Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion
Background/Aims Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results The majority of patients had Barc...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of the Liver
2017-06-01
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| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2016-0088.pdf |
| _version_ | 1819082274357903360 |
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| author | Jihyun An Kwang Sun Lee Kang Mo Kim Do Hyun Park Sang Soo Lee Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee |
| author_facet | Jihyun An Kwang Sun Lee Kang Mo Kim Do Hyun Park Sang Soo Lee Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee |
| author_sort | Jihyun An |
| collection | DOAJ |
| description | Background/Aims Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results The majority of patients had Barcelona Clinic Liver Cancer (BCLC) stage C HCC (66.8%). Portal vein tumor thrombosis was present in 166 (67.2%) patients. Median survival was 4.1 months. Various modalities of treatment were initially employed including surgical resection (10.9%), repeated transarterial chemoembolization (TACE) (42.5%), and conservative management (42.9%). Among the patients with obstructive jaundice (n=88), successful biliary drainage was associated with better overall survival rate. Among the patients with BCLC stage C, overall survival differed depending on the initial treatment for HCC; surgical resection, TACE, systemic chemotherapy, and conservative management showed overall survival rates of 11.5, 6.0 ,2.4, and 1.6 months, respectively. After adjusting for confounders, surgical resection and repeated TACE were significant prognostic factors for HCC patients with bile duct invasion (hazard ratios 0.47 and 0.39, Ps <0.001, respectively). Conclusions The survival of HCC patients with bile duct invasion at initial diagnosis is generally poor. However, aggressive treatments for HCC such as resection or biliary drainage may be beneficial therapeutic options for patients with preserved liver function. |
| first_indexed | 2024-12-21T20:14:04Z |
| format | Article |
| id | doaj.art-0803010cb4b746a19ff582721bf8bd1d |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-21T20:14:04Z |
| publishDate | 2017-06-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-0803010cb4b746a19ff582721bf8bd1d2022-12-21T18:51:40ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2017-06-0123216016910.3350/cmh.2016.00881359Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasionJihyun An0Kwang Sun Lee1Kang Mo Kim2Do Hyun Park3Sang Soo Lee4Danbi Lee5Ju Hyun Shim6Young-Suk Lim7Han Chu Lee8Young-Hwa Chung9Yung Sang Lee10 Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results The majority of patients had Barcelona Clinic Liver Cancer (BCLC) stage C HCC (66.8%). Portal vein tumor thrombosis was present in 166 (67.2%) patients. Median survival was 4.1 months. Various modalities of treatment were initially employed including surgical resection (10.9%), repeated transarterial chemoembolization (TACE) (42.5%), and conservative management (42.9%). Among the patients with obstructive jaundice (n=88), successful biliary drainage was associated with better overall survival rate. Among the patients with BCLC stage C, overall survival differed depending on the initial treatment for HCC; surgical resection, TACE, systemic chemotherapy, and conservative management showed overall survival rates of 11.5, 6.0 ,2.4, and 1.6 months, respectively. After adjusting for confounders, surgical resection and repeated TACE were significant prognostic factors for HCC patients with bile duct invasion (hazard ratios 0.47 and 0.39, Ps <0.001, respectively). Conclusions The survival of HCC patients with bile duct invasion at initial diagnosis is generally poor. However, aggressive treatments for HCC such as resection or biliary drainage may be beneficial therapeutic options for patients with preserved liver function.http://e-cmh.org/upload/pdf/cmh-2016-0088.pdfHepatocellular carcinomaBile duct invasionTreatmentPrognosisObstructive jaundice |
| spellingShingle | Jihyun An Kwang Sun Lee Kang Mo Kim Do Hyun Park Sang Soo Lee Danbi Lee Ju Hyun Shim Young-Suk Lim Han Chu Lee Young-Hwa Chung Yung Sang Lee Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion Clinical and Molecular Hepatology Hepatocellular carcinoma Bile duct invasion Treatment Prognosis Obstructive jaundice |
| title | Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| title_full | Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| title_fullStr | Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| title_full_unstemmed | Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| title_short | Clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| title_sort | clinical features and outcomes of patients with hepatocellular carcinoma complicated with bile duct invasion |
| topic | Hepatocellular carcinoma Bile duct invasion Treatment Prognosis Obstructive jaundice |
| url | http://e-cmh.org/upload/pdf/cmh-2016-0088.pdf |
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