European Radiology

, Volume 28, Issue 5, pp 2184–2193 | Cite as

Portal hypertension is associated with poor outcome of transarterial chemoembolization in patients with hepatocellular carcinoma

  • Jin Woo Choi
  • Jin Wook Chung
  • Dong Ho Lee
  • Hyo-Cheol Kim
  • Saebeom Hur
  • Myungsu Lee
  • Hwan Jun Jae
Interventional
  • 131 Downloads

Abstract

Objectives

To determine whether clinically relevant portal hypertension (CRPH) influences outcome and whether it may serve as a prognostic marker in patients treated with transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).

Methods

One hundred and forty-seven patients underwent conventional TACE as a first-line treatment for a single HCC. CRPH was graded as 0, 1, or 2. The influence of CRPH, together with other factors, on local tumour progression (LTP) and overall survival (OS) were analysed using Cox proportional hazards regression.

Results

A higher CRPH grade (grade 1, p = 0.005, hazard ratio [HR] = 3.282; grade 2, p < 0.001, HR = 7.144) and less selective catheterization (p = 0.009, HR = 1.951) were significantly associated with early LTP. Regarding OS, older age, (p < 0.001, HR = 1.050), CRPH grade 2 (p = 0.024, HR = 2.058), and a larger tumour (p < 0.001, HR = 1.454) were significantly associated with early death.

Conclusions

Portal hypertension was significantly associated with poor outcome after TACE, and non-invasive CRPH grading may be a useful prognostic marker of TACE.

Key Points

Portal hypertension was significantly associated with poor outcome after TACE.

Grading portal hypertension non-invasively can help predict TACE outcome in HCC patients.

CRPH grading can aid in selecting optimal candidates for TACE.

Keywords

Hepatocellular carcinoma Chemoembolization, therapeutic Portal hypertension Computed tomography, X-ray Survival 

Abbreviations

BCLC

Barcelona Clinic Liver Cancer

CI

Confidence interval

CR

Complete response

CRPH

Clinically relevant portal hypertension

CT

Computed tomography

CTP

Child-Turcotte-Pugh

ECOG

Eastern Cooperative Oncology Group

HCC

Hepatocellular carcinoma

HR

Hazard ratio

HVPG

Hepatic venous pressure gradient

LCOS

LT-censored OS

LT

Liver transplantation

LTP

Local tumour progression

MR

Magnetic resonance

OS

Overall survival

PBP

Peribiliary plexus

TACE

Transarterial chemoembolization

Notes

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Jin Wook Chung, MD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by the Korean Health Industry Development Institute (KHIDI), supported by the Ministry of Health & Welfare, Republic of Korea (Grant Number: HI15C2797).

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Study subjects or cohorts overlap

No subjects / cohorts of this study have been previously reported.

Methodology

• retrospective

• observational

• performed at one institution

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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.Section of Interventional Radiology, Department of Radiology, Seoul National University College of MedicineSeoul National University HospitalSeoulRepublic of Korea

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