title: The efficacy and safety of postoperative adjuvant transarterial embolization and radiotherapy in hepatocellular carcinoma patients with portal vein tumor thrombus.
abstract: OBJECTIVE
  This study aims to find out the safety and efficiency of postoperative adjuvant transarterial chemoembolization (TACE) and radiotherapy (RT) in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT).
  
  
  METHODS
  From 2009 to 2010, a total of 92 HCC patients with PVTT were enrolled in this retrospective study. Patients were divided into three groups according to their adjuvant therapies (conservative group, n=51; TACE group, n=31; RT group, n=10).
  
  
  RESULTS
  In our analysis, median survival in patients with postoperative adjuvant TACE (21.91±3.60 months) or RT (14.53±1.61 months) was significantly longer than patients with hepatectomy alone (8.99±1.03 months). But the difference between adjuvant TACE and RT was of no significance (P=0.716). Also a similar result could be observed in median disease-free survival: conservative group (6.51±1.44 months), TACE group (13.98±3.38 months), and RT group (14.03±2.40 months). Treatment strategies (hazard ratio [HR] =0.411, P<0.001) and PVTT type (HR =4.636, P<0.001) were the independent prognostic factors for overall survival. Similarly, the risk factors were the same when multivariate analysis was conducted in disease-free survival (treatment strategies, HR =0.423, P<0.001; PVTT type, HR =4.351, P<0.001) and recurrence (treatment strategies, HR =0.459, P=0.030; PVTT type, HR =2.908, P=0.047). Patients with PVTT type I had longer overall survival than patients with PVTT type II (median survival: 18.43±2.88 months vs 11.59±1.45 months, P=0.035).
  
  
  CONCLUSIONS
  Postoperative adjuvant TACE and RT may be a choice for HCC patients with PVTT.
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning.
authors.forename: Tao
authors.initials: T
authors.lastname: Bai
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning.
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai.
authors.forename: Zhi-Bo
authors.initials: ZB
authors.lastname: Xie
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning.
authors.forename: Fei-Xiang
authors.initials: FX
authors.lastname: Wu
authors.affiliation: Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning; Department of Ultrasound Diagnosis, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Si-Da
authors.initials: SD
authors.lastname: Wang
authors.affiliation: Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning; Department of Ultrasound Diagnosis, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, People's Republic of China.
authors.forename: Jun-Jie
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Nanning.
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
keywords: HCC; portal vein tumor thrombus; radiotherapy; surgery; transarterial chemoembolization