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Journal of Gastrointestinal Surgery

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01-11-2009 | 2009 SSAT Poster Presentation

Efficacy of a Hepatectomy and a Tumor Thrombectomy for Hepatocellular Carcinoma with Tumor Thrombus Extending to the Main Portal Vein

Authors: Daisuke Ban, Kazuaki Shimada, Yusuke Yamamoto, Satoshi Nara, Minoru Esaki, Yoshihiro Sakamoto, Tomoo Kosuge

Published in: Journal of Gastrointestinal Surgery | Issue 11/2009

Abstract

Introduction

Hepatocellular carcinoma (HCC) with major portal tumor thrombus has been considered to be a fatal disease. A thrombectomy remains the only therapeutic option that offer a chance of complete tumor removal avoiding acute portal vein obstruction. However, the efficacy of tumor thrombectomy in addition to hepatectomy has not been well evaluated.

Methods

Of 979 patients who consecutively underwent initial HCC resection, 45 (4.6%) HCC patients with tumor invasion of the first branch of the portal vein (vp3) and tumor in the main portal trunk or the opposite-side portal branch (vp4) were retrospectively analyzed to evaluate the efficacy of hepatectomy and tumor thrombectomy.

Results

Alpha-fetoprotein, serosal invasion, and intrahepatic metastases were independently significant prognostic factors in all the 45 patients with vp3 or vp4 HCC. The 3- and 5-year survival rates in vp3 and vp4 group were 35.3% and 41.8%, and 21.2% and 20.9%, respectively. There were longer operative times and more intraoperative bleeding in patients with vp4, but no significant difference in mortality, morbidity, and survival between patients with vp3 and vp4.

Conclusion

Hepatectomy and thrombectomy for vp4 could not only avoid acute portal occlusion due to tumor thrombus but provide a comparable survival benefit with hepatectomy for vp3.

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Title: Efficacy of a Hepatectomy and a Tumor Thrombectomy for Hepatocellular Carcinoma with Tumor Thrombus Extending to the Main Portal Vein
Authors: Daisuke Ban
Kazuaki Shimada
Yusuke Yamamoto
Satoshi Nara
Minoru Esaki
Yoshihiro Sakamoto
Tomoo Kosuge
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-009-0998-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of a Hepatectomy and a Tumor Thrombectomy for Hepatocellular Carcinoma with Tumor Thrombus Extending to the Main Portal Vein

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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