Factors influencing the short-term and long-term survival of hepatocellular carcinoma patients with portal vein tumor thrombosis who underwent chemoembolization

doi:10.3748/wjg.v27.i13.1330

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Apr 7, 2021; 27(13): 1330-1340
Published online Apr 7, 2021. doi: 10.3748/wjg.v27.i13.1330

Table 1 Characteristic of the 181 patients

Parameters	Patients, n = 181
Age in yr	52.16 ± 9.73
Sex, men/women	159/22
Cause of liver disease, hepatitis B/C/B and C/others	163/3/1/14
Tumor size, < 5 cm/≥ 5 cm, < 10 cm/≥ 10 cm	39/86/56
Number of tumors, 1/2/≥ 3	82/12/87
Liver cirrhosis, no/yes	48/133
Ascites, no/small/moderate-massive	91/70/20
CTPV, no/yes	158/23
Invade left and right liver lobes, no/yes	119/62
Type of gross pathology, massive/nodular/diffuse	112/59/10
PVTT type, I/II/III/IV	29/77/68/7
Inferior vena cava tumor thrombus, no/yes	171/10
Arteriovenous fistula, no/yes	125/56
Total bilirubin, µmol/L	17.1 (12.3-24.7)
Prealbumin, mg/L	110 (79-147)
Albumin, g/L	37 ± 4.8
Hemoglobin, g/L	127 (115-142)
WBC, 10⁹/L	5.1 (3.925-6.505)
PLT, 10⁹/L	116 (81- 179.5)
INR	1.12 (1.055-1.205)
PT, S	14.3 (13.7-15.25)
APTT, S	39.5 (37-42.8)
ALT, U/L	46 (31-71.5)
AST, U/L	65 (46-109.5)
GGT, U/L	211 (124.5-352.5)
Cholinesterase, kU/L	4.5 (3.065-5.78)
Creatinine, µmol/L	68 (57.7-78.1)
AFP, µg/L	1210 (82.905-1210)
Child-Pugh grade, A/B/C	123/55/3
ECOG score, 0/1/2/3	8/142/29/2
ALBI grade, 1/2/3	56/120/5
MELD score	7.67 (6.08-9.54)
Overall survival time, mo	4.8 (2.5-8.85)

AFP: Alpha fetoprotein; ALBI: Albumin-bilirubin; ALT: Alanine aminotransferase; APTT: Activated partial thromboplastin time; AST: Aspartate aminotransferase; CTPV: Cavernous transformation of the portal vein; ECOG: Eastern Cooperative Oncology Group; GGT: Gamma-glutamyl transpeptidase; INR: International normalized ratio; MELD: Model of end-stage liver disease; PLT: Platelets; PVTT: Portal vein tumor thrombosis; WBC: White blood cell.

Table 2 Univariate analysis of survivors vs non-survivors at 3 mo after transarterial chemoembolization

Parameters	Survivors, n = 125	Non-survivors, n = 56	P value
Age in yr	52.56 ± 9.966	51.27 ± 9.212	0.18
Sex, men/women	114/11	45/11	0.04
Cause of liver disease, hepatitis B/C/B and C/others	113/1/0/11	50/2/1/3	0.157
Tumor size, < 5 cm/≥ 5 cm, < 10 cm/≥ 10 cm	29/57/39	10/29/17	0.659
Number of tumors, 1/2/≥ 3	62/10/53	20/2/34	0.06
Liver cirrhosis, no/yes	36/89	12/44	0.299
Ascites, no/small/moderate-massive	68/47/10	23/23/10	0.087
CTPV, no/yes	110/15	48/8	0.67
Invade left and right liver lobes, no/yes	85/40	34/22	0.34
Type of gross pathology, massive / nodular and diffuse	78/47	34/22	0.829
PVTT type, I/II/III/IV	24/52/44/5	5/25/24/2	0.354
Inferior vena cava tumor thrombus, no/yes	119/6	52/4	0.775
Arteriovenous fistula, no/yes	89/36	36/20	0.352
Total bilirubin, µmol/L	15 (11.15-21.75)	22.25 (17.175-32)	< 0.01
Prealbumin, mg/L	119 (87-159.5)	91.5 (67.25-120.5)	< 0.01
Albumin, g/L	36.407 ± 4.749	37.205 ± 4.853	0.758
Hemoglobin, g/L	127 (115-142)	127 (113.25-143)	0.89
WBC, 10⁹/L	5.06 (4.06-6.27)	5.09 (3.61-6.72)	0.87
PLT, 10⁹/L	119.00 (86.00-180.50)	111.00 (69.25-178.25)	0.15
INR	1.11 (1.06-1.19)	1.12 (1.05-1.26)	0.33
PT, S	14.20 (13.70-15.20)	14.35 (13.70-15.78)	0.38
APTT, S	39.60 (37.25-42.80)	39.35 (36.32-42.85)	0.47
ALT, U/L	41.00 (29.50-62.00)	58.00 (41.25-85.75)	< 0.01
AST, U/L	56.00 (41.00-81.00)	109.00 (72.00-161.75)	< 0.01
GGT, U/L	188.00 (109.00-300.50)	256.00 (186.00-415.25)	< 0.01
Cholinesterase, kU/L	4.88 (3.44-5.84)	3.89 (2.69-5.4675)	0.02
Creatinine, µmol/L	68.60 (58.20-77.25)	66.95 (54.98-79.60)	0.63
AFP, µg/L	1210 (47.86-1210)	1210 (270-1210)	0.34
Child-Pugh grade, A/B/C	94/30/1	29/25/2	< 0.01
ECOG score, 0/1/2/3	8/102/14/1	0/40/15/1	0.016
ALBI grade, 1/2/3	43/79/9	13/41/2	0.31
MELD score	7.53 (5.88-9.02)	9.10 (7.08-11.19)	< 0.01

Table 3 Multivariate analysis of short-term and long-term survival

Variables	Short-term survival		Long-term survival
Variables	OR (95%CI)	P value	OR (95%CI)	P value
Total bilirubin, µmol/L	1.027 (1-1.054)	0.046
AST, U/L	1.014 (1.006-1.021)	P < 0.01
Sex
Men	1
Women	2.832 (1.025-7.828)	0.045
Type of gross pathology
Massive			1
Nodular and diffuse			0.197 (0.075-0.521)	0.001
Number of tumors
1			1
2			1.365 (0.283-6.581)	0.698
3			5.809 (1.563-21.594)	0.009

AST: Aspartate aminotransferase; CI: Confidence interval; OR: Odds ratio.

Table 4 Univariate analysis of survivors vs non-survivors at 12 mo after transarterial chemoembolization

Parameters	Survivors, n = 31	Non-survivors, n = 150	P value
Age in yr	54.770 ± 10.724	51.800 ± 9.400	0.225
Sex, men/women	28/3	131/19	0.871
Cause of liver disease, hepatitis B/C/B and C/others	30/0/0/1	133/3/1/13	0.751
Tumor size, < 5 cm/≥ 5 cm, < 10 cm/≥ 10 cm	11/14/6	28/72/50	0.081
Number of tumors, 1/2/≥ 3	21/4/6	61/8/81	0.002
Liver cirrhosis, no/yes	4/27	44/106	0.059
Ascites, no/small/moderate-massive	16/11/4	75/59/16	0.892
CTPV, no/yes	26/5	132/18	0.74
Invade left and right liver lobes, no/yes	26/5	93/57	0.019
Type of gross pathology, massive/nodular and diffuse	13/18	99/51	0.012
PVTT type, I/II, III/IV	7/10/11/3	22/67/57/4	0.155
Inferior vena cava tumor thrombus, no/yes	30/1	141/9	0.854
Arteriovenous fistula, no/yes	21/10	104/46	0.861
Total bilirubin, µmol/L	19.550 (11.200-33.400)	16.600 (12.900-24.000)	0.436
Prealbumin, mg/L	124.500 (86.750-160.500)	105.000 (78.000-142.000)	0.163
Albumin, g/L	37.047 ± 5.635	36.813 ± 4.622	0.669
Hemoglobin, g/L	132.500 (117.500-146.500)	125.000 (115.000-142.000)	0.316
WBC, 10⁹/L	4.565 (3.398-5.850)	5.100 (4.050-6.610)	0.284
PLT, 10⁹/L	89.000 (63.250-126.000)	119.000 (87.000-182.000)	0.046
INR	1.120 (1.070-1.253)	1.110 (1.050-1.200)	0.281
PT, S	14.400 (13.850-15.875)	14.300 (13.700-15.200)	0.266
APTT, S	39.200 (36.450-42.075)	39.700 (37.100-42.900)	0.541
ALT, U/L	46.500 (38.500-72.000)	45.000 (30.000-72.000)	0.770
AST, U/L	56.500 (41.750-83.750)	71.000 (46.000-115.000)	0.108
GGT, U/L	177.500 (72.250-265.250)	216.000 (132.000-356.000)	0.036
Cholinesterase, kU/L	4.25 (2.775-5.905)	4.51 (3.08-5.79)	0.945
Creatinine, µmol/L	71.300 (61.475-79.500)	67.600 (57.400-78.100)	0.220
AFP, µg/L	568 (15.13~1210)	1210 (97.335-1210)	0.188
Child-Pugh grade, A/B/C	19/11/1	104/44/2	0.373
ECOG score, 0/1/2/3	4/24/3/0	4/118/26/2	0.086
ALBI grade, 1/2/3	13/16/2	43/104/3	0.09
MELD score	7.130 (5.548-9.315)	7.860 (6.070-9.790)	0.348

AFP: Alpha fetoprotein; ALBI: Albumin-bilirubin; ALT: Alanine aminotransferase; APTT: Activated partial thromboplastin time; AST: Aspartate aminotransferase; CTPV: Cavernous transformation of the portal vein; ECOG: Eastern Cooperative Oncology Group; GGT: Gamma-glutamyl transpeptidase; INR: International normalized ratio; MELD: Model of end-stage liver disease; PLT: Platelets; PVTT Portal vein tumor thrombosis; WBC: White blood cell.

Citation: Chen KL, Gao J. Factors influencing the short-term and long-term survival of hepatocellular carcinoma patients with portal vein tumor thrombosis who underwent chemoembolization. World J Gastroenterol 2021; 27(13): 1330-1340
URL: https://www.wjgnet.com/1007-9327/full/v27/i13/1330.htm
DOI: https://dx.doi.org/10.3748/wjg.v27.i13.1330