Document Detail


Surgical resection versus conformal radiotherapy combined with TACE for resectable hepatocellular carcinoma with portal vein tumor thrombus: a comparative study.
MedLine Citation:
PMID:  23456227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of this study was to compare the results of surgical resection with three-dimensional conformal radiotherapy (3D-CRT) in the treatment of resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT). Transarterial chemoembolization (TACE) was given to both groups of patients when possible.
METHODS: A retrospective study of 371 patients with resectable HCC with PVTT was conducted in two tertiary referral centers. The treatment of choice for these patients in one center was surgical resection. In the other center it was 3D-CRT. In the radiotherapy group (RG, n = 185), patients received 3D-CRT to the tumor and PVTT for a total radiation dose of 30-52 Gy (median 40 Gy). In the surgical group (SG, n = 186), patients underwent surgical resection. TACE was applied after surgery or 3D-CRT and then was repeated every 4-6 weeks if the patient tolerated the treatment.
RESULTS: The median survival was 12.3 months for RG and 10.0 months for SG. The 1-, 2-, and 3-year overall survivals were 51.6, 28.4, and 19.9 %, respectively, for RG and 40.1, 17.0, and 13.6 %, respectively, for SG (p = 0.029). Stepwise multivariate analysis showed that the extent of PVTT and mode of treatment were independent risk factors of overall survival. The most common cause of death after treatment was liver failure as a consequence of progressive intrahepatic disease.
CONCLUSIONS: 3D-CRT gave better survival than surgical resection for HCC with PVTT.
Authors:
Qing-he Tang; Ai-jun Li; Guang-ming Yang; Eric C H Lai; Wei-ping Zhou; Zhi-hao Jiang; Wan Yee Lau; Meng-chao Wu
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  37     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2014-01-09     Revised Date:  2014-05-13    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1362-70     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Carcinoma, Hepatocellular / pathology*,  therapy*
Chemoembolization, Therapeutic
Combined Modality Therapy
Female
Hepatectomy / methods
Humans
Liver Neoplasms / pathology*,  therapy*
Male
Middle Aged
Portal Vein / pathology*
Radiation Dosage
Radiotherapy, Conformal
Retrospective Studies
Survival Rate
Thrombosis / pathology*,  therapy*
Treatment Outcome
Comments/Corrections
Comment In:
World J Surg. 2014 May;38(5):1246   [PMID:  24101027 ]
World J Surg. 2014 May;38(5):1247-8   [PMID:  24271695 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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