Therapeutic value of transcatheter arterial chemoembolization combined with portal vein embolization for primary hepatocellular carcinoma with portal vein tumor thrombus: A pilot study

AIM: To compare clinical outcome and safety of transcatheter arterial chemoembolization (TACE) + portal vein embolization (PVE) with TACE alone in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). METHODS: We retrospectively collected patients of HCC with PVTT treated with TACE (5-FU, oxaliplatin and mitomycin) or TACE + PVE (doxorubicin) between October 2000 and July 2008. Outcomes evaluated include overall survival, response to treatment and side effects. RESULTS: One hundred and sixteen patients were assessed. The median follow-up of TACE group and TACE + PVE group was 83 and 85 months, respectively. The tumor response rates were respectively 48/64 and 49/52. The 1-, 3- and 5-year overall survival rates for the TACE and TACE + PVE groups were 39/64, 16/64, 0/64 and 42/52, 19/52, 6/52 respectively (P = 0.015, 0.046 and 0.002, respectively). Three factors were shown as the risk factors which affect the survival of patients: treated by TACE + PVE or TACE; type of PVTT; and absence of cirrhosis. CONCLUSION: TACE + PVE may be better than TACE alone to treat primary HCC with PVTT.