title: Microwave ablation of hepatocellular carcinoma with portal vein tumor thrombosis after transarterial chemoembolization: a prospective study.
abstract: OBJECTIVE
  To prospectively assess the use of microwave ablation (MWA) to treat hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) after transarterial chemoembolization (TACE), and to evaluate factors that significantly affect treatment outcomes.
  
  
  METHODS
  Sixty patients with HCC [55 male, 5 female; mean age, 54.1 ± 10.2 (range 36-77) years] + PVTT were enrolled. Patients were treated with MWA after TACE. Results were compared with those of 54 patients treated by TACE alone in another retrospective study. Data analyzed included patient demographics, Eastern Cooperative Oncology Group performance status, liver cirrhosis, liver volume, Child-Pugh class, Cancer of the Liver Italian Program (CLIP) score, and imaging findings. Survival time (from occurrence of PVTT to last follow-up) and predictive factors and their correlation with survival were statistically evaluated.
  
  
  RESULTS
  The median 3-year overall survival (OS) duration was 13.5 months, and the 1- and 3-year OS rates were 48 and 23 %, respectively. Cox hazards regression analysis revealed that change in the neutrophil-to-lymphocyte ratio, CLIP score, and treatment efficacy were the only independent predictive factors for outcome (p = 0.035, 0.024, and 0.000, respectively).
  
  
  CONCLUSIONS
  Combination therapy with MWA after TACE may provide a substantial benefit for patients with HCC + PVTT type I, II, or partial III and Child-Pugh class A or B by reducing the tumor burden.
  
  
  BACKGROUND
  Chinese Clinical Trial Register (ChiCTR): ChiCTR-ONC-12002689.
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Oncology Minimally Invasive Interventional Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China. 13522561745@163.com.
authors.forename: Jia-sheng
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: Bin
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: Ningning
authors.initials: N
authors.lastname: Lu
mesh_terms: D055011:Ablation Techniques; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology* / Q000601:surgery; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000601:surgery / Q000628:therapy*
keywords: Hepatocellular carcinoma (HCC); Microwave ablation (MWA); Neutrophil-to-lymphocyte ratio (NLR); Portal vein tumor thrombosis (PVTT); Survival