Conversion Therapy for Liver Carcinoma
Clinical efficacy of portal vein embolization with different embolization materials in patients with initially unresectable hepatocellular carcinoma
Ni Junsheng, Li Yao, Li Huifen, Tian Tao, Hou Guojun, Yang Yuan, Zhou Weiping
Published 2023-06-28
Cite as Chin J Hepatobiliary Surg, 2023, 29(6): 406-411. DOI: 10.3760/cma.j.cn113884-20230411-00114
Abstract
ObjectiveTo study the clinical effects of portal vein embolization (PVE) with N-butyl cyanoacrylate copolymer (NBCA) and with gelatin sponge (GS) as embolization materials in patients with initially unresectable hepatocellular carcinoma (HCC).
MethodsClinical data of 90 patients with initial unresectable HCC who underwent PVE treatment at the Third Affiliated Hospital of Naval Medical University from November 2014 to April 2020 were included. There were 77 males and 13 females, aged 48 (25, 67) years old. Patients were divided into two groups according to the embolization materials selected in PVE: NBCA group (n=60) and GS group (n=30). Forty-eight and 18 patients finally underwent secondary hepatectomy in NBCA group (resectable NBCA group) and GS group (resectable GS group), respectively. Clinical data including future liver remnant (FLR) growth rate and secondary hepatectomy rate were analyzed. Survivals after hepatectomy was followed up by telephone, WeChat, and outpatient review.
ResultsThe secondary hepatectomy rate in NBCA group was higher than that in GS group [80%(48/60) vs. 60%(18/30), P=0.043]. The waiting time from primary intervention to secondary hepatectomy in resectable NBCA group was 15 (7, 96) d, which was shorter than that in resectable GS group [40 (28, 118) d, P<0.001]. The FLR growth rate of resectable NBCA group was 9.03 (1.24, 29.64) ml/d, which was faster than that in resectable GS group [3.76 (0.08, 8.03) ml/d, P<0.001]. The recurrence-free survival (RFS) rates of patients in resectable NBCA group were 69.1%, 62.0% and 44.7% at 1, 2 and 3 years after surgery, and the overall survival (OS) rates were 76.4%, 69.5% and 59.6%, respectively. The RFS rates of patients in resectable GS group were 60.6%, 48.5% and 35.4% at 1, 2 and 3 years after surgery, and the OS rates were 66.7%, 60.6% and 42.4%, respectively. There were no significant differences in RFS and OS between two groups (all P>0.05).
ConclusionsPVE with NBCA and GS as embolization material showed good efficacy in patients with initially unresectable HCC. The FLR growth rate and secondary hepatectomy rate of patients using NBCA were better than those of patients using GS.
Key words:
Portal vein; Embolization materials; Liver regeneration; Planned hepatectomy
Contributor Information
Ni Junsheng
Third Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Li Yao
First Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Li Huifen
First Department of Interventional Radiology, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Tian Tao
Third Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Hou Guojun
Third Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Yang Yuan
Third Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
Zhou Weiping
Third Department of Hepatic Surgery, Third Affiliated Hospital of Naval Medical University (Eastern Hepatobiliary Surgery Hospital), Shanghai 200438, China
