Korean J Hepatobiliary Pancreat Surg.  2011 Feb;15(1):19-27.

Hepatic Resection in Patients with Hepatocellular Carcinoma Accompanied by Portal Vein Thrombus

• Jung SM
• Ahn CS
• Lee SG
• Lee YJ
• Park KM
• Hwang S
• Kim KH
• Moon DB
• Ha TY

Abstract

PURPOSE
Although surgical resection is the most effective treatment for hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombus (PVTT), the recurrence rate is very high and prognosis is poor. This retrospective analysis aimed to establish a surgical strategy for patients with portal vein thrombus and to identify predictors of tumor thrombus in these patients.
METHODS
From 2006 to 2007, 63 hepatocellular carcinoma patients with portal vein thrombus detected by preoperative imaging underwent hepatic resection, and their clinical data were retrospectively analyzed. Possible prognostic factors for survival were analyzed with postoperative survival curves, and significant factors were determined by univariate and multivariate analysis.
RESULTS
31 patients (49.2%) with portal vein tumor thrombus were detected by pathologic reports in 63 HCC patients with portal vein thrombus. Significant prognostic factors included Serum Albumin < or =3.5 g/dl, Alkaline phosphatase (ALP)> or =100 IU/L, Tumor size> or =10 cm, non-expanding type, PVTT and Alpha-feto protein (AFP)> or =104 IU/L by univariate analysis. Independent prognostic factors included PVTT.
CONCLUSION
PVTT is not always detected in patients with HCC accompanied by portal vein thrombus. Although patients have a portal vein tumor thrombus, some patients have greater long-term survival. Hepatic resection should be considered for patients with portal vein thrombus.

Keyword

Hepatocellular carcinoma; Portal vein tumor thrombus; Hepatic resection

MeSH Terms

Alkaline Phosphatase
Carcinoma, Hepatocellular
Humans
Portal Vein
Prognosis
Recurrence
Retrospective Studies
Serum Albumin
Thrombosis
Alkaline Phosphatase
Serum Albumin