Therapeutic value of transcatheter arterial chemoembolization combined with portal vein embolization for primary hepatocellular carcinoma with portal vein tumor thrombus: A pilot study

Aim To compare clinical outcome and safety of transcatheter arterial chemoembolization ( TACE ) + portal vein embolization ( PVE ) with TACE alone in hepatocellular c arcinoma ( HCC ) patients with portal vein tumor thrombus ( PVTT ). Methods We retrospectively collected patients of HCC with PVTT treated with TACE (5‐ FU , oxaliplatin and mitomycin) or TACE  +  PVE (doxorubicin) between O ctober 2000 and J uly 2008. Outcomes evaluated include overall survival, response to treatment and side effects. Results One hundred and sixteen patients were assessed. The median follow‐up of TACE group and TACE  +  PVE group was 83 and 85 months, respectively. The tumor response rates were respectively 48/64 and 49/52. The 1‐, 3‐ and 5‐year overall survival rates for the TACE and TACE  +  PVE groups were 39/64, 16/64, 0/64 and 42/52, 19/52, 6/52 respectively ( P  = 0.015, 0.046 and 0.002, respectively). Three factors were shown as the risk factors which affect the survival of patients: treated by TACE  +  PVE or TACE ; type of PVTT ; and absence of cirrhosis. Conclusion TACE  +  PVE may be better than TACE alone to treat primary HCC with PVTT .