Survival benefits of intra-arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein tumor thrombosis.
OBJECTIVE
: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis has a poor prognosis. This study was undertaken to evaluate the therapeutic effects of intra-arterial infusion chemotherapy in advanced HCC, and tried to identify prognostic factors that could affect survival.


METHODS
: Between January 1995 and January 2001, a total of 102 patients with advanced HCC with portal vein thrombosis were enrolled and divided into three groups: group 1 (n=24) was managed with only supportive care, group 2 (n=25) received systemic combination chemotherapy and group 3 (n=52) received intra-arterial infusion chemotherapy with 5-fluorouracil+cisplatin via implanted chemoport.


RESULTS
: One-year survival rates were 0, 4, 21% and median survivals were 2, 4, 6 months in groups 1, 2, 3, respectively (p=0.003). When we divide group 3 patients into long-term (more than 8 months) or short-term survivors, long-term survivor had significantly low level of serum AST (p=0.032) and alkaline phosphatase (p=0.033). Especially, all female patients (n=9) survived more than 8 months (p=0.000). Other favorable prognostic factors for survival were cirrhosis of Child-Pugh class A (p=0.003), only one major branch involvement of the portal vein by tumor (p=0.005), presence of enhancement of tumor portion in arterial phase of CT scan (p=0.044), presence of enhancement of non-tumor portion in portal phase of CT scan (p=0.029).


CONCLUSIONS
: Intra-arterial infusion chemotherapy achieved favorable results in advanced HCC with portal vein thrombosis and showed better survival in selected patients.
Cheong
Jae Youn
JY
Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
Lee
Kee Myung
KM
Cho
Sung Won
SW
Won
Je Hwan
JH
Kim
Jai Keun
JK
Wang
Hee Jung
HJ
Hahm
Ki Baik
KB
Kim
Jin Hong
JH