Clinical features and treatment outcome of advanced hepatocellular carcinoma with inferior vena caval invasion or atrial tumor thrombus

Seungup Kim, Y. R. Kim, doyoung kim, Ja Kyung Kim, Hyun Woong Lee, Beom Kyung Kim, KwangHyub Han, Chae Yoon Chon, Young Myoung Moon, SangHoon Ahn

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) with an extension to the inferior vena cava (IVC) or right atrium is uncommon, and its prognosis remains unclear due to the few case reports. In order to elucidate the natural history and treatment outcome, this study investigated advanced HCC patients with an IVC invasion or atrial tumor thrombus. METHODS: Between November 1987 and June 2004, a total of 41 patients were diagnosed as having HCC with IVC or right atrial involvement using the new imaging techniques including a two-dimensional echocardiography. Those patients were stratified into the untreated 'control group' (n=17) and 'treated group' (n=24). The clinical features, treatment outcome and prognosis including patient survival were analyzed. RESULTS: The mean age of the total patients was 55 years (male:female, 33:8). The most common cause of HCC was a hepatitis B virus infection (85.4%), followed by a hepatitis C virus infection (7.4%). According to the Child-Pugh classification, 24 patients were Child-Pugh class A (58.5%), 15 were Child-Pugh class B (36.6%), and 2 were Child-Pugh class C (4.9%). Lung metastases were identified in 10 patients (24.5%). The treatment modalities of the treated group included 11 systemic chemotherapy regimens (5-FU and cisplatin), 10 transarterial chemotherapy regimens, 2 chemoradiation procedures and 1 hepatic resection. The overall survival was 3.0 months (range, 1-29 months). The 6 month survival rate was 23.5% (4/17) in the control group and 29.2% (7/24) in the treated group. The 12 months survival rate was 0% (0/17) and 25.0% (6/24), respectively. Independent prognostic factor affecting the survival was whether or not any treatment had been carried out. CONCLUSIONS: Although the prognosis of advanced HCC with IVC invasion or a right atrial tumor thrombi is poor, treatment might improve the survival rate.

Original languageEnglish
Pages (from-to)387-395
Number of pages9
JournalThe Korean journal of hepatology
Volume13
Issue number3
DOIs
Publication statusPublished - 2007 Jan 1

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Venae Cavae
Hepatocellular Carcinoma
Thrombosis
Inferior Vena Cava
Neoplasms
Survival Rate
Virus Diseases
Survival
Drug Therapy
Control Groups
Heart Atria
Natural History
Hepatitis B virus
Fluorouracil
Hepacivirus
Cisplatin
Echocardiography
Therapeutics
Outcome Assessment (Health Care)
Neoplasm Metastasis

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

@article{beead85cf69d431eb6d8916370db6228,
title = "Clinical features and treatment outcome of advanced hepatocellular carcinoma with inferior vena caval invasion or atrial tumor thrombus",
abstract = "BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) with an extension to the inferior vena cava (IVC) or right atrium is uncommon, and its prognosis remains unclear due to the few case reports. In order to elucidate the natural history and treatment outcome, this study investigated advanced HCC patients with an IVC invasion or atrial tumor thrombus. METHODS: Between November 1987 and June 2004, a total of 41 patients were diagnosed as having HCC with IVC or right atrial involvement using the new imaging techniques including a two-dimensional echocardiography. Those patients were stratified into the untreated 'control group' (n=17) and 'treated group' (n=24). The clinical features, treatment outcome and prognosis including patient survival were analyzed. RESULTS: The mean age of the total patients was 55 years (male:female, 33:8). The most common cause of HCC was a hepatitis B virus infection (85.4{\%}), followed by a hepatitis C virus infection (7.4{\%}). According to the Child-Pugh classification, 24 patients were Child-Pugh class A (58.5{\%}), 15 were Child-Pugh class B (36.6{\%}), and 2 were Child-Pugh class C (4.9{\%}). Lung metastases were identified in 10 patients (24.5{\%}). The treatment modalities of the treated group included 11 systemic chemotherapy regimens (5-FU and cisplatin), 10 transarterial chemotherapy regimens, 2 chemoradiation procedures and 1 hepatic resection. The overall survival was 3.0 months (range, 1-29 months). The 6 month survival rate was 23.5{\%} (4/17) in the control group and 29.2{\%} (7/24) in the treated group. The 12 months survival rate was 0{\%} (0/17) and 25.0{\%} (6/24), respectively. Independent prognostic factor affecting the survival was whether or not any treatment had been carried out. CONCLUSIONS: Although the prognosis of advanced HCC with IVC invasion or a right atrial tumor thrombi is poor, treatment might improve the survival rate.",
author = "Seungup Kim and Kim, {Y. R.} and doyoung kim and Kim, {Ja Kyung} and Lee, {Hyun Woong} and Kim, {Beom Kyung} and KwangHyub Han and Chon, {Chae Yoon} and Moon, {Young Myoung} and SangHoon Ahn",
year = "2007",
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doi = "10.3350/kjhep.2007.13.3.387",
language = "English",
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journal = "Clinical and molecular hepatology",
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Clinical features and treatment outcome of advanced hepatocellular carcinoma with inferior vena caval invasion or atrial tumor thrombus. / Kim, Seungup; Kim, Y. R.; kim, doyoung; Kim, Ja Kyung; Lee, Hyun Woong; Kim, Beom Kyung; Han, KwangHyub; Chon, Chae Yoon; Moon, Young Myoung; Ahn, SangHoon.

In: The Korean journal of hepatology, Vol. 13, No. 3, 01.01.2007, p. 387-395.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical features and treatment outcome of advanced hepatocellular carcinoma with inferior vena caval invasion or atrial tumor thrombus

AU - Kim, Seungup

AU - Kim, Y. R.

AU - kim, doyoung

AU - Kim, Ja Kyung

AU - Lee, Hyun Woong

AU - Kim, Beom Kyung

AU - Han, KwangHyub

AU - Chon, Chae Yoon

AU - Moon, Young Myoung

AU - Ahn, SangHoon

PY - 2007/1/1

Y1 - 2007/1/1

N2 - BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) with an extension to the inferior vena cava (IVC) or right atrium is uncommon, and its prognosis remains unclear due to the few case reports. In order to elucidate the natural history and treatment outcome, this study investigated advanced HCC patients with an IVC invasion or atrial tumor thrombus. METHODS: Between November 1987 and June 2004, a total of 41 patients were diagnosed as having HCC with IVC or right atrial involvement using the new imaging techniques including a two-dimensional echocardiography. Those patients were stratified into the untreated 'control group' (n=17) and 'treated group' (n=24). The clinical features, treatment outcome and prognosis including patient survival were analyzed. RESULTS: The mean age of the total patients was 55 years (male:female, 33:8). The most common cause of HCC was a hepatitis B virus infection (85.4%), followed by a hepatitis C virus infection (7.4%). According to the Child-Pugh classification, 24 patients were Child-Pugh class A (58.5%), 15 were Child-Pugh class B (36.6%), and 2 were Child-Pugh class C (4.9%). Lung metastases were identified in 10 patients (24.5%). The treatment modalities of the treated group included 11 systemic chemotherapy regimens (5-FU and cisplatin), 10 transarterial chemotherapy regimens, 2 chemoradiation procedures and 1 hepatic resection. The overall survival was 3.0 months (range, 1-29 months). The 6 month survival rate was 23.5% (4/17) in the control group and 29.2% (7/24) in the treated group. The 12 months survival rate was 0% (0/17) and 25.0% (6/24), respectively. Independent prognostic factor affecting the survival was whether or not any treatment had been carried out. CONCLUSIONS: Although the prognosis of advanced HCC with IVC invasion or a right atrial tumor thrombi is poor, treatment might improve the survival rate.

AB - BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) with an extension to the inferior vena cava (IVC) or right atrium is uncommon, and its prognosis remains unclear due to the few case reports. In order to elucidate the natural history and treatment outcome, this study investigated advanced HCC patients with an IVC invasion or atrial tumor thrombus. METHODS: Between November 1987 and June 2004, a total of 41 patients were diagnosed as having HCC with IVC or right atrial involvement using the new imaging techniques including a two-dimensional echocardiography. Those patients were stratified into the untreated 'control group' (n=17) and 'treated group' (n=24). The clinical features, treatment outcome and prognosis including patient survival were analyzed. RESULTS: The mean age of the total patients was 55 years (male:female, 33:8). The most common cause of HCC was a hepatitis B virus infection (85.4%), followed by a hepatitis C virus infection (7.4%). According to the Child-Pugh classification, 24 patients were Child-Pugh class A (58.5%), 15 were Child-Pugh class B (36.6%), and 2 were Child-Pugh class C (4.9%). Lung metastases were identified in 10 patients (24.5%). The treatment modalities of the treated group included 11 systemic chemotherapy regimens (5-FU and cisplatin), 10 transarterial chemotherapy regimens, 2 chemoradiation procedures and 1 hepatic resection. The overall survival was 3.0 months (range, 1-29 months). The 6 month survival rate was 23.5% (4/17) in the control group and 29.2% (7/24) in the treated group. The 12 months survival rate was 0% (0/17) and 25.0% (6/24), respectively. Independent prognostic factor affecting the survival was whether or not any treatment had been carried out. CONCLUSIONS: Although the prognosis of advanced HCC with IVC invasion or a right atrial tumor thrombi is poor, treatment might improve the survival rate.

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