Cargando…
Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension
BACKGROUND: Patients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis (mPVTT) and cirrhotic portal hypertension (CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment paradigm. AIM: To evaluate the efficacy and safety of transj...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258232/ https://www.ncbi.nlm.nih.gov/pubmed/35979417 http://dx.doi.org/10.4240/wjgs.v14.i6.567 |
_version_ | 1784741502069506048 |
---|---|
author | Yan, Xuan-Hui Yue, Zhen-Dong Zhao, Hong-Wei Wang, Lei Fan, Zhen-Hua Wu, Yi-Fan Meng, Ming-Ming Zhang, Ke Jiang, Li Ding, Hui-Guo Zhang, Yue-Ning Yang, Yong-Ping Liu, Fu-Quan |
author_facet | Yan, Xuan-Hui Yue, Zhen-Dong Zhao, Hong-Wei Wang, Lei Fan, Zhen-Hua Wu, Yi-Fan Meng, Ming-Ming Zhang, Ke Jiang, Li Ding, Hui-Guo Zhang, Yue-Ning Yang, Yong-Ping Liu, Fu-Quan |
author_sort | Yan, Xuan-Hui |
collection | PubMed |
description | BACKGROUND: Patients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis (mPVTT) and cirrhotic portal hypertension (CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment paradigm. AIM: To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with radioactive seed strand for the treatment of mPVTT patients with CPH. METHODS: The clinical data of 83 consecutive patients who underwent TIPS combined with (125)I seed strand placement for mPVTT and CPH from January 2015 to December 2018 were retrospectively reviewed. Procedure-related data (success rate, relief of portal vein pressure and CPH symptoms, and adverse events), PVTT response, and patient survival were assessed through a 2-year follow-up. RESULTS: The success rate was 100.0% without perioperative death or procedure-related severe adverse events. The mean portal vein pressure was significantly decreased after the procedure (22.25 ± 7.33 mmHg vs 35.12 ± 7.94 mmHg, t = 20.61, P < 0.001). The symptoms of CPH were all effectively relieved within 1 mo. The objective response rate of PVTT was 67.5%. During a mean follow-up of 14.5 ± 9.4 mo (range 1-37 mo), the cumulative survival rates at 6, 12 and 24 mo were 83.1%, 49.7%, and 21.8%, respectively. The median survival time was 12.0 ± 1.3 mo (95% confidence interval: 9.5-14.5). In multivariate Cox regression analysis, body mass index, Child-Pugh grade, cTNM stage, and PVTT response were independent prognostic factors (P < 0.05). CONCLUSION: TIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH. |
format | Online Article Text |
id | pubmed-9258232 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-92582322022-08-16 Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension Yan, Xuan-Hui Yue, Zhen-Dong Zhao, Hong-Wei Wang, Lei Fan, Zhen-Hua Wu, Yi-Fan Meng, Ming-Ming Zhang, Ke Jiang, Li Ding, Hui-Guo Zhang, Yue-Ning Yang, Yong-Ping Liu, Fu-Quan World J Gastrointest Surg Retrospective Cohort Study BACKGROUND: Patients with hepatocellular carcinoma complicated with main portal vein tumor thrombosis (mPVTT) and cirrhotic portal hypertension (CPH) have an extremely poor prognosis, and there is a lack of a clinically effective treatment paradigm. AIM: To evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with radioactive seed strand for the treatment of mPVTT patients with CPH. METHODS: The clinical data of 83 consecutive patients who underwent TIPS combined with (125)I seed strand placement for mPVTT and CPH from January 2015 to December 2018 were retrospectively reviewed. Procedure-related data (success rate, relief of portal vein pressure and CPH symptoms, and adverse events), PVTT response, and patient survival were assessed through a 2-year follow-up. RESULTS: The success rate was 100.0% without perioperative death or procedure-related severe adverse events. The mean portal vein pressure was significantly decreased after the procedure (22.25 ± 7.33 mmHg vs 35.12 ± 7.94 mmHg, t = 20.61, P < 0.001). The symptoms of CPH were all effectively relieved within 1 mo. The objective response rate of PVTT was 67.5%. During a mean follow-up of 14.5 ± 9.4 mo (range 1-37 mo), the cumulative survival rates at 6, 12 and 24 mo were 83.1%, 49.7%, and 21.8%, respectively. The median survival time was 12.0 ± 1.3 mo (95% confidence interval: 9.5-14.5). In multivariate Cox regression analysis, body mass index, Child-Pugh grade, cTNM stage, and PVTT response were independent prognostic factors (P < 0.05). CONCLUSION: TIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH. Baishideng Publishing Group Inc 2022-06-27 2022-06-27 /pmc/articles/PMC9258232/ /pubmed/35979417 http://dx.doi.org/10.4240/wjgs.v14.i6.567 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Cohort Study Yan, Xuan-Hui Yue, Zhen-Dong Zhao, Hong-Wei Wang, Lei Fan, Zhen-Hua Wu, Yi-Fan Meng, Ming-Ming Zhang, Ke Jiang, Li Ding, Hui-Guo Zhang, Yue-Ning Yang, Yong-Ping Liu, Fu-Quan Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title_full | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title_fullStr | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title_full_unstemmed | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title_short | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
title_sort | transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9258232/ https://www.ncbi.nlm.nih.gov/pubmed/35979417 http://dx.doi.org/10.4240/wjgs.v14.i6.567 |
work_keys_str_mv | AT yanxuanhui transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT yuezhendong transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT zhaohongwei transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT wanglei transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT fanzhenhua transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT wuyifan transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT mengmingming transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT zhangke transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT jiangli transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT dinghuiguo transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT zhangyuening transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT yangyongping transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension AT liufuquan transjugularintrahepaticportosystemicshuntwithradioactiveseedstrandformainportalveintumorthrombosiswithcirrhoticportalhypertension |