| Title | Transjugular intrahepatic portosystemic shunt with radioactive seed strand for main portal vein tumor thrombosis with cirrhotic portal hypertension |
| Authors | 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 |
| Affiliation | Peking Univ, Beijing Shijitan Hosp, Sch Clin Med 9, Dept Intervent Therapy, Beijing 100038, Peoples R China Capital Med Univ, Beijing Shijitan Hosp, Dept Intervent Therapy, Beijing 100038, Peoples R China Capital Med Univ, Beijing Tongren Hosp, Dept Intervent Therapy, Beijing 100005, Peoples R China Capital Med Univ, Beijing Shijitan Hosp, Dept Gastroenterol, Beijing 100038, Peoples R China Capital Med Univ, Beijing Ditan Hosp, Dept Gen Surg, Beijing 100102, Peoples R China Capital Med Univ, Beijing Youan Hosp, Dept Gastroenterol, Beijing 100069, Peoples R China Capital Med Univ, Beijing Youan Hosp, Dept Liver Dis Digest Ctr, Beijing 100069, Peoples R China Fifth Med Ctr Chinese PLA Gen Hosp, Dept Liver Dis, Beijing 100039, Peoples R China Peking Univ, Beijing Shijitan Hosp, Sch Clin Med 9, Dept Intervent Therapy, 10 Tie Yi Rd, Beijing 100038, Peoples R China |
| Keywords | I-125 IRRADIATION STENT HEPATOCELLULAR-CARCINOMA MANAGEMENT CONSENSUS |
| Issue Date | 27-Jun-2022 |
| Publisher | WORLD JOURNAL OF GASTROINTESTINAL SURGERY |
| Abstract | BACKGROUNDPatients 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.AIMTo evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) combined with radioactive seed strand for the treatment of mPVTT patients with CPH.METHODSThe clinical data of 83 consecutive patients who underwent TIPS combined with I-125 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.RESULTSThe 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 & PLUSMN; 7.33 mmHg vs 35.12 & PLUSMN; 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 & PLUSMN; 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 & PLUSMN; 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).CONCLUSIONTIPS combined with radioactive seed strand might be effective and safe in treating mPVTT patients with CPH. |
| URI | http://hdl.handle.net/20.500.11897/648984 |
| ISSN | 1948-9366 |
| DOI | 10.4240/wjgs.v14.i6.567 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京世纪坛医院 |
