Effect of different minimally invasive therapies on the prognosis of patients with HBV-related primary liver cancer complicated by portal vein tumor thrombus

Objective To investigate the effect of minimally invasive therapy on the 1-year survival of patients with HBV-related primary liver cancer ( PLC) complicated by portal vein tumor thrombus ( PVTT) , and to provide a guidance for clinical treatment. Methods A total of 191 patients who were diagnosed with HBV-related PLC complicated by PVTT in Beijing Ditan Hospital, Capital Medical University, from January 2012 to December 2014 and met the inclusion criteria were enrolled. The patients were followed up to observe their survival time, and they were divided into survival group and death group. The demographic features and related clinical indices were collected. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. The Cox regression model was used for multivariate analysis. Results Of all patients, 80 achieved a 6-month survival time, among whom 52 ( 65%) underwent minimally invasive therapy, and 57 achieved a 1-year survival time, among whom 36 ( 63. 16%) underwent minimally invasive therapy. In patients with HBV-related PLC complicated by PVTT, minimally invasive therapy had a significant effect on the 6-month survival rate ( χ2= 5. 419, P = 0. 009) and had no significant effect on the 1-year survival rate ( χ2= 1. 881, P = 0.093) , with a significant effect on survival time ( P = 0. 001) . The Cox multivariate analysis showed that direct bilirubin and gamma-glutamyl transpeptidase were risk factors for 1-year survival in patients with HBV-related PLC complicated by PVTT, while minimally invasive therapy was a protective factor for 1-year survival ( RR = 0. 812, 1. 007, and 1. 002, P < 0. 001, P = 0. 002, and P = 0. 017) . Conclusion Radiofrequency ablation combined with transcatheter arterial chemoembolization should be performed as early as possible for patients with HBV-related PLC complicated by PVTT and can prolong survival time.