摘要
Background:The presence of hepatic vein tumor thrombus(HVTT)is a major determinant of survival outcomes in hepatocellular carcinoma(HCC)patients.This study compared survival outcomes between liver resection(LR)and intensity-modulated radiation therapy(IMRT)in HCC patients with HVTT.Methods:Data from patients who underwent LR or IMRT for HCC with HVTT at the Eastern Hepatobiliary Surgery Hospital were retrospectively analyzed.Their survival outcomes were compared before and after propensity score matching(PSM).Results:Three hundred and seven HCC patients with HVTT who underwent either LR(n=140)or IMRT(n=167)were enrolled.PSM matched 82 pairs of patients.The overall survival(OS)and recurrence-free survival(RFS)rates were significantly higher for patients in the LR group than those in the IMRT group.On subgroup analysis,significantly better survival outcomes were obtained after LR than IMRT in patients with peripheral type of HVTT(pHVTT)and major type of HVTT(mHVTT).However,similar survival outcomes were obtained after LR and IMRT when the HVTT had developed into inferior vena cava tumor thrombus(IVCTT).Conclusions:LR resulted in significantly better survival outcomes in HCC patients with HVTT when compared to IMRT.Once the HVTT had developed IVCTT,LR and IMRT resulted in similarly bad survival outcomes.
基金
This work was supported by the Key Project of the Natural Science Foundation of China(No.81730097)
grants of the Science Fund for Creative Research Groups(No.81521091)
the National Key Basic Research Program“973 Project”(No.2015CB554000)
the National Natural Science Foundation of China(No.81602523 and No.81702335).
