Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 7, 2021; 27(13): 1330-1340
Published online Apr 7, 2021. doi: 10.3748/wjg.v27.i13.1330
Factors influencing the short-term and long-term survival of hepatocellular carcinoma patients with portal vein tumor thrombosis who underwent chemoembolization
Ke-Li Chen, Jian Gao
Ke-Li Chen, Jian Gao, Department of Gastroenterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Author contributions: Chen KL was responsible for designing the study, collecting data, analyzing data and writing the paper; Gao J was responsible for designing the study and guiding important content of the article.
Supported by National Natural Science Foundation of China, No. 81572888.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Second Affiliated Hospital of Chongqing Medical University (No. 2020-122).
Informed consent statement: All study participants gave their informed consent prior to study enrollment (by written or verbal).
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian Gao, PhD, Chief Doctor, Professor, Department of Gastro-enterology and Hepatology, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China.982213482@qq.com
Received: January 9, 2021
Peer-review started: January 9, 2021
First decision: February 11, 2021
Revised: February 19, 2021
Accepted: March 7, 2021
Article in press: March 7, 2021
Published online: April 7, 2021
Processing time: 79 Days and 18 Hours
ARTICLE HIGHLIGHTS
Research background

Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) have poor prognosis. Transarterial chemoembolization (TACE) is an effective treatment for HCC patients with PVTT. The factors affecting the short-term and long-term prognosis of HCC patients with PVTT receiving TACE are still unclear.

Research motivation

The main aim of this study was to clarify the predictors correlated with the short-term and long-term survival of HCC patients with PVTT who underwent TACE.

Research objectives

We can provide some guidance to clinicians for selecting suitable patients for TACE by analyzing preoperative indicators.

Research methods

A total of 181 HCC patients with PVTT who underwent TACE were enrolled in this retrospective study. 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 was used to evaluate the predictive ability of the factors related to the short-term and long-term prognosis.

Research results

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. In long-term survival analysis, we found that patients with only one lesion had better long-term survival than those with ≥ three lesions. Patients with massive block liver cancer had a worse long-term outcome than patients with nodular and diffuse liver cancer.

Research conclusions

Sex, AST, and total bilirubin were associated with short-term survival outcomes in HCC patients with PVTT who underwent TACE. According to the area under the curve, AST was the best predictor of short-term survival, followed by total bilirubin. Multiple tumor lesions and massive block types of liver cancer were closely related to long-term adverse survival outcomes in HCC patients with PVTT who underwent TACE.

Research perspectives

Larger and multicenter studies are needed to validate further the results in the future.