Retrospective Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Dec 15, 2018; 10(12): 496-504
Published online Dec 15, 2018. doi: 10.4251/wjgo.v10.i12.496
Stents combined with iodine-125 implantation to treat main portal vein tumor thrombus
Yi-Fan Wu, Tao Wang, Zhen-Dong Yue, Hong-Wei Zhao, Lei Wang, Zhen-Hua Fan, Fu-Liang He, Fu-Quan Liu
Yi-Fan Wu, Zhen-Dong Yue, Hong-Wei Zhao, Lei Wang, Zhen-Hua Fan, Fu-Liang He, Fu-Quan Liu, Department of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
Tao Wang, Department of Interventional Therapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai 264000, Shandong Province, China
Author contributions: Wu YF, Wang T, Yue ZD, Zhao HW, Wang L, Fan ZH, He FL and Liu FQ designed the research; Zhao HW, Wang L, Fan ZH and He FL performed the research; Wu YF, Wang T, Yue ZD and Liu FQ analyzed the data; Wu YF wrote the paper.
Supported by the Beijing Municipal Science and Technology Commission project, the Capital of the Public Health Cultivation - Transcatheter active particles implantation combined with TACE/TAE in the treatment of portal vein tumor thrombus in clinical research, No. Z171100000417031.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee for Scientific Research of Beijing Shijitan Hospital Affiliated to Capital Medical University.
Informed consent statement: The patients provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: Dataset available from the corresponding author at the provided email address. Participants gave informed consent for data sharing.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author to: Fu-Quan Liu, MD, Professor, De¬partment of Interventional Therapy, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tie Yi Road, Haidian District, Beijing 100038, China. liufq_sjt@163.com
Telephone: +86-10-63926272 Fax: +86-10-63925588
Received: August 7, 2018
Peer-review started: August 8, 2018
First decision: October 4, 2018
Revised: October 19, 2018
Accepted: November 23, 2018
Article in press: November 24, 2018
Published online: December 15, 2018
Processing time: 129 Days and 20.1 Hours
Abstract
AIM

To evaluate the efficacy of main portal vein stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus.

METHODS

From January 1, 2010 to January 1, 2015, 111 patients were diagnosed with liver cancer combined with main portal vein tumor thrombus. They were non-randomly assigned to undergo treatment with transarterial chemoembolization (TACE)/transarterial embolization (TAE) + portal vein stents combined with 125I implantation (Group A) and TACE/TAE + portal vein stents only (Group B). After the operation, scheduled follow-up was performed at 6, 12 and 24 mo. The recorded information included clinical manifestations, survival rate, and stent restenosis rate. Kaplan–Meier curves, log-rank test and Cox regression were used for data analyses.

RESULTS

From January 1, 2010 to January 1, 2015, 54 and 57 patients were allocated to Groups A and B, respectively. The survival rates at 6, 12 and 24 mo were 85.2%, 42.6% and 22.2% in Group A and 50.9%, 10.5% and 0% in Group B. The differences were significant [log rank P < 0.05, hazard ratio (HR): 0.37, 95%CI: 0.24-0.56]. The rates of stent restenosis were 18.5%, 55.6% and 83.3% in Group A and 43.9%, 82.5% and 96.5% in Group B. The differences were significant (log rank P < 0.05, HR: 0.42, 95%CI: 0.27-0.63). Cox regression identified that treatment was the only factor affecting survival rate in this study.

CONCLUSION

Main portal vein stents combined with 125I can significantly improve survival rate and reduce the rate of stent restenosis.

Keywords: Iodine-125; Liver cancer; Stent; Main portal vein tumor thrombus; Transarterial chemoembolization/transarterial embolization

Core tip: This study evaluated the efficacy of stents combined with iodine-125 (125I) to treat main portal vein tumor thrombus and its complications. 125I was placed between the stent and tumor thrombus, and not in the form of particle strands. In this way, the quantity and position of 125I could be flexibly adjusted. Transarterial chemoembolization or transarterial embolization was used as basic treatment. Patients with liver cancer and main portal vein tumor thrombus were non-randomly assigned to undergo portal vein stents combined with 125I implantation or portal vein stents only. Portal vein stent combined with 125I significantly improved survival rate and reduced stent restenosis.