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Cited 5 time in webofscience Cited 6 time in scopus
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Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion

Authors
Lee, Han AhPark, SunminSeo, Yeon SeokYoon, Won SupRim, Chai Hong
Issue Date
Apr-2021
Publisher
MDPI
Keywords
radiotherapy; portal vein thrombosis; BCLC C; ALBI grade
Citation
BIOLOGY-BASEL, v.10, no.4
Indexed
SCIE
SCOPUS
Journal Title
BIOLOGY-BASEL
Volume
10
Number
4
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/53151
DOI
10.3390/biology10040326
ISSN
2079-7737
Abstract
Simple Summary The benefit of local treatment for hepatocellular carcinoma (HCC) with portal invasion is unclear. Radiotherapy can technically palliate vessel-invasive HCC; however, the survival benefit has not been confirmed. Local treatment including radiotherapy showed a survival benefit in large propensity score-matched cohorts (median survival: 8 vs. 2 months, p < 0.001). The benefit persisted among patients with Child-Pugh class A and B liver function. Our results represent community-level data from all Korean administrative districts. We aimed to identify the oncologic benefits of local treatment including radiotherapy (LRT) in hepatocellular carcinoma (HCC) invading the portal vein. We used clinical data of patients with HCC invading the portal vein from 2008 to 2014 provided by 50 hospitals nationwide. A total of 1163 patients were included in the analysis. The LRT group was younger than the best supportive care (BSC) group (p < 0.001). The mean Child-Pugh score of the LRT group (6.1) was significantly lower than that of the BSC group (7.7) (p < 0.001). Propensity score-matched analysis generated 222 pairs. The median survival of all patients, LRT, and BSC groups were 5.0, 8.0, and 2.0 months, respectively. The overall survival (OS) rates in the LRT and BSC groups were 34.2% and 16.2% at one year, and 12.6% and 6.8% at two years, respectively (p < 0.001). Multivariate analysis showed that LRT (HR 0.41, 95% CI 0.32-0.52), age >60 years, extrahepatic metastases, tumor size >= 10 cm, and Child-Pugh class (CPC) B or C were independent predictors of higher mortality (all p < 0.05). Statistical differences in survival were maintained in all CPC-albumin-bilirubin classes (all p < 0.05). LRT was significant in patients with HCC with portal invasion, valid for patients with CPC A and B.
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2. Clinical Science > Department of Radiation Oncology > 1. Journal Articles
2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles

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Yoon, Won Sup
Ansan Hospital (Department of Radiation Oncology, Ansan Hospital)
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