Published online Dec 15, 2018. doi: 10.4251/wjgo.v10.i12.496
Peer-review started: August 8, 2018
First decision: October 4, 2018
Revised: October 19, 2018
Accepted: November 23, 2018
Article in press: November 24, 2018
Published online: December 15, 2018
Processing time: 129 Days and 20.1 Hours
To evaluate the efficacy of main portal vein stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus.
From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization (TACE)/transarterial embolization (TAE) + portal vein stents combined with 125I implantation (Group A) and TACE/TAE + portal vein stents only (Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses.
From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio (HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant (log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.
Main portal vein stents combined with 125I can significantly improve survival rate and reduce the rate of stent restenosis.
Core tip: This study evaluated the efficacy of stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus and its complications. 125I was placed between the stent and tumor thrombus, and not in the form of particle strands. In this way, the quantity and position of 125I could be flexibly adjusted. Transarterial chemoembolization or transarterial embolization was used as basic treatment. Patients with liver cancer and main portal vein tumor thrombus were non-randomly assigned to undergo portal vein stents combined with 125I implantation or portal vein stents only. Portal vein stent combined with 125I significantly improved survival rate and reduced stent restenosis.