCC with PVTT. Based on existing evidences and common current practices, Chinese Experts on Multidisciplinary Diagnosis and Treatment of HCC with portal vein tumor thrombus met to develop a national consensus on diagnosis and treatment of HCC with PVTT. The meeting concluded with the First Edition (version 2016) of consensus statements with grades of evidence given as grades Ia, Ib, IIa, IIb, III and IV, and ranking as Classes A, B, C, D and I for quality of evidence and strength of recommendation by the United State Preventive Service Task Force, respectively. The consensus suggests recommended treatment to be based on patients PVTT type and ECOG functional status; surgery being the preferred treatment for Child-Pugh A, PVTT type I/II, and ECOG PS 0-1; transcatheter arterial chemoembolization (TACE) for non-resectable PVTT I/II and Child-Pugh A; and radiotherapy for non-resectable PVTT I/II/III and Child-Pugh A. Symptomatic treatment is recommended for Child-Pugh C, with massive ascites or gastrointestinal bleeding. By updating clinicians with treatment options for HCC with PVTT, the consensus statement aimed to prolong overall survival and to improve quality of life of patients with minimal treatment complication. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials, especially studies defining the role of traditional Chinese medicine and clarifying molecular aspects of HCC.

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“…To the best of our knowledge, no case was reported before for portal vein thrombosis occurring after TACE. Proximal portal thrombosis diagnosed before TACE is an absolute contraindication of TACE because it is associated to a high risk of hepatic failure and infraction [10].…”

Section: Observation N°2mentioning

confidence: 99%

Liver Abscess and Portal Vein Thrombosis Complicating TACE for HCC: Case Study and Literature Review

Hassani¹,

Idrissi²,

Haloua³

et al. 2020

J Clin Gastroenterol Treat

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Major complications after TACE remain rare but deadly, the main complications can be vascular: within the access artery or the hepatic artery, or non-vascular: post-embolization syndrome (PES), biliary tract injuries, non-target regional or distant (cerebral or pulmonary) embolization, intra-or extra hepatic infection, TACE induced hepatic failure, hepatic rupture and many others. We report 3 complications in 2 patients: hepatic abscess, portal thrombosis and hepatic failure. The 2 patients unfortunately died after severe hepatic failure. Both of the two patients developed portal thrombosis after chemoembolization. This is the first case report of portal thrombosis developed after TACE with an extended hepatic necrosis in the second case. This article reviews different aspects of liver abscess complicating TACE for HCC.

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Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma with Portal Vein Thrombosis: A Perspective on Survival

Abstract: TACE is a promising procedure in unresectable hepatocellular carcinoma with PV thrombosis. Response to chemoembolization, ascites and Child-Pugh class were the most important determining factors of survival.

Cited by 21 publications

References 13 publications

Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers

Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers

Chinese expert consensus on multidisciplinary diagnosis and treatment of hepatocellular carcinoma with portal vein tumor thrombus: 2016 edition

Liver Abscess and Portal Vein Thrombosis Complicating TACE for HCC: Case Study and Literature Review

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