Background: Portal vein thrombosis (PVT) is common in patients with hepatocellular carcinoma (HCC), portends a poor prognosis, and is a contraindication for resection. PVT has also been considered a relative contraindication to regional therapies, including embolization, because of the risk of liver failure. Objective: To evaluate survival and complication rates in treating HCC with PVT using bland transcatheter arterial embolization (TAE). Methods: A retrospective database review identified 452 patients who underwent TAE for treatment of HCC between January 1997 and August 2004. Eighty-five (19%) patients had PVT at the time of the first embolization, and these patients comprise the study population. Complications were categorized using National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v3.0, and overall survival was calculated using the Kaplan-Meier method. Results: Actual 6-month and 1-, 2-, and 3-year survival was 60%, 38%, 13%, and 6%, respectively. Twenty-two complications (13.7%) occurred following 160 embolizations. Three (3.5%) patients died within 30 days of embolization, one each owing to liver failure, hemorrhage, and progression of disease. There were 12 grade 2 (requiring bedside management) and 7 grade 1 (no intervention required) complications. Conclusions: TAE in patients with HCC and PVT can be performed with an acceptable risk of liver failure and achieves overall survival similar to that reported for transcatheter arterial chemoembolization.
- Hepatocellular cancer
ASJC Scopus subject areas