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Prognostic effect of preoperative sequential transcatheter arterial chemoembolization and portal vein embolization for right hepatectomy in patients with solitary hepatocellular carcinoma.

Choi JH, Hwang S, Lee YJ, Kim KH, Ko GY, Gwon DI, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Bottom Line: Patients were also sub-grouped according to tumor size, and those with a tumor of up to cutoff at 5 cm showed no prognostic difference (p=0.774), but tumor size >5 cm was associated with inferior patient survival only in the TACE-PVE group (p=0.018).Preoperative sequential TACE and PVE appear to be compliant to the conventional oncological concept in addition to induction of the future remnant liver regeneration.Therefore, we suggest that preoperative TACE should be come first whenever preoperative PVE for major hepatectomy is planned, especially in patients with hypervascular HCC tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Both preoperative transcatheter arterial chemoembolization (TACE) alone and portal vein embolization (PVE) alone have a detrimental prognostic effect on the post-resection outcomes in patients with hepatocellular carcinoma (HCC). The main objective of this study was to assess the prognostic impact of preoperative TACE on the long-term survival outcomes in patients undergoing preoperative PVE and right liver resection for solitary HCC.

Methods: Patients who underwent macroscopic curative right liver resection of solitary HCC that lied between 3.0 and 7.0 cm (n=113) with or without preoperative TACE and PVE were selected for the study, making these subjects were divided into three groups; the TACE-PVE group (n=27), the PVE-alone group (n=13), and the control group (n=73). The subjects in the three groups were followed up for ≥36 months or until death.

Results: The 1-, 3-, 5-, and 10-year overall patient survival rates of all 113 patients were 96.5%, 88.2%, 81.3% and 65.0%, respectively. The 1-, 3-, 5-, and 10-year overall patient survival rates were 96.3%, 83.4%, 83.4% and 47.6% respectively in the TACE-PVE group; 84.6%, 76.9%, 57.7% and 19.2% respectively in the PVE-alone group; and 98.6%, 91.7%, 85.1% and 81.7% respectively in the control group (p=0.047). Patients were also sub-grouped according to tumor size, and those with a tumor of up to cutoff at 5 cm showed no prognostic difference (p=0.774), but tumor size >5 cm was associated with inferior patient survival only in the TACE-PVE group (p=0.018).

Conclusions: Preoperative sequential TACE and PVE appear to be compliant to the conventional oncological concept in addition to induction of the future remnant liver regeneration. Therefore, we suggest that preoperative TACE should be come first whenever preoperative PVE for major hepatectomy is planned, especially in patients with hypervascular HCC tumors.

No MeSH data available.


Related in: MedlinePlus

Comparison of the overall patient survival curves according to tumor size with a cutoff at 5 cm in the TACE-PVE group (A), PVE-alone group (B) and control group (C).
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Figure 4: Comparison of the overall patient survival curves according to tumor size with a cutoff at 5 cm in the TACE-PVE group (A), PVE-alone group (B) and control group (C).

Mentions: The all patients were divided into two groups by tumor size >5 cm (n=51) and ≤5 cm (n=62). The 1-, 3-, 5-, and 10-year overall patient survival rates were 94.1%, 83.7%, 81.0% and 52.9% respectively in patients with tumor size >5 cm and 98.4%, 91.9%, 81.4% and 69.1% respectively in patients with tumor size ≤5 cm (Fig. 3, p=0.774). After further division according to TACE an PVE, the tumor size cutoff at 5 cm showed significant survival difference only in the TACE-PVE group (Fig. 4A, p=0.018), but no difference in the PVE-alone group (Fig. 4B, p=0.698) and the control group (Fig. 4C, p=0.669).


Prognostic effect of preoperative sequential transcatheter arterial chemoembolization and portal vein embolization for right hepatectomy in patients with solitary hepatocellular carcinoma.

Choi JH, Hwang S, Lee YJ, Kim KH, Ko GY, Gwon DI, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Comparison of the overall patient survival curves according to tumor size with a cutoff at 5 cm in the TACE-PVE group (A), PVE-alone group (B) and control group (C).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494078&req=5

Figure 4: Comparison of the overall patient survival curves according to tumor size with a cutoff at 5 cm in the TACE-PVE group (A), PVE-alone group (B) and control group (C).
Mentions: The all patients were divided into two groups by tumor size >5 cm (n=51) and ≤5 cm (n=62). The 1-, 3-, 5-, and 10-year overall patient survival rates were 94.1%, 83.7%, 81.0% and 52.9% respectively in patients with tumor size >5 cm and 98.4%, 91.9%, 81.4% and 69.1% respectively in patients with tumor size ≤5 cm (Fig. 3, p=0.774). After further division according to TACE an PVE, the tumor size cutoff at 5 cm showed significant survival difference only in the TACE-PVE group (Fig. 4A, p=0.018), but no difference in the PVE-alone group (Fig. 4B, p=0.698) and the control group (Fig. 4C, p=0.669).

Bottom Line: Patients were also sub-grouped according to tumor size, and those with a tumor of up to cutoff at 5 cm showed no prognostic difference (p=0.774), but tumor size >5 cm was associated with inferior patient survival only in the TACE-PVE group (p=0.018).Preoperative sequential TACE and PVE appear to be compliant to the conventional oncological concept in addition to induction of the future remnant liver regeneration.Therefore, we suggest that preoperative TACE should be come first whenever preoperative PVE for major hepatectomy is planned, especially in patients with hypervascular HCC tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Both preoperative transcatheter arterial chemoembolization (TACE) alone and portal vein embolization (PVE) alone have a detrimental prognostic effect on the post-resection outcomes in patients with hepatocellular carcinoma (HCC). The main objective of this study was to assess the prognostic impact of preoperative TACE on the long-term survival outcomes in patients undergoing preoperative PVE and right liver resection for solitary HCC.

Methods: Patients who underwent macroscopic curative right liver resection of solitary HCC that lied between 3.0 and 7.0 cm (n=113) with or without preoperative TACE and PVE were selected for the study, making these subjects were divided into three groups; the TACE-PVE group (n=27), the PVE-alone group (n=13), and the control group (n=73). The subjects in the three groups were followed up for ≥36 months or until death.

Results: The 1-, 3-, 5-, and 10-year overall patient survival rates of all 113 patients were 96.5%, 88.2%, 81.3% and 65.0%, respectively. The 1-, 3-, 5-, and 10-year overall patient survival rates were 96.3%, 83.4%, 83.4% and 47.6% respectively in the TACE-PVE group; 84.6%, 76.9%, 57.7% and 19.2% respectively in the PVE-alone group; and 98.6%, 91.7%, 85.1% and 81.7% respectively in the control group (p=0.047). Patients were also sub-grouped according to tumor size, and those with a tumor of up to cutoff at 5 cm showed no prognostic difference (p=0.774), but tumor size >5 cm was associated with inferior patient survival only in the TACE-PVE group (p=0.018).

Conclusions: Preoperative sequential TACE and PVE appear to be compliant to the conventional oncological concept in addition to induction of the future remnant liver regeneration. Therefore, we suggest that preoperative TACE should be come first whenever preoperative PVE for major hepatectomy is planned, especially in patients with hypervascular HCC tumors.

No MeSH data available.


Related in: MedlinePlus