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. 2021 Apr 14;10(4):326.
doi: 10.3390/biology10040326.

Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion

Han Ah Lee  1   2 , Sunmin Park  3 , Yeon Seok Seo  2 , Won Sup Yoon  3 , Chai Hong Rim  3 , On Behalf Of The Korean Liver Cancer Study Group
Affiliations

Benefits of Local Treatment Including External Radiotherapy for Hepatocellular Carcinoma with Portal Invasion

Han Ah Lee et al. Biology (Basel). .

Abstract

We aimed to identify the oncologic benefits of local treatment including radiotherapy (LRT) in hepatocellular carcinoma (HCC) invading the portal vein. We used clinical data of patients with HCC invading the portal vein from 2008 to 2014 provided by 50 hospitals nationwide. A total of 1163 patients were included in the analysis. The LRT group was younger than the best supportive care (BSC) group (p < 0.001). The mean Child-Pugh score of the LRT group (6.1) was significantly lower than that of the BSC group (7.7) (p < 0.001). Propensity score-matched analysis generated 222 pairs. The median survival of all patients, LRT, and BSC groups were 5.0, 8.0, and 2.0 months, respectively. The overall survival (OS) rates in the LRT and BSC groups were 34.2% and 16.2% at one year, and 12.6% and 6.8% at two years, respectively (p < 0.001). Multivariate analysis showed that LRT (HR 0.41, 95% CI 0.32-0.52), age >60 years, extrahepatic metastases, tumor size ≥10 cm, and Child-Pugh class (CPC) B or C were independent predictors of higher mortality (all p < 0.05). Statistical differences in survival were maintained in all CPC-albumin-bilirubin classes (all p < 0.05). LRT was significant in patients with HCC with portal invasion, valid for patients with CPC A and B.

Keywords: ALBI grade; BCLC C; portal vein thrombosis; radiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the study design; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Patient selection process.
Figure 2
Figure 2
Descriptive graphs of overall and cause-specific survival. (A) All propensity-score matched patients. (B) Local treatment including radiotherapy (LRT) versus best supportive care (BSC) groups. (C) Comparison among subgroups according to Child-Pugh class (CPC) and Albumin-Bilirubin index (ALBI).
Figure 3
Figure 3
Descriptive graphs of overall and cause-specific survival according to treatment modalities (local treatment including radiotherapy [LRT] versus best supportive care [BSC] groups) of (A) Child-Pugh class (CPC) and albumin-bilirubin index (ALBI) A1 group. (B) CPC-ALBI A2 group. (C) CPC-ALBI B or higher group.
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