Preliminary study of the transcatheter arterial chemoembolization in combination of percutaneous injection of chemoembolization agent intra-portal vein tumor thrombosis in treatment of primary hepatic carcinoma accompanied by portal vein tumor thrombosis

Objective: To assess the therapeutic outcomes of transcatheter arterial chemoembolization combined with percutaneous injection of chemoembolization agent intra-portal vein tumor thrombosis for primary hepatic carcinoma accompanied by portal vein tumor thrombus. Methods: Thirty patients with primary hepatic carcinoma accompanied by portal vein tumor thrombosis of type II and type III were randomly divided into two groups. The Child-Pugh ratings (class A and B) of group A and B were 9 vs 9 (class A) and 5 vs 7 (class B) respectively (χ2=0.201, P>0.05). The constitution of Type II and type III portal vein tumor thrombus in group A and B were 8 vs 9 and 6 vs 7 respectively (χ2= 0.002, P>0.05). The median values of ALT, TBIL, ALB and AFP in group A and B were 58.7U/L vs 70.5 U/L (W=191.5, P>0.05), 21.4 μmol/L vs 21.7 μmol/L (W=203, P>0.05), 35.3 g/L vs 37.5 g/L (W=214,P>0.05) and 680 μg/L vs 873 μg/L (W=179.00, P>0.05) respectively. Group A was treated with transcatheter arterial chemoembolization (TACE) using emulsion made up of adriamycin, cisplatin, mitomycin and ultraliquidlipiodol plus percutaneous injection of chemoembolization agent intra- portal vein tumor thrombosis using emulsion consisted of cisplatin and ultraliquidlipiodol, while group B was treated with TACE only as a control group. Survival analyses were performed via the Kaplan-Meier test in SPSS11.5 with the log-rank tests with an threshold of 0.05. Results: The 3, 6 and 12 months survival cases of group A and B were 11 vs 10, 10 vs 3, and 7 vs 0 respectively. The median survival time of group A and group B were 14.0 months and 4.0 months respectively. The difference of the two groups was significantly (χ2=11.728, P<0.01). There was no severe side-effect related to therapy in both groups. Conclusion: Comparing with the control group, TACE combined with percutaneous injection of chemoembolization agent intra-portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma accompanied by type II and type III portal vein tumor thrombosis. (authors)