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[Members Only] J.Jpn. Surg. Soc.. 120(2): 172-176, 2019
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TREATMENT STRATEGY FOR HEPATOCELLULAR CARCINOMA WITH PORTAL VEIN TUMOR THROMBUS IN THE FIRST BRANCH OF THE PORTAL VEIN AND THE MAIN PORTAL TRUNK
The prognosis of patients with hepatocellular carcinoma (HCC) with tumor thrombus in the major portal vein (PVTT) is extremely poor. International guidelines according to the BCLC staging system recommend systemic chemotherapy for advanced HCC with vascular invasion. On the other hand, hepatic resection could be curative even for advanced HCC with PVTT. We conducted a retrospective multiple-institution study on the outcome of hepatic resection in patients with HCC with PVTT in the first branch or main portal trunk at 22 institutions. The median survival time (MST) was 21.5 months. The MST of the group who underwent surgery plus adjuvant hepatic arterial infusion chemotherapy (HAIC) was longer than that of the non-HAIC group (28.1 months vs. 18.7 months, p=0.0024). Macroscopically curative resection was of benefit to HCC patients with PVTT. Adjuvant postoperative HAIC may prolong survival time. Furthermore, a multidisciplinary approach with surgery plus new drugs could be expected to result in the cure of HCC with PVTT.
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