title: Survival benefit of chemoembolization plus Iodine125 seed implantation in unresectable hepatitis B-related hepatocellular carcinoma with PVTT: a retrospective matched cohort study.
abstract: OBJECTIVE
  To investigate the survival benefit of transarterial chemoembolization (TACE) plus Iodine125 seed implantation (TACE-Iodine125) in hepatitis B-related HCC patients with portal vein tumour thrombus (PVTT) and the underlying prognostic factors.
  
  
  METHODS
  A retrospective matched cohort study was performed on consecutive HCC patients with PVTT from January 2011 to June 2014. Seventy patients (TACE-Iodine125 group) who underwent TACE-Iodine125 were compared with a historical case-matched control group of 140 patients (TACE group) who received TACE alone. The survival of patients and the underlying prognostic factors were analysed.
  
  
  RESULTS
  The median survival times of the TACE-Iodine125 and TACE groups were 11.0 and 7.5 months, respectively (p < 0.001). The survival probability at 12, 24, and 36 months was 50 %, 14.5 %, and 14.5 % vs. 25 %, 9 %, and 5 % in the TACE-Iodine125 and TACE groups, respectively (p < 0.001). The PVTT responders had better survival than the PVTT non-responders (p < 0.001). For the PVTT non-responders, there were no differences in the survival curves between the groups (p = 0.353). Multivariate analysis showed that type III PVTT (p < 0.001) and APS (p < 0.001) were independent predictors of poor prognosis. In contrast, the treatment modality of TACE-Iodine125 (p < 0.001) and PVTT response (p = 0.001) were favourable prognostic features.
  
  
  CONCLUSIONS
  TACE combined with Iodine125 seed implantation may be a good choice for selected HB-HCC patients with PVTT.
  
  
  CONCLUSIONS
  • TACE-Iodine125 was more effective than TACE for patients with HCC-PVTT. • The TACE-Iodine125 procedure was safe. • TACE-Iodine125 was conditional for patients with HCC-PVTT. • TACE-Iodine125 resulted in a better PVTT response compared to TACE alone. • A good PVTT response is a favourable prognostic factor.
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China. huangmsh@mail.sysu.edu.cn.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China. huangmsh@mail.sysu.edu.cn.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China. huangmsh@mail.sysu.edu.cn.
authors.forename: Mingsheng
authors.initials: M
authors.lastname: Huang
authors.affiliation: Department of Oncology, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Qu
authors.initials: Q
authors.lastname: Lin
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Haofan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Junwei
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Mingjun
authors.initials: M
authors.lastname: Bai
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Long
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Kangshun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Zaibo
authors.initials: Z
authors.lastname: Jiang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Shouhai
authors.initials: S
authors.lastname: Guan
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Zhengran
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Jiesheng
authors.initials: J
authors.lastname: Qian
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Mingan
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China.
authors.forename: Pengfei
authors.initials: P
authors.lastname: Pang
authors.affiliation: Department of Radiology, the Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China. shanhong@mail.sysu.edu.cn.|Department of Interventional Radiology, Ling-nan Hospital, Sun Yat-Sen University, Guangzhou, China. shanhong@mail.sysu.edu.cn.|Interventional Radiology Institute, Sun Yat-sen University, Guangzhou, China. shanhong@mail.sysu.edu.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Shan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes
keywords: Brachytherapy; Hepatocellular carcinoma; Interventional therapy; Portal vein tumour thrombus; Survival