Safety and efficacy of transcatheter arterial embolization with particles only in the treatment of hepatocellular carcinoma with portal vein thrombus

Ajita Deodhar, Anne M. Covey, Raymond Thornton, Mary Maluccio, Lynn A. Brody, Elena Petre, George I. Getrajdman, Constantinos T. Sofocleous, Yuman Fong, Karen T. Brown

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)3-11
Number of pages9
JournalJournal of Interventional Oncology
Volume3
Issue number1
DOIs
StatePublished - Mar 2010

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Portal Vein
Hepatocellular Carcinoma
Thrombosis
Safety
Liver Failure
Survival
Therapeutics
National Cancer Institute (U.S.)
Terminology
Disease Progression
Survival Rate
Databases
Hemorrhage
Population

Keywords

  • Ablation
  • Embolization
  • Hepatocellular cancer

ASJC Scopus subject areas

  • Oncology

Cite this

Safety and efficacy of transcatheter arterial embolization with particles only in the treatment of hepatocellular carcinoma with portal vein thrombus. / Deodhar, Ajita; Covey, Anne M.; Thornton, Raymond; Maluccio, Mary; Brody, Lynn A.; Petre, Elena; Getrajdman, George I.; Sofocleous, Constantinos T.; Fong, Yuman; Brown, Karen T.

In: Journal of Interventional Oncology, Vol. 3, No. 1, 03.2010, p. 3-11.

Research output: Contribution to journalArticle

Deodhar, A, Covey, AM, Thornton, R, Maluccio, M, Brody, LA, Petre, E, Getrajdman, GI, Sofocleous, CT, Fong, Y & Brown, KT 2010, 'Safety and efficacy of transcatheter arterial embolization with particles only in the treatment of hepatocellular carcinoma with portal vein thrombus', Journal of Interventional Oncology, vol. 3, no. 1, pp. 3-11. https://doi.org/10.2310/6650.2010.100006
Deodhar, Ajita ; Covey, Anne M. ; Thornton, Raymond ; Maluccio, Mary ; Brody, Lynn A. ; Petre, Elena ; Getrajdman, George I. ; Sofocleous, Constantinos T. ; Fong, Yuman ; Brown, Karen T. / Safety and efficacy of transcatheter arterial embolization with particles only in the treatment of hepatocellular carcinoma with portal vein thrombus. In: Journal of Interventional Oncology. 2010 ; Vol. 3, No. 1. pp. 3-11.
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AU - Covey, Anne M.

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AU - Maluccio, Mary

AU - Brody, Lynn A.

AU - Petre, Elena

AU - Getrajdman, George I.

AU - Sofocleous, Constantinos T.

AU - Fong, Yuman

AU - Brown, Karen T.

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N2 - 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.

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