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- Title
A combination therapy with transarterial chemo-lipiodolization and systemic chemo-infusion for large extensive hepatocellular carcinoma invading portal vein in comparison with conservative management.
- Authors
Jeong Won Jang; Si Hyun Bae; Jong Young Choi; Hyun Jong Oh; Min Soo Kim; So Yeon Lee; Chang Wook Kim; U Im Chang; Soon Woo Nam; Sang Bok Cha; Seung Kew Yoon; Young Joon Lee; Ho Jong Chun; Byung Gil Choi; Jae Young Byun
- Abstract
Purpose: Hepatocellular carcinoma (HCC) invading the portal vein is a medical challenge. We evaluated the therapeutic efficacy of a combination of transarterial and systemic chemo-infusion for large HCC with portal vein thrombosis (PVT) compared with conservative management. Patients and methods: This was a case-control cohort study of 103 consecutive patients with Child-Pugh class A who had a large (>10 cm) HCC with PVT. The patients were assigned to receive either combined transarterial epirubicin (50 mg/m2) plus cisplatin (60 mg/m2) chemo-lipiodolization and systemic 5-fluorouracil (200 mg/m2) chemo-infusion (ECF regimen) at monthly intervals ( n=80) or conservative management ( n=23). Results: The objective tumor response (21.3 vs. 0%, P=0.011) and overall survival (8.7 vs. 3.5 months, P<0.001) were significantly better in the treatment group than in the conservative group. The prognostic factors for survival were tumor type ( P=0.007), bilobar involvement ( P=0.001), distant metastasis ( P=0.009) and objective tumor response ( P<0.001) for the treatment group. Survival benefits with the treatment were also maintained in each subgroup after stratification of these variables. Conclusions: This study suggests that when the hepatic function is preserved, a therapeutic strategy could be more beneficial than conservative management for such a large extensive HCC. As a therapeutic option, a combination therapy using ECF regimen may provide a significantly better tumor response and survival benefit in patients with large HCC invading the portal vein.
- Subjects
LIVER cancer; LIVER metastasis; PORTAL vein; THROMBOSIS; DRUG therapy; THERAPEUTICS
- Publication
Cancer Chemotherapy & Pharmacology, 2007, Vol 59, Issue 1, p9
- ISSN
0344-5704
- Publication type
Article
- DOI
10.1007/s00280-006-0239-0