Gamma Knife Radiosurgery Versus Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: a Propensity Score Matching Study

Overview

Journal Hepatol Int

Publisher Springer

Specialty Gastroenterology

Date 2022 Jun 21

PMID 35729469

Authors

Ke Su

Tao Gu

Ke Xu

Hongfei Liao

Xueting Li

Lianbin Wen

Yanqiong Song

Jiaqi Zhong

BingSheng He

Xin Liu

Jie He

Yanlin Liu

Qi Li

Xunjie Feng

Siyu Chen

Binbin Yang

Weihong Huang

Hongping Jin

Xiaotong Luo

Teng Hu

Jiali Chen

Zhenying Wu

Simin Lu

Jianwen Zhang

Mingyue Rao

Yunchuan Xie

Jing Wang

Xiaoning Zhu

Lan Chen

Bo Li

Song Su

Xiaoli Yang

Juan Wang

Hao Zeng

Pan Wang

Min Yan

Xiaojing Chen

Kun He

Yunwei Han

Affiliations

Soon will be listed here.

Abstract

Background: The optimal locoregional treatment for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) is unclear. This study aimed to investigate the efficacy of Gamma knife radiosurgery (GKR) versus transcatheter arterial chemoembolization (TACE) in HCC patients with PVTT.

Methods: This retrospective study included 544 HCC patients with PVTT (GKR, 202; TACE, 342). Propensity score matching (PSM) analysis identified 171 matched pairs of patients. The primary endpoint was overall survival (OS).

Results: Before PSM, the GKR group exhibited longer median OS (mOS) than the TACE group (17.2 vs. 8.0 months, p < 0.001). We followed the Cheng's classification for PVTT. In the subgroup analysis, GKR was associated with significantly longer mOS for patients with PVTT II-IV (17.5 vs. 8.7 months, p < 0.001; 17.2 vs. 7.8 months, p = 0.001; 14.5 vs. 6.5 months, p = 0.001, respectively) and comparable OS for patients with PVTT I. After PSM, the GKR group had also a longer mOS than the TACE group (15.8 vs. 10.4 months, p < 0.001). In the subgroup analysis, the GKR group demonstrated superior mOS for patients with PVTT II-IV (all p < 0.05) and comparable OS for patients with PVTT I.

Conclusions: GKR was associated better OS than TACE in HCC patients with PVTT, especially for patients with PVTT II-IV.

Clinical Trials Registration: The study was registered in the Chinese Clinical Trials Registry under the registration number ChiCTR2100051057.

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