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Transarterial chemoembolization in hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis.
Silva, Jack P; Berger, Nicholas G; Tsai, Susan; Christians, Kathleen K; Clarke, Callisia N; Mogal, Harveshp; White, Sarah; Rilling, William; Gamblin, T Clark.
Afiliação
  • Silva JP; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Berger NG; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Tsai S; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Christians KK; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Clarke CN; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Mogal H; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • White S; Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Rilling W; Division of Vascular and Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA.
  • Gamblin TC; Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: tcgamblin@mcw.edu.
HPB (Oxford) ; 19(8): 659-666, 2017 08.
Article em En | MEDLINE | ID: mdl-28552299
BACKGROUND: Transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) remains controversial. This systematic review sought to examine the role of TACE in the treatment of HCC with PVT in either the main portal vein (MPV) or portal vein branches (PVB). METHODS: PubMed was searched for "hepatocellular carcinoma" and "transarterial chemoembolization" from January 1, 2006 to August 31, 2016. Cohorts treated with TACE for HCC with PVT were included. Meta-analysis of overall survival (OS), mRECIST response, and complication incidence was performed. MPV and PVB subgroups were compared. RESULTS: Of 136 search results, 13 studies with 1933 TACE patients were included. Median OS (95% CI) was eight (5-15) months. Survival rates after one, three, and five years were 29% (20%-40%), 4% (1%-11%), and 1% (0%-5%), respectively. Only 1% experienced liver failure and 18% had post-treatment complications. Patients with MPV thrombosis had worse survival than PVB patients (p < 0.001), but similar mRECIST response rates (14% vs. 16%, p = 0.238). CONCLUSION: TACE is a safe treatment for a highly selected population of HCC patients with PVT. Despite worse survival rates compared to PVB thrombosis, PVT in the MPV should not be considered an absolute contraindication to TACE.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Veia Porta / Quimioembolização Terapêutica / Carcinoma Hepatocelular / Trombose Venosa / Neoplasias Hepáticas / Células Neoplásicas Circulantes Tipo de estudo: Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Veia Porta / Quimioembolização Terapêutica / Carcinoma Hepatocelular / Trombose Venosa / Neoplasias Hepáticas / Células Neoplásicas Circulantes Tipo de estudo: Etiology_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Ano de publicação: 2017 Tipo de documento: Article