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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2006

01-07-2006

Effects of Location and Extension of Portal Vein Tumor Thrombus on Long-Term Outcomes of Surgical Treatment for Hepatocellular Carcinoma

Authors: Xiao-Ping Chen, MD, PhD, FACS, Fa-Zu Qiu, MD, PhD, Zai-De Wu, MD, PhD, Zhi-Wei Zhang, MD, PhD, Zhi-Yong Huang, MD, PhD, Yi-Fa Chen, MD, PhD, Bi-Xiang Zhang, MD, PhD, Song-Qing He, MD, PhD, Wan-Guang Zhang, MD, PhD

Published in: Annals of Surgical Oncology | Issue 7/2006

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Abstract

Background

The role of surgical resection and thrombectomy for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) is controversial. This study aimed to evaluate the effects of the location and extent of PVTT on the long-term outcomes of surgical treatment for HCC.

Methods

A total of 438 patients with HCC and PVTT underwent liver resection with or without thrombectomy. These 438 patients were divided into 2 groups: in group A, PVTT was located in the hepatic resection area or protruded into the first branch of the main portal vein beyond the resection line for <1 cm (286 patients), and in group B, PVTT extended into the main portal vein (152 patients). Concomitant thrombectomy was performed in 147 patients (51.4%) of group A and in all patients of group B.

Results

PVTT recurrence within 6 months after surgery in group B was significantly higher than that in group A: 76.9% vs. 11.3%. Remnant liver recurrence within 1 year after surgery was 45.0% in group A and 78.8% in group B. The cumulative 1-, 2-, 3-, and 5-year overall survival rates were 58.7%, 39.9%, 22.7%, and 18.1% for group A and 39.5%, 20.4%, 5.7%, and 0% for group B, respectively. The overall survivals were significantly better in group A than group B (P < .02).

Conclusions

Liver resection with thrombectomy yielded better outcomes in the HCC patients with PVTT confined to the first or second branch of the main portal vein compared with PVTT extending into the main portal vein.
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Metadata
Title
Effects of Location and Extension of Portal Vein Tumor Thrombus on Long-Term Outcomes of Surgical Treatment for Hepatocellular Carcinoma
Authors
Xiao-Ping Chen, MD, PhD, FACS
Fa-Zu Qiu, MD, PhD
Zai-De Wu, MD, PhD
Zhi-Wei Zhang, MD, PhD
Zhi-Yong Huang, MD, PhD
Yi-Fa Chen, MD, PhD
Bi-Xiang Zhang, MD, PhD
Song-Qing He, MD, PhD
Wan-Guang Zhang, MD, PhD
Publication date
01-07-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.08.007

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