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首页> 外文期刊>Anticancer Research: International Journal of Cancer Research and Treatment >Treatment of Naive HCC Combined with Segmental or Subsegmental Portal Vein Tumor Thrombosis: Liver Resection Versus TACE Followed by Radiotherapy
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Treatment of Naive HCC Combined with Segmental or Subsegmental Portal Vein Tumor Thrombosis: Liver Resection Versus TACE Followed by Radiotherapy

机译：Naive HCC与节段性或亚段门静脉肿瘤血栓形成的治疗：肝切除与TACE接下来的放射治疗

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Background/Aim: There is no definite consensus regarding management of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). This study aimed to compare clinical outcomes according to initial treatment modality for treatment of naive HCC combined with subsegmental (Vp1)/ segmental (Vp2) PVTT with liver resection (LR) versus trans-arterial chemoembolization (TACE) followed by radiotherapy (RT). Materials and Methods: From our institutional registry, we enrolled 78 patients diagnosed with HCC combined with Vp1 or Vp2 PVTT and treated with LR or TACE followed by RT (TACE-RT) as a primary treatment. Results: LR was more frequently applied for younger, nodular tumor morphology, or solitary tumor. Overall, LR yielded significantly better progression free survival (PFS) (p=0.02, 41.9% vs. 15.7% at 2-years), and marginally higher overall survival (OS) (p=0.09, 75.8% vs. 61.5% at 2-years). There was an interaction effect between primary treatment and tumor morphology, and a significantly higher PFS was observed after LR in nodular morphology, in contrast with the lower PFS that was achieved after LR in infiltrative or massive morphology. Conclusion: Although LR yielded higher PFS than TACE-RT in HCC with Vp1 or Vp2 PVTT with similar acute complications, the difference in PFS between the LR and TACE-RT groups was significantly affected by tumor morphology.
机译：背景/目的：与门静脉肿瘤血栓形成（PVTT）的肝细胞癌（HCC）的管理没有明确的共识。本研究旨在根据初始治疗方式比较临床结果，用于治疗幼稚（VP1）/节段性（VP2）PVTT与肝切除（LR）与逆动脉化疗栓塞（TACE）的初级（VP1）/节段（VP2）PCVTT进行，然后进行放射疗法（RT）。材料和方法：从我们的机构注册表中，我们注册了78名患者，诊断患有vp1或vp2 pvtt，并用LR或TACE处理，然后进行RT（TACE-RT）作为主要处理。结果：LR更频繁地应用于较年轻，结节肿瘤形态或孤立肿瘤。总体而言，LR产生显着更好的进展自由存活（PFS）（P = 0.02,41.9％与2年的41.9％），总存活率略高（OS）（P = 0.09,75.8％与2 -年）。初级治疗和肿瘤形态之间存在相互作用效果，并且在结节形态的LR后观察到显着更高的PFs，相反，与LR渗透或大规模形态学后实现的下部PFS相反。结论：虽然LR在具有类似急性并发症的HCC中产生高于TACE-RT的PFS，但具有类似急性并发症的TAC，LR和TACE-RT组之间的PFS差异受到肿瘤形态的显着影响。

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