TY - JOUR
T1 - Advanced-stage hepatocellular carcinoma with portal vein thrombosis
T2 - conventional versus drug-eluting beads transcatheter arterial chemoembolization
AU - Gorodetski, Boris
AU - Chapiro, Julius
AU - Schernthaner, Ruediger
AU - Duran, Rafael
AU - Lin, Ming De
AU - Lee, Howard
AU - Lenis, David
AU - Stuart, Elizabeth A.
AU - Nonyane, Bareng Aletta Sanny
AU - Pekurovsky, Vasily
AU - Tamrazi, Anobel
AU - Gebauer, Bernhard
AU - Schlachter, Todd
AU - Pawlik, Timothy M.
AU - Geschwind, Jean Francois
N1 - Publisher Copyright:
© 2016, European Society of Radiology.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objectives: Our study sought to compare the overall survival in patients with hepatocellular carcinoma (HCC) and portal venous thrombosis (PVT), treated with either conventional trans-arterial chemoembolization (cTACE) or drug-eluting beads (DEB) TACE. Methods: This retrospective analysis included a total of 133 patients, treated without cross-over and compared head-to-head by means or propensity score weighting. Mortality was compared using survival analysis upon propensity score weighting. Adverse events and liver toxicity grade ≥3 were recorded and reported for each TACE. In order to compare with historical sorafenib studies, a sub-group analysis was performed and included patients who fulfilled the SHARP inclusion criteria. Results: The median overall survival (MOS) of the entire cohort was 4.53 months (95 % CI, 3.63–6.03). MOS was similar across treatment arms, no significant difference between cTACE (N = 95) and DEB-TACE (N = 38) was observed (MOS of 5.0 vs. 3.33 months, respectively; p = 0.157). The most common adverse events after cTACE and DEB- TACE, respectively, were as follows: post-embolization syndrome [N = 57 (30.0 %) and N = 38 (61.3 %)], diarrhea [N = 3 (1.6 %) and N = 3 (4.8 %)], and encephalopathy [N = 11 (5.8 %) and N = 2 (3.2 %)]. Conclusion: Our retrospective study could not reveal a difference in toxicity and efficiency between cTACE and DEB-TACE for treatment of advanced stage HCC with PVT. Key Points: • Conventional TACE (cTACE) and drug-eluting-beads TACE (DEB-TACE) demonstrated equal safety profiles. • Survival rates after TACE are similar to patients treated with sorafenib. • Child-Pugh class and tumor burden are reliable predictors of survival.
AB - Objectives: Our study sought to compare the overall survival in patients with hepatocellular carcinoma (HCC) and portal venous thrombosis (PVT), treated with either conventional trans-arterial chemoembolization (cTACE) or drug-eluting beads (DEB) TACE. Methods: This retrospective analysis included a total of 133 patients, treated without cross-over and compared head-to-head by means or propensity score weighting. Mortality was compared using survival analysis upon propensity score weighting. Adverse events and liver toxicity grade ≥3 were recorded and reported for each TACE. In order to compare with historical sorafenib studies, a sub-group analysis was performed and included patients who fulfilled the SHARP inclusion criteria. Results: The median overall survival (MOS) of the entire cohort was 4.53 months (95 % CI, 3.63–6.03). MOS was similar across treatment arms, no significant difference between cTACE (N = 95) and DEB-TACE (N = 38) was observed (MOS of 5.0 vs. 3.33 months, respectively; p = 0.157). The most common adverse events after cTACE and DEB- TACE, respectively, were as follows: post-embolization syndrome [N = 57 (30.0 %) and N = 38 (61.3 %)], diarrhea [N = 3 (1.6 %) and N = 3 (4.8 %)], and encephalopathy [N = 11 (5.8 %) and N = 2 (3.2 %)]. Conclusion: Our retrospective study could not reveal a difference in toxicity and efficiency between cTACE and DEB-TACE for treatment of advanced stage HCC with PVT. Key Points: • Conventional TACE (cTACE) and drug-eluting-beads TACE (DEB-TACE) demonstrated equal safety profiles. • Survival rates after TACE are similar to patients treated with sorafenib. • Child-Pugh class and tumor burden are reliable predictors of survival.
KW - Adverse effects
KW - Chemoembolization
KW - Hepatocellular carcinoma
KW - Liver
KW - Propensity score
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U2 - 10.1007/s00330-016-4445-9
DO - 10.1007/s00330-016-4445-9
M3 - Article
C2 - 27277261
AN - SCOPUS:84976274819
SN - 0938-7994
VL - 27
SP - 526
EP - 535
JO - European radiology
JF - European radiology
IS - 2
ER -