TACE combined with implantation of IVC irradiation stent or bare stent for the treatment of HCC complicated by IVCTT: a comparative study

Objective: To investigate the safety and efficacy of transarterial chemoembolization (TACE) combined with implantation of irradiation IVC stent in treating hepatocellular carcinoma (HCC) complicated by inferior vena cava tumor thrombosis (IVCTT). Methods: The clinical data of 61 consecutive patients with HCC complicated by IVCTT were retrospectively analyzed. Irradiation IVC stent was prepared by strapping ¹²⁵I particles on the bare stent, and it was employed in 33 patients (group A). Bare stent was adopted in 28 patients (group B). Propensity score matching method was used to conduct randomized analysis of the original data in order to reduce the selection bias. The survival time, remission rate of symptom and procedure-related adverse events of both groups were calculated and the results were compared between the two groups. Results: The incidence of adverse reactions was similar in the two groups, and symptomatic treatment with internal medicine was adopted. The survival time in group A was superior to that in group B. The median survival time in group A was (203.0 ± 28.1) days, which was (93.0 ± 24.3) days in group B (P = 0.006). Propensity score matching (24 pairs in total) cohort analysis showed that the median survival time was (200 ± 31) days in group A and (66 ± 23) days in group B (P = 0.019). The edema remission rates in group A and in group B were 97.0% and 96.4% respectively. Multiple factor analysis revealed that irradiation stent implantation and objective tumor response were independent factors predicting a good prognosis. Conclusion: For the treatment of HCC associated with IVCTT, TACE combined with irradiation stent implantation is safe and effective, this therapy can prolong the patient's survival time. (authors)