title: Transcatheter arterial chemoembolization combined with radiofrequency ablation can improve survival of patients with hepatocellular carcinoma with portal vein tumour thrombosis: extending the indication for ablation?
abstract: OBJECTIVE
  To retrospectively assess long-term survival benefit and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in hepatocellular carcinoma (HCC) patients with portal vein tumour thrombosis (PVTT), and to evaluate factors that significantly affect outcomes of these patients.
  
  
  METHODS
  One hundred and thirty-four HCC patients (118 men and 16 women; mean age 54.8 years, range 26-79 years) with PVTT were retrospectively assessed. Patients were treated with TACE combined with RFA. Data analysed included patient demographics, liver volume, Child-Pugh score, and Cancer of the Liver Italian Programme (CLIP) score and imaging findings. Survival time (from occurrence of PVTT to last follow-up) was calculated using the Kaplan-Meier method, predictive factors and its correlation with survival was assessed using the multivariate Cox proportional hazards regression method.
  
  
  RESULTS
  The median overall survival (OS) time was 29.5 months (range 16.6-42.4 months), the 1, 3, and 5 year OS were 63%, 40%, and 23%. Cox hazards regression analysis revealed that functional remnant liver volume (FRLV), remnant liver volume (RLV)/total liver volume (TLV), radiation, tumour number, vascular endothelial growth factor (VEGF) distribution, and gross type were the only independent predictive factors of outcome (p = 0.039, 0.010, 0.009, 0.034, 0.031, and 0.000, respectively).
  
  
  CONCLUSIONS
  TACE combined with RFA was found to be an effective therapy, FRLV and RLV/TLV have close correlation with survival for HCC patients with PVTT type I, II, or partial III and Child-Pugh A or B.
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China. Electronic address: zhengjiasheng6@163.com.
authors.forename: J-S
authors.initials: JS
authors.lastname: Zheng
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: J
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: B
authors.initials: B
authors.lastname: Sun
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: N-N
authors.initials: NN
authors.lastname: Lu
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: D
authors.initials: D
authors.lastname: Fang
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: L-Y
authors.initials: LY
authors.lastname: Zhao
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China.
authors.forename: N
authors.initials: N
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017115:Catheter Ablation / Q000379:methods* / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000379:methods* / Q000401:mortality; D003131:Combined Modality Therapy / Q000379:methods; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D036542:Tomography, Spiral Computed; D047368:Tumor Burden