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Intra-arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein thrombosis

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dc.contributor.author정, 재연-
dc.contributor.author김, 진홍-
dc.contributor.author이, 기명-
dc.contributor.author왕, 희정-
dc.contributor.author조, 성원-
dc.contributor.author함, 기백-
dc.contributor.author원, 제환-
dc.contributor.author김, 재근-
dc.date.accessioned2012-03-27T01:16:28Z-
dc.date.available2012-03-27T01:16:28Z-
dc.date.issued2004-
dc.identifier.issn1226-329X-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/6333-
dc.description.abstractBackground: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis has a poor prognosis and has little hope for meaningful therapy. Transarterial chemoembolization has been performed as a treatment for advanced HCC, but some patients die from progressive liver failure after therapy. This study was undertaken to evaluate the therapeutic effects of intra-arterial infusion chemotherapy in advanced HCC with portal vein thrombosis, and to compare with those of systemic chemotherapy, and to identify prognostic factors that could affect survival.
Methods: Between January 1995 and January 2001, a total of 102 patients with advanced HCC having portal vein thrombosis (TNM stage IVa) were enrolled and divided into 3 groups; Group 1 (n=24) was managed with only conservative treatment, group 2 (n=25) received systemic combination chemotherapy consisting of 5-fluorouracil (FU) + Adriamycin + Mitomycin C, or 5-FU + Etoposide Cisplatin, and group 3 (n=52) received intra-arterial infusion chemotherapy with 5-FU (250 mg for 5 days) + cisplatin (10 mg for 5 days) via implanted chemoport.
Results: One-year survival rates were 0%, 4%, 21%, and median survivals were 2-, 4-, 6 months in group 1, group 2, group 3, respectively (p=0.003). When we divide group 3 patients into long term survivors (more than 8 months) or short term survivors (less than 8 months), former had significantly lower level of serum AST (p=0.032) and alkaline phosphatase (p=0.033). Especially, all female patients (n=9) survived more than 8 months, and had a longer survival than male patients (p=0.000). Other favorable prognostic factors for survival were cirrhosis of Child-Pugh class A (p=0.003), only one major branch involvement of the portal vein by tumor (p=0.005), presence of enhancement of tumor portion in arterial phase of CT scan (p=0.044), presence of enhancement of non-tumor portion in portal phase of CT scan (p=0.029).
Conclusion: Intra-arterial infusion chemotherapy achieved favorable results in advanced HCC with portal vein thrombosis and showed better survival in selected patients. This therapy can be tried as a treatment option for the management of advanced HCC.
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dc.formattext/plain-
dc.language.isoko-
dc.titleIntra-arterial infusion chemotherapy in patients with advanced hepatocellular carcinoma with portal vein thrombosis-
dc.title.alternative간문맥 혈전이 동반된 진행성 간세포암에서 간동맥내 항암제 주입요법-
dc.typeArticle-
dc.identifier.urlhttp://kmbase.medric.or.kr/Main.aspx?d=KMBASE&m=VIEW&i=0882420040670010040-
dc.subject.keywordHepatocellular carcinoma-
dc.subject.keywordPortal vein-
dc.subject.keywordThrombosis-
dc.subject.keywordIntra-arterial infusion-
dc.subject.keywordChemotherapy-
dc.contributor.affiliatedAuthor정, 재연-
dc.contributor.affiliatedAuthor김, 진홍-
dc.contributor.affiliatedAuthor이, 기명-
dc.contributor.affiliatedAuthor왕, 희정-
dc.contributor.affiliatedAuthor조, 성원-
dc.contributor.affiliatedAuthor함, 기백-
dc.contributor.affiliatedAuthor원, 제환-
dc.contributor.affiliatedAuthor김, 재근-
dc.type.localJournal Papers-
dc.citation.titleKorean journal of medicine-
dc.citation.volume67-
dc.citation.number1-
dc.citation.date2004-
dc.citation.startPage40-
dc.citation.endPage48-
dc.identifier.bibliographicCitationKorean journal of medicine, 67(1). : 40-48, 2004-
dc.relation.journalidJ01226329X-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
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