Percutaneous thermal ablation combined with TACE versus TACE monotherapy in the treatment for liver cancer with hepatic vein tumor thrombus: A retrospective study

PURPOSE: To investigate the efficacy of percutaneous thermal ablation combined with transarterial chemoembolization (TACE) versus TACE monotherapy in treating primary liver cancer with hepatic vein tumor thrombus (HVTT), and to identify potential factors of overall survival after combination therapy. MATERIALS AND METHODS: Patients with primary liver cancer and HVTT from 2011 to 2016 at our institute were retrospectively identified. They were divided into two groups (group A and group B). Patients in group A underwent TACE with subsequent percutaneous thermal ablation, while patients in group B who were unsuitable for ablation received TACE monotherapy. Characteristics and survival data of the two groups were analyzed and compared. Relevant factors for overall survival (OS) of group A were explored by univariate analysis. RESULTS: Twenty-six patients were included and analyzed. The median OS for group A (n = 13) was 18 months, while the 1-, 2- and 3-year survival rates were 58.6%, 46.9% and 46.9%, respectively. The median OS for group B (n = 13) was 6.5 months and the 1-year survival rate was 10.9%. The survival of group A was significantly better than group B (P = 0.02). The following factors were related with overall survival of group A: ablation technique, complete response of tumor and HVTT, Child-pugh grade, pre-operative extrahepatic metastases and lymph node metastases. In group A, patients who achieved complete response had the longest average survival time (42.1 months). CONCLUSION: For patients with primary liver cancer and HVTT, percutaneous thermal ablation and TACE present better efficacy than TACE monotherapy. Long-term survival could be achieved in selected patients.