Hepatic Resection for Hepatocellular Carcinoma with Tumor Thrombus in the Major Portal Vein

Digestive Surgery
Hidenobu KojimaShinji Uemoto

Abstract

The prognosis of hepatocellular carcinoma (HCC) with tumor thrombus in the major portal vein has been extremely poor. We investigated the outcome of hepatic resection in HCC with major portal vein tumor thrombus (PVTT). We retrospectively evaluated 52 consecutive patients who underwent hepatic resection for HCC with tumor thrombi in the first branch or trunk of the portal vein. Factors related to disease-free survival (DFS) and overall survival (OS) were analyzed. The median DFS and OS times were 8.9 and 27.6 months for the whole cohort, respectively. Multiple tumors (hazard ratio 2.12; 95% CI 1.11-4.33; p = 0.023), positive surgical margins (hazard ratio 2.45; 95% CI 1.19-4.81; p = 0.016), and non-adjuvant hepatic arterial infusion chemotherapy (HAIC; hazard ratio 2.07; 95% CI 1.11-3.90; p = 0.023) were independent risk factors for DFS. Non-adjuvant HAIC (hazard ratio 1.84; 95% CI 1.01-3.37; p = 0.047) was an independent risk factor for OS. Macroscopically curative resection seems to be of benefit to HCC patients with PVTT, even with tumor thrombi in the first branch or trunk of the portal vein. Adjuvant postoperative HAIC might improve DFS and OS in such patients.

Citations

Oct 19, 2016·Journal of Hepatology·Takashi KokudoUNKNOWN Liver Cancer Study Group of Japan
Jan 24, 2018·World Journal of Hepatology·Toshiya KamiyamaKenji Wakayama
Nov 6, 2018·World Journal of Gastroenterology : WJG·Shu-You PengBin Xu
May 7, 2019·Annals of Surgery·Tomoaki YohShinji Uemoto
Oct 31, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shohei KomatsuTakumi Fukumoto

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Carcinoma, Hepatocellular

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