8:00 AM Abstract No. 128 - Transcatheter arterial chemoembolization with drug eluting beads in the setting of portal vein thrombosis: Single center evaluation of survival

Abstract

Purpose To evaluate the short- and long-term survival outcomes of drug-eluting bead transcatheter arterial chemoembolization (DEB-TACE) in patients with portal vein tumor thrombus (PVTT). Materials and Methods Between November 2007 and June 2012, 1019 DEB-TACE procedures were performed with doxorubicin loaded 100-300 LC Beads (Biocompatibles, United Kingdom) in 626 consecutive patients with hepatocellular carcinoma (HCC). Retrospective analysis of the medical record revealed a cohort of 35 patients that had PVTT with no prior treatment. 30-day mortality, overall survival, and treatment response to DEB-TACE on follow-up imaging, as determined by mRECIST criteria, was compared in patients with main PVTT to those with branch PVTT. No patients had PVTT extending into the superior mesenteric vein or splenic vein. Results Mean overall survival was significantly shorter in patients with main PVTT compared to those with branch PVTT (105 ± 68 days vs. 283 ± 257 days, p=0.05). Mortality at 30 days was 22% and 8% in the main PVTT and branch PVTT groups respectively, not significantly different (p=0.27). Disease progression on initial follow-up imaging was 22% and 15% in the main PVTT and branch PVTT groups respectively, not significantly different (p=0.60). Conclusion Extent of PVTT has important prognostic value, with main PVTT associated with significantly shorter overall survival compared to patients with branch PVTT. Main PVTT was not associated with a significantly higher 30-day mortality.