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 21.7μmol/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 ultraliquidlipiadol, 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. Key words: Liver neoplasms;  Neoplasm metastasis;  Portal vein;  Tumor thrombus;  Embolization, therapeutic