title: Efficacy and safety of preoperative chemoembolization for resectable hepatocellular carcinoma with portal vein invasion: a prospective comparative study.
abstract: OBJECTIVE
  To evaluate the outcomes of preoperative transarterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC) with portal vein invasion.
  
  
  METHODS
  From February 2006 to July 2011, 320 patients initially diagnosed with resectable HCC and portal vein invasion were prospectively non-randomized into two arms. In the immediate resection arm (Arm 1, n = 205) patients received immediate surgical resection. 115 patients were included in the preoperative TACE arm (Arm 2), and eventually 85 patients underwent TACE followed by surgical resection.
  
  
  RESULTS
  The 1-, 3- and 5-year overall survival rates were 48.3 %, 18.7 % and 13.9 % for Arm 1 and 61.2 %, 31.7 % and 25.3 % for Arm 2 (P = 0.001), respectively. In the subgroup analysis of types I and II portal vein tumour thrombus (PVTT), the preoperative TACE arm demonstrated significantly better survival rates than the immediate resection arm (P I  = 0.001, P II  = 0.036). However, no significant difference was found for patients with type III PVTT (P III  = 0.684). No significant difference was found between the two arms in terms of complications and mortality.
  
  
  CONCLUSIONS
  Preoperative TACE seems to confer a survival benefit for resectable HCC with PVTT, especially for types I and II PVTT, and preoperative TACE should therefore be recommended as a routine procedure.
  
  
  CONCLUSIONS
  • Preoperative TACE improves the clinical outcomes for patients with PVTT • Preoperative TACE could significantly improve the rate of en bloc thrombectomy • Preoperative TACE does not increase the related adverse events.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Yong-Fa
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Rong-Ping
authors.initials: RP
authors.lastname: Guo
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Ultrasound, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Ru-Hai
authors.initials: RH
authors.lastname: Zou
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Jing-Xian
authors.initials: JX
authors.lastname: Shen
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Li
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Han-Yue
authors.initials: HY
authors.lastname: OuYang
authors.affiliation: Department of Medical Oncology of the First Affiliated Hospital of the University of South China, Hengyang, China.
authors.forename: Hong-Bo
authors.initials: HB
authors.lastname: Zhu
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
authors.forename: Xiang-Ming
authors.initials: XM
authors.lastname: Lao
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China. shiming@sysu.edu.cn.|Department of Hepatobiliary Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, People's Republic of China. shiming@sysu.edu.cn.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China. shiming@sysu.edu.cn.
authors.forename: Ming
authors.identifier: http://orcid.org/0000-0002-4051-4474
authors.initials: M
authors.lastname: Shi
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000556:secondary* / Q000601:surgery
keywords: Hepatocellular carcinoma; Overall survival; Portal vein tumour thrombus; Surgical resection; Transarterial chemoembolization