Effect of Transarterial Chemoembolisation in Unresectable Hepatocellular Carcinoma with Portal Vein Tumour Thrombosis: Single-centre Study

Full Article

KL Siu, PY Chu, HW Lau, CX Chan, SK Ip

Hong Kong J Radiol 2015;18:277-81

DOI: 10.12809/hkjr1515316

Objectives: To determine the effect of transarterial chemoembolisation (TACE) on liver function and procedure-related mortality in patients with unresectable hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT).

Methods: This was a retrospective study of patients with HCC and PVTT who underwent TACE from January 2012 to December 2013 at a single tertiary medical centre in Hong Kong. Patient demographics, aetiology of cirrhosis, alpha fetoprotein (AFP) level, tumour size, number of tumours, liver function (total bilirubin, albumin, international normalised ratio [INR]), and Child-Pugh score were evaluated before and 4 weeks after TACE. The 30-day mortality was also recorded.

Results: TACE was performed in 26 patients with unresectable HCC and PVTT (mean age, 61 years). The mean total bilirubin level before and after TACE was 18.2 µmol/l and 26.8 µmol/l (p = 0.140), respectively, and mean albumin level fell from 36.8 g/l to 33.9 g/l (p = 0.009). The respective mean INR before and after TACE was 1.1 and 1.2 (p = 0.120), the AFP level was 35,364.0 ng/ml and 37,424.5 ng/ml (p = 0.563), and the mean Child-Pugh score was 6.0 and 6.6. The mean and median survival of patients was 5.1 months (range, 1.5-8.8 months) and there was no 30-day mortality.

Conclusion: TACE has a deteriorating effect on liver function in patients with unresectable HCC and PVTT. Nonetheless since there were no procedure-related deaths and TACE has potential survival benefits, it should be a treatment option along with superselective catheterisation of tumour feeding vessels for patients with HCC and PVTT.









結果:共26例有PVTT並不能切除的肝癌患者進行TACE,平均年齡61歲。進行TACE前後的平均總膽紅素水平分別為18.2 µmol/l和26.8 µmol/l (p = 0.140),白蛋白平均水平從36.8 g/l下降至33.9 g/l (p=0.009),而相應的INR平均值為1.1和1.2(p=0.120)、AFP水平為35,364.0 ng/ml和37,424.5 ng/ml(p=0.563)、Child-Pugh平均分數為6.0和6.6。患者的平均和中位生存期為5.1個月(介乎1.5-8.8個月)。無30天內死亡率患者。