Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites
Background: Currently, hepatocellular carcinoma (HCC) patients with refractory ascites (RA) have a very poor prognosis, and there are no effective treatments recommended by the guidelines. A treatment strategy that utilizes a transjugular intrahepatic portosystemic shunt (TIPS) combined with subsequ...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | Translational Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1936523320303569 |
| _version_ | 1818411005727735808 |
|---|---|
| author | Huzheng Yan Guobao Wang Wenliang Zhu Kai Feng Wenke Zhu Xuan Wu Zhenkang Qiu Guanyu Chen Weiwei Jiang Fujun Zhang Fei Gao |
| author_facet | Huzheng Yan Guobao Wang Wenliang Zhu Kai Feng Wenke Zhu Xuan Wu Zhenkang Qiu Guanyu Chen Weiwei Jiang Fujun Zhang Fei Gao |
| author_sort | Huzheng Yan |
| collection | DOAJ |
| description | Background: Currently, hepatocellular carcinoma (HCC) patients with refractory ascites (RA) have a very poor prognosis, and there are no effective treatments recommended by the guidelines. A treatment strategy that utilizes a transjugular intrahepatic portosystemic shunt (TIPS) combined with subsequent antitumor treatment is explored in this study for its feasibility and clinical value. Methods: One month after TIPS, the ascites grade and Child-Pugh scores and stages were reassessed to compare changes in the preoperative indicators. Results: A total of 68 patients from 3 centers were enrolled. After TIPS, the following results were obtained: a complete response (CR), partial response (PR), or absent RA response (AR) of 38 [55.9%], 21 [30.9%], and 9 [13.2%], respectively. The control of RA was 86.8%. The median Child–Pugh scores prior to TIPS and one month after TIPS were 8 (IQR 7–9) and 7 (IQR 6–8), respectively. The down, unchanged, and elevated Child–Pugh stages were 26 [38.2%], 36 [53.0%], and 6 [8.8%], respectively. The postoperative Child–Pugh scores were significantly lower than the preoperative (p < 0.001). 92.6% (63/61) of the patients received subsequent anti-tumor treatment opportunities. The median overall survival (OS) was 8.7 (range, 0.4–49.6) months. The lower postoperative Child-Pugh stage(p = 0.001), downward change of the Child-Pugh stage(p = 0.027), and downward change of the Child-Pugh score (p = 0.002) were independent protected prognostic factors for OS. Conclusion: As a minimally invasive method, TIPS can effectively control ascites and improve Child–Pugh scores and stages. TIPS combined with subsequent anti-tumor therapy is a feasible and effective management for HCC patients with RA. |
| first_indexed | 2024-12-14T10:24:32Z |
| format | Article |
| id | doaj.art-1d152b0cfb604483bf3f2e5d302bedd7 |
| institution | Directory Open Access Journal |
| issn | 1936-5233 |
| language | English |
| last_indexed | 2024-12-14T10:24:32Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Translational Oncology |
| spelling | doaj.art-1d152b0cfb604483bf3f2e5d302bedd72022-12-21T23:06:23ZengElsevierTranslational Oncology1936-52332020-12-011312100864Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascitesHuzheng Yan0Guobao Wang1Wenliang Zhu2Kai Feng3Wenke Zhu4Xuan Wu5Zhenkang Qiu6Guanyu Chen7Weiwei Jiang8Fujun Zhang9Fei Gao10Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, ChinaDepartment of Endoscopy, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, ChinaDepartment of Radiology, The Third People's Hospital of Shenzhen, Shenzhen, ChinaDepartment of Radiology, The Third People's Hospital of Shenzhen, Shenzhen, ChinaVascular&Tumor Intervention Department, Dongguan Kanghua Hospital, Dongguan, ChinaDepartment of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, ChinaDepartment of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, ChinaDepartment of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, ChinaDepartment of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China; Corresponding authors.Department of Minimally Invasive & Interventional Radiology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China; Corresponding authors.Background: Currently, hepatocellular carcinoma (HCC) patients with refractory ascites (RA) have a very poor prognosis, and there are no effective treatments recommended by the guidelines. A treatment strategy that utilizes a transjugular intrahepatic portosystemic shunt (TIPS) combined with subsequent antitumor treatment is explored in this study for its feasibility and clinical value. Methods: One month after TIPS, the ascites grade and Child-Pugh scores and stages were reassessed to compare changes in the preoperative indicators. Results: A total of 68 patients from 3 centers were enrolled. After TIPS, the following results were obtained: a complete response (CR), partial response (PR), or absent RA response (AR) of 38 [55.9%], 21 [30.9%], and 9 [13.2%], respectively. The control of RA was 86.8%. The median Child–Pugh scores prior to TIPS and one month after TIPS were 8 (IQR 7–9) and 7 (IQR 6–8), respectively. The down, unchanged, and elevated Child–Pugh stages were 26 [38.2%], 36 [53.0%], and 6 [8.8%], respectively. The postoperative Child–Pugh scores were significantly lower than the preoperative (p < 0.001). 92.6% (63/61) of the patients received subsequent anti-tumor treatment opportunities. The median overall survival (OS) was 8.7 (range, 0.4–49.6) months. The lower postoperative Child-Pugh stage(p = 0.001), downward change of the Child-Pugh stage(p = 0.027), and downward change of the Child-Pugh score (p = 0.002) were independent protected prognostic factors for OS. Conclusion: As a minimally invasive method, TIPS can effectively control ascites and improve Child–Pugh scores and stages. TIPS combined with subsequent anti-tumor therapy is a feasible and effective management for HCC patients with RA.http://www.sciencedirect.com/science/article/pii/S1936523320303569 |
| spellingShingle | Huzheng Yan Guobao Wang Wenliang Zhu Kai Feng Wenke Zhu Xuan Wu Zhenkang Qiu Guanyu Chen Weiwei Jiang Fujun Zhang Fei Gao Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites Translational Oncology |
| title | Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites |
| title_full | Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites |
| title_fullStr | Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites |
| title_full_unstemmed | Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites |
| title_short | Feasibility and clinical value of TIPS combined with subsequent antitumor treatment in HCC patients with refractory ascites |
| title_sort | feasibility and clinical value of tips combined with subsequent antitumor treatment in hcc patients with refractory ascites |
| url | http://www.sciencedirect.com/science/article/pii/S1936523320303569 |
| work_keys_str_mv | AT huzhengyan feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT guobaowang feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT wenliangzhu feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT kaifeng feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT wenkezhu feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT xuanwu feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT zhenkangqiu feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT guanyuchen feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT weiweijiang feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT fujunzhang feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites AT feigao feasibilityandclinicalvalueoftipscombinedwithsubsequentantitumortreatmentinhccpatientswithrefractoryascites |