Hepatocellular Carcinoma Associated with Membranous Obstruction of the Inferior Vena Cava: Incidence, Characteristics, and Risk Factors and Clinical Efficacy of TACE
Hepatocellular Carcinoma Associated with Membranous Obstruction of the Inferior Vena Cava: Incidence, Characteristics, and Risk Factors and Clinical Efficacy of TACE
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DOI：
10.1148/radiol.09090738
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发表时间：
2010-02-01
期刊：
影响因子：
19.7
通讯作者：
Song, Ho-Young
中科院分区：
文献类型：
--
作者：
Gwon, Dong Il;Ko, Gi-Young;Song, Ho-Young
目的：目的：分析肝细胞癌（HCC）合并下腔静脉（MOVC）膜性梗阻的特点，评价肝动脉化疗栓塞（TACE）的临床疗效。材料与方法：本回顾性研究由机构审查委员会批准，并豁免知情同意书。回顾性评价了98例MOVC患者（平均年龄48.5岁± 12.9岁[标准差]）。通过多普勒超声检查、计算机断层扫描、磁共振成像和/或下腔静脉造影术的结果证实了布加综合征的诊断。采用Kaplan-Meier法计算HCC的累积发病率和患者生存期。结果：在98例MOVC患者中，37例（38%）检出肝结节，其中23例为MOVC合并HCC，14例为良性结节。1年、5年和10年时HCC的累积发病率分别为7.3%、13.5%和31.8%。女性是唯一与HCC发生相关的重要因素（优势比，6.02; P <0.001）。HCC为单发结节型，位于外周。在23例HCC患者中，20例患者仅接受TACE治疗，3例患者在TACE后接受肝移植。TACE治疗后，14例（61%）患者完全缓解，1、2、3、4和5年生存率分别为90%、85%、61%、61%和46%.Conclusion：MOVC患者HCC的发病率与其他研究中发现的相似。TACE对HCC产生了有效的肿瘤反应，似乎能有效延长患者生存期。女性是与HCC发生相关的唯一显著因素。一个单一的结节性肿瘤与周围的位置似乎有较高的概率肝癌。(C)RSNA，2010年
Purpose: To analyze the characteristics associated with membranous obstruction of the inferior vena cava (MOVC) associated hepatocellular carcinoma (HCC) and to evaluate the clinical efficacy of transcatheter arterial chemoembolization ( TACE).Materials and Methods: This retrospective study was approved by an institutional review board, and informed consent was waived. Ninety-eight patients (mean age, 48.5 years +/- 12.9 [standard deviation]) with MOVC were retrospectively evaluated. The diagnosis of Budd-Chiari syndrome was confirmed with results from Doppler ultrasonography, computed tomography, magnetic resonance imaging, and/or inferior venacavography. The cumulative incidences of HCC and the patient survival period were calculated by using the Kaplan-Meier method. Factors associated with the development of HCC were evaluated by using multivariate Cox regression analysis.Results: Among 98 patients with MOVC, liver nodules were detected in 37 patients (38%), 23 of whom had HCC associated with MOVC and 14 of whom had benign nodules. The cumulative incidence of HCC at 1, 5, and 10 years was 7.3%, 13.5%, and 31.8%, respectively. Female sex was the only significant factor associated with the development of HCC (odds ratio, 6.02; P < .001). HCC was of the single nodular type and of peripheral location. Among 23 patients with HCC, 20 patients were treated with only TACE and three with liver transplantation after TACE. After TACE, 14 (61%) of the study patients had a complete response, and survival rates at 1, 2, 3, 4, and 5 years were 90%, 85%, 61%, 61%, and 46%, respectively.Conclusion: The incidence of HCC in patients with MOVC was similar to that found in other studies. TACE resulted in an effective tumor response for HCC and seemed to be effective in prolonging patient survival. Female sex was the only significant factor associated with the development of HCC. A single nodular tumor with a peripheral location appears to have a higher probability of HCC. (C) RSNA, 2010