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Erschienen in: European Radiology 2/2017

08.06.2016 | Hepatobiliary-Pancreas

Advanced-stage hepatocellular carcinoma with portal vein thrombosis: conventional versus drug-eluting beads transcatheter arterial chemoembolization

verfasst von: Boris Gorodetski, Julius Chapiro, Ruediger Schernthaner, Rafael Duran, MingDe Lin, Howard Lee, David Lenis, Elizabeth A. Stuart, Bareng Aletta Sanny Nonyane, Vasily Pekurovsky, Anobel Tamrazi, Bernhard Gebauer, Todd Schlachter, Timothy M. Pawlik, Jean-Francois Geschwind

Erschienen in: European Radiology | Ausgabe 2/2017

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Abstract

Objectives

Our study sought to compare the overall survival in patients with hepatocellular carcinoma (HCC) and portal venous thrombosis (PVT), treated with either conventional trans-arterial chemoembolization (cTACE) or drug-eluting beads (DEB) TACE.

Methods

This retrospective analysis included a total of 133 patients, treated without cross-over and compared head-to-head by means or propensity score weighting. Mortality was compared using survival analysis upon propensity score weighting. Adverse events and liver toxicity grade ≥3 were recorded and reported for each TACE. In order to compare with historical sorafenib studies, a sub-group analysis was performed and included patients who fulfilled the SHARP inclusion criteria.

Results

The median overall survival (MOS) of the entire cohort was 4.53 months (95 % CI, 3.63–6.03). MOS was similar across treatment arms, no significant difference between cTACE (N = 95) and DEB-TACE (N = 38) was observed (MOS of 5.0 vs. 3.33 months, respectively; p = 0.157). The most common adverse events after cTACE and DEB- TACE, respectively, were as follows: post-embolization syndrome [N = 57 (30.0 %) and N = 38 (61.3 %)], diarrhea [N = 3 (1.6 %) and N = 3 (4.8 %)], and encephalopathy [N = 11 (5.8 %) and N = 2 (3.2 %)].

Conclusion

Our retrospective study could not reveal a difference in toxicity and efficiency between cTACE and DEB-TACE for treatment of advanced stage HCC with PVT.

Key Points

Conventional TACE (cTACE) and drug-eluting-beads TACE (DEB-TACE) demonstrated equal safety profiles.
Survival rates after TACE are similar to patients treated with sorafenib.
Child-Pugh class and tumor burden are reliable predictors of survival.
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Metadaten
Titel
Advanced-stage hepatocellular carcinoma with portal vein thrombosis: conventional versus drug-eluting beads transcatheter arterial chemoembolization
verfasst von
Boris Gorodetski
Julius Chapiro
Ruediger Schernthaner
Rafael Duran
MingDe Lin
Howard Lee
David Lenis
Elizabeth A. Stuart
Bareng Aletta Sanny Nonyane
Vasily Pekurovsky
Anobel Tamrazi
Bernhard Gebauer
Todd Schlachter
Timothy M. Pawlik
Jean-Francois Geschwind
Publikationsdatum
08.06.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 2/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4445-9

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