Factors influencing the short-term and long-term survival of hepatocellular carcinoma patients with portal vein tumor thrombosis who underwent chemoembolization
Open Access
- 7 April 2021
- journal article
- research article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 27 (13), 1330-1340
- https://doi.org/10.3748/wjg.v27.i13.1330
Abstract
The factors affecting the short-term and long-term prognosis of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) receiving transarterial chemoembolization (TACE) are still unclear. To clarify the predictors correlated with the short-term and long-term survival of HCC patients with PVTT who underwent TACE. The medical records of 181 HCC patients with PVTT who underwent TACE at the Second Affiliated Hospital of Chongqing Medical University from January 2015 to July 2019 were retrospectively analyzed. We explored the short-term and long-term prognostic factors by comparing the preoperative indicators of patients who died and survived within 3 mo and 12 mo after TACE. Multivariate analyses were conducted using logistic regression. The area under the receiver operating characteristic curve (area under curve) was used to evaluate the predictive ability of the factors related to the short-term and long-term prognosis. The median survival time was 4.8 mo (range: 2.5-8.85 mo). The 3 mo, 6 mo, and 12 mo survival rates were 68.5%, 38.7%, and 15.5%, respectively. In multivariable analysis, total bilirubin, sex, and aspartate aminotransferase (AST) were closely linked to short-term survival. When AST ≥ 87 U/L and total bilirubin ≥ 16.15 µmol/L, the 3-mo survival rate after TACE was reduced significantly (P < 0.05). AST had the best predictive ability, followed by total bilirubin, while sex had the worst predictive ability for short-term survival area under curve: 0.763 (AST) vs 0.707 (total bilirubin) vs 0.554 (sex)]. The long-term survival outcome was significantly better in patients with a single lesion than in those with ≥ three lesions (P = 0.009). Patients with massive block HCC had a worse long-term survival than patients with nodular and diffuse HCC (P = 0.001). AST, total bilirubin, and sex are independent factors associated with short-term survival. The number of tumors and the gross pathological type of tumor are related to the long-term outcome.Keywords
This publication has 16 references indexed in Scilit:
- Comprehensive treatments for hepatocellular carcinoma with portal vein tumor thrombosisJournal of Cellular Physiology, 2018
- Transarterial chemoembolization in hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysisHPB, 2017
- The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombusInternational Journal of Surgery, 2015
- The evolving epidemiology of hepatocellular carcinoma: a global perspectiveExpert Review of Gastroenterology & Hepatology, 2015
- Assessment of Liver Function in Patients With Hepatocellular Carcinoma: A New Evidence-Based Approach—The ALBI GradeJournal of Clinical Oncology, 2015
- Transarterial Chemoembolization for the Treatment of Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: Prognostic Factors in a Single-Center Study of 188 PatientsBioMed Research International, 2014
- Association of Abnormal Plasma Bilirubin With Aggressive Hepatocellular Carcinoma PhenotypeSeminars in Oncology, 2014
- Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Prospective Comparative StudyAnnals of Surgical Oncology, 2010
- Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein.2007