title: NEOADJUVANT TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION FOR BILIARY TUMOR THROMBOSIS: A RETROSPECTIVE STUDY.
abstract: OBJECTIVE
  Curative hepatectomy and tumor thrombectomy for hepatocellular carcinoma with complicating biliary tumor thrombosis (HCC/BTT) is associated with high surgical morbidity and mortality. This retrospective study evaluated the effectiveness and safety of neoadjuvant transcatheter arterial chemoembolization (TACE) in HCC/BTT patients scheduled for curative resection.
  
  
  METHODS
  Thirty consecutive patients with diagnosed HCC/BTT were hospitalized for neoadjuvant TACE and elective curative liver resection (group A; n=20) or curative liver resection alone (group B; n=10). The primary outcome measure was median survival.
  
  
  RESULTS
  Group A had a significantly shorter overall operative time (160±25 versus 190±35 min; p < .01) and duration of inflow control (14.3±3.6 versus 25.1±5.1 min; p < .01) and significantly less intraoperative blood loss (150±35 versus 520±75 ml; p < .01) and transfusion (100±40 versus 375±55 ml; p < .01) as compared to group B. Among patients undergoing both thrombectomy and curative resection, the median survival of group A was significantly longer than that of group B (28.5 [9-54] versus 21.5 [6-39] months; p < .01); among those who received thrombectomy alone, the median survival of group A was also significantly longer than that of group B (12.8 [6-25] versus 4.5 [2-7] months; p < .01).
  
  
  CONCLUSIONS
  Neoadjuvant TACE significantly reduced the surgical risk of curative liver resection and significantly prolonged median survival in HCC patients with complicating BTT.
authors: Shandong Cancer Hospital affiliated to Shandong University,Shandong Academy of Medical Sciences.
authors: Yangyang
authors: Y
authors: Shen
authors: Department of General Surgery,Lianyuan People's Hospital of Hunan Province.
authors: Pang
authors: P
authors: Li
authors: Shandong Cancer Hospital affiliated to Shandong University,Shandong Academy of Medical Sciences.
authors: Kai
authors: K
authors: Cui
authors: Shandong Cancer Hospital affiliated to Shandong University,Shandong Academy of Medical Sciences.
authors: Zhendan
authors: Z
authors: Wang
authors: Department of Internal Medicine,Ji'nan Fifth People's Hospital.
authors: Fachang
authors: F
authors: Yu
authors: Shandong Cancer Hospital affiliated to Shandong University,Shandong Academy of Medical Sciencessyyvly@126.com.
authors: He
authors: H
authors: Tian
authors: Shandong Cancer Hospital affiliated to Shandong University,Shandong Academy of Medical Sciences.
authors: Sheng
authors: S
authors: Li
mesh_terms: D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*
keywords: Biliary tumor thrombosis; Curative resection; Hepatocellular carcinoma; Neoadjuvant therapy; Survival; Thrombectomy