ArticleEuropean radiology2022
TIPS plus sequential systemic therapy of advanced HCC patients with tumour thrombus-related symptomatic portal hypertension.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- Vanishing Act: Spontaneous Regression of Hepatocellular Carcinoma After Hepatitis C Virus Treatment and Emergent Transjugular Intrahepatic Portosystemic Shunt Placement.ACG case reports journal · 2026Article
- Combined TIPS and TACE for patients with hepatocellular carcinoma and variceal bleeding secondary to portal vein tumor thrombus.BMC gastroenterology · 2026Article
- Case Report: Percutaneous portal-central venous bypass: a novel salvage therapy for refractory variceal bleeding in TIPS-ineligible patients with portal vein tumor thrombus.Frontiers in medicine · 2026Article
- Pre-transplant downstaging strategies for hepatocellular carcinoma with portal vein tumor thrombus: Current therapies and future challenges.World journal of hepatology · 2025Review
- Targeting immune checkpoints in hepatocellular carcinoma therapy: toward combination strategies with curative potential.Experimental hematology & oncology · 2025Review
- Fully Covered Stent-TIPS for Advanced HCC Patients with Portal Vein Tumor Thrombus-Related Severe Symptomatic Portal Hypertension.Journal of hepatocellular carcinoma · 2025Article
- Emergent TIPS for acute gastroesophageal variceal bleeding in cirrhotic patients with hepatocellular carcinoma.Abdominal radiology (New York) · 2024Article
- Risks and benefits of TIPS in HCC and other liver malignancies: a literature review.BMC gastroenterology · 2023Review
- The Role of Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Treating Portal Hypertension in Patients with Hepatocellular Carcinoma.Medicina (Kaunas, Lithuania) · 2023Review
- TIPS for Portal Hypertension in HCC With Tumour Invasion of the Portal Vein Trunk: Anecdote or Promise?Journal of clinical and experimental hepatologyArticle
- Transjugular Intrahepatic Portosystemic Shunt for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombus-Related Symptomatic Portal Hypertension.Journal of clinical and experimental hepatologyArticle
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Authors and funding
12 authors at 3 institutions in 2 countries.
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Abstract
objectivesPortal vein tumour thrombus (PVTT)-related symptomatic portal hypertension (SPH) leads to a poor prognosis in hepatocellular carcinoma (HCC) patients. A transjugular intrahepatic portosystemic shunt (TIPS) can effectively relieve SPH but its effect remains unclear in PVTT-related SPH. This study aimed to evaluate the clinical value of the TIPS procedure combined with sequential systemic therapy in advanced HCC patients with PVTT-related SPH.
methodsAfter 1:1 propensity score matching (PSM), this retrospective study analysed 42 patients who underwent TIPS placement plus sequential systemic therapy (group A) and 42 patients who received only symptomatic and supportive treatment (group B). The evaluated outcomes were overall survival (OS) and SPH control rate. Cox proportional hazards regression analysis was used to compare OS in the two groups.
resultsIn group A, the technical success rate of the TIPS procedure was 95.2%, and no severe complications occurred. The rebleeding rates in group A and group B were 5.0% and 73.7%, respectively (p < 0.001), and the ascites control rates were 92.0% and 28.0%, respectively (p < 0.001). The median OS of group A was significantly better than that of group B (9.6 [95% CI: 7.1, 12.0] vs. 4.9 [95% CI: 3.9, 5.8], months, p < 0.001). Multivariable analysis showed that TIPS plus sequential systemic therapy (hazard ratio [HR] = 5.799; 95% CI: 3.177, 10.585; p < 0.001) was an independent prognostic factor related to OS. Additionally, PVTT degree (I+II) (p = 0.008), AFP ≤ 400 ng/ml (p = 0.003), and Child-Pugh class A (p = 0.046) were significant predictors of OS.
conclusionTIPS plus sequential systemic therapy is safe and feasible for treating advanced HCC with tumour thrombus-related SPH. KEY POINTS: • Portal vein tumour thrombus (PVTT) is common in advanced hepatocellular carcinoma (HCC) and transforms compensated portal hypertension into symptomatic portal hypertension (SPH). • HCC patients with PVTT-related SPH have a very poor prognosis, and there are no effective treatments recommended by the guidelines. • Therefore, a treatment strategy that utilises a transjugular intrahepatic portosystemic shunt (TIPS) to manage SPH combined with sequential systemic therapy in advanced HCC patients is explored in this study for its feasibility and clinical value. This research can fill the gap in current research data to provide clinically meaningful treatment options.
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