Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites.
Transl Oncol
; 13(12): 100864, 2020 Dec.
Article
en En
| MEDLINE
| ID: mdl-32950928
ABSTRACT
BACKGROUND:
Currently, hepatocellular carcinoma (HCC) patients with refractory ascites (RA) have a very poor prognosis, and there are no effective treatments recommended by the guidelines. A treatment strategy that utilizes a transjugular intrahepatic portosystemic shunt (TIPS) combined with subsequent antitumor treatment is explored in this study for its feasibility and clinical value.METHODS:
One month after TIPS, the ascites grade and Child-Pugh scores and stages were reassessed to compare changes in the preoperative indicators.RESULTS:
A total of 68 patients from 3 centers were enrolled. After TIPS, the following results were obtained a complete response (CR), partial response (PR), or absent RA response (AR) of 38 [55.9%], 21 [30.9%], and 9 [13.2%], respectively. The control of RA was 86.8%. The median Child-Pugh scores prior to TIPS and one month after TIPS were 8 (IQR 7-9) and 7 (IQR 6-8), respectively. The down, unchanged, and elevated Child-Pugh stages were 26 [38.2%], 36 [53.0%], and 6 [8.8%], respectively. The postoperative Child-Pugh scores were significantly lower than the preoperative (pâ¯<â¯0.001). 92.6% (63/61) of the patients received subsequent anti-tumor treatment opportunities. The median overall survival (OS) was 8.7 (range, 0.4-49.6) months. The lower postoperative Child-Pugh stage(pâ¯=â¯0.001), downward change of the Child-Pugh stage(pâ¯=â¯0.027), and downward change of the Child-Pugh score (pâ¯=â¯0.002) were independent protected prognostic factors for OS.CONCLUSION:
As a minimally invasive method, TIPS can effectively control ascites and improve Child-Pugh scores and stages. TIPS combined with subsequent anti-tumor therapy is a feasible and effective management for HCC patients with RA.
Texto completo:
1
Banco de datos:
MEDLINE
Tipo de estudio:
Guideline
/
Prognostic_studies
Idioma:
En
Año:
2020
Tipo del documento:
Article