scholarly journals Nomogram for Individualized Prediction of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis on Conservative Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Yao Liu ◽  
Dongying Xue ◽  
Xiaogang Zhang ◽  
Fangyuan Gao ◽  
Le Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Conservative Treatment ◽  
Portal Vein ◽  
Low Risk ◽  
Portal Vein Tumor Thrombosis ◽  
Derivation Cohort ◽  
Tumor Thrombosis ◽  
Individualized Prediction ◽  
Glutamyl Transferase

Background. Portal vein tumor thrombosis (PVTT) is one of the major predictive factors for patients with hepatocellular carcinoma (HCC). The objective of this study was to establish a prognostic nomogram for identifying individual survival outcomes in patients with HCC and PVTT on conservative treatment based on specific factors. Methods. Two hundred and ten patients with HCC and PVTT on conservative treatment in Beijing Ditan Hospital between June 2008 and May 2017 were studied retrospectively as a derivation cohort. We built a nomogram based on independent risk factors for survival prediction. The concordance index (c-index) and a calibration curve were used to evaluate the predictive accuracy. During the study, 102 patients were included at the Putuo Hospital and Third People’s Hospital of Changzhou as a validation cohort. Results. In the derivation cohort, the independent factors for overall survival were identified by multivariate analysis, namely, aspartate aminotransferase ≥119 IU/L, gamma-glutamyl transferase ≥115 IU/L, Child–Pugh class C liver function, creatinine ≥91 μmoI/L, α-fetoprotein ≥400 ng/ml, and largest tumor diameter ≥5 cm. The nomogram had a c-index of 0.737 (95% confidence interval, 0.692–0.782) and the calibration curves fitted well. The median survival time was 4.2 months in the derivation cohort, with an MST of 5 months for BCLC C stage and 1.8 months for BCLC D stage patients. Kaplan–Meier analysis showed significant statistical differences in the 6-month overall survival rates of the primary and validation cohorts after the total scores were divided into three quartiles (low risk: 0–85; intermediate risk: 86–210; high risk: ≥211; p<0.0001 in both cohorts). Conclusions. The nomogram can be a more accurate and individualized prediction for 6-month overall survival of patients with HCC and PVTT on conservative treatment, and it is possible to consider further active interventions for patients in the low-risk group (0–85 scores) to achieve the aim of prolonging survival.

scholarly journals Improving outcomes of liver resection for hepatocellular carcinoma associated with portal vein tumor thrombosis over the evolving eras of treatment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yu-Chao Wang ◽  
Jin-Chiao Lee ◽  
Tsung-Han Wu ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Liver Resection ◽  
Portal Vein ◽  
Survival Rates ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis ◽  
Evolutionary Changes ◽  
Hcc Recurrence

Abstract Background The outcomes and management of hepatocellular carcinoma (HCC) have undergone several evolutionary changes. This study aimed to analyze the outcomes of patients who had undergone liver resection for HCC with portal vein tumor thrombosis (PVTT) in terms of the evolving era of treatment. Materials and methods A retrospective analysis of 157 patients who had undergone liver resection for HCC associated with PVTT was performed. The outcomes and prognostic factors related to different eras were further examined. Results Overall, 129 (82.1%) patients encountered HCC recurrence after liver resection, and the median time of recurrence was 4.1 months. Maximum tumor size ≥ 5 cm and PVTT in the main portal trunk were identified as the major prognostic factors influencing HCC recurrence after liver resection. Although the recurrence-free survival had no statistical difference between the two eras, the overall survival of patients in the second era was significantly better than that of the patients in the first era (p = 0.004). The 1-, 2-, and 3-year overall survival rates of patients in the second era were 60.0%, 45.7%, and 35.8%, respectively, with a median survival time of 19.6 months. Conclusion The outcomes of HCC associated with PVTT remain unsatisfactory because of a high incidence of tumor recurrence even after curative resection. Although the management and outcomes of patients with HCC and PVTT have greatly improved over the years, surgical resection remains an option to achieve a potential cure of HCC in well-selected patients.

scholarly journals Transarterial chemoembolization for hepatocellular carcinoma combined with portal vein tumor thrombosis

2018 ◽  
Vol Volume 10 ◽  
pp. 4719-4726 ◽  
Author(s):  
Wei-Fu Lv ◽  
Kai-Cai Liu ◽  
Dong Lu ◽  
Chun-Ze Zhou ◽  
De-Lei Cheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis

Predictive factors of benefit from iodine-125 brachytherapy for hepatocellular carcinoma with portal vein tumor thrombosis

Brachytherapy ◽  
2019 ◽  
Vol 18 (2) ◽  
pp. 233-239 ◽  
Author(s):  
Junqing Lin ◽  
Han Jiang ◽  
Weizhu Yang ◽  
Na Jiang ◽  
Qubin Zheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Predictive Factors ◽  
Portal Vein Tumor Thrombosis ◽  
Tumor Thrombosis ◽  
Iodine 125

scholarly journals Observation of Stereotactic Radiosurgery (Cyberknife) on Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Yang Tang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Survival Rate ◽  
Portal Vein ◽  
Stereotactic Radiosurgery ◽  
Cox Proportional Hazards Model ◽  
Cumulative Survival Rate ◽  
Portal Vein Tumor Thrombosis ◽  
Cumulative Survival ◽  
Tumor Thrombosis ◽  
Stable Conditions

The purpose of the study was to analyze the clinical effect of stereotactic radiosurgery (SRS) (Cyberknife) on hepatocellular carcinoma with portal vein tumor thrombosis (HCC-PVTT). Data from 50 patients with HCC-PVTT who received Cyberknife from August 2013 to April 2016 was collected for efficacy analysis. Moreover, survival correlation was evaluated by Cox proportionalhazards model. The total effective rate in 1–3 months after treatment was 64.00%, including 7 cases in complete remission, 12 cases in partial remission, 13 cases in stable conditions, and 18 cases with enlargement; a 4–24-months follow-up (with an average of 11.58 ± 2.58 months) showed that median survival, 1-year cumulative survival rate, and 2-year cumulative survival rate were, respectively, 11.86 ± 1.79 months, 48.00%, and 20.00%. Moreover, the Cox proportional-hazards model indicates that it was with no correlation between lesion diameter, classification of liver function, pre-operative alphafetoprotein, types of hepatitis, number of tumors, ascites, types of tumor emboli, total dose, and survival rate. SRS is effective for HCC-PVTT and serves as an ideal treatment clinically to help preserve patients’ lives, which is worthy of clinical promotion and application.

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