Assessment of efficacy and prognostic factors by Gelfoam for DEB-TACE in unresectable large hepatocellular carcinoma with portal vein tumor thrombus: a multi-center retrospective study

ABSTRACT

Objective

To explore the clinical efficacy and prognostic factors of the use of Gelfoam for drug-eluting bead (DEB) transarterial chemoembolization (GMD-TACE) in patients with unresectable large hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT).

Methods

A retrospective analysis was conducted using the mRECIST standard to evaluate tumor response after GMD-TACE. Overall survival time, median survival time, time to progression (TTP) after the first intervention, and other treatment methods were recorded.

Results

The follow-up time was 2–110 months (mean 17.97 + 19.12 months), the median follow-up time was 12.5 months, and the first TTP after the first GMD-TACE was 4 months (95% CI 3.020–4.980). The median overall survival (OS) time was 14 months (95% CI 9.801–18.199). The 1-, 3-, and 5-year survival rates were 53.6%, 32.3%, and 8.9%, respectively. Multivariate analysis showed that the type of tumor thrombus was an independent factors affecting prognosis, and combination therapy was a protective factor affecting prognosis.

Conclusions

GMD-TACE can be used as the core treatment for unresectable large HCC combined with a PVTT. This can improve the quality of life and further improve the median OS, and is worthy of clinical promotion and application.

KEYWORDS:

• Unresectable HCC
• PVTT
• gelfoam microparticles
• DEB-TACE
• chemoembolization
• prognosis

Authors’ contributions

GSZ: responsible for clinical trial research and paper writing; SL and LY: responsible for patient follow-up and data statistics; CL, RYW and JB: responsible for experiment management; JZ, YWZ and YJL: responsible for project design and experimental implementation. All authors read and approved the final manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Data availability statement

All data generated or analyzed during this study are included in this published article.

Ethics approval and consent to participate

The study was approved by the Ethics Committee of Affiliated Zhongshan Hospital of Dalian University. All the patients participate in the study have signed the informed consent. All methods were performed in accordance with the relevant guidelines and regulations.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.