Liver resection with thrombectomy as a treatment of hepatocellular carcinoma with major vascular invasion: results from a retrospective multicentric study

Pesi, Benedetta; Ferrero, Alessandro; Grazi, Gian Luca; Cescon, Matteo; Russolillo, Nadia; Leo, Francesca De; Boni, Luca; Pinna, Antonio; Capussotti, Lorenzo; Batignani, Giacomo

doi:10.1016/j.amjsurg.2014.09.041

Cited by 42 publications

(29 citation statements)

References 74 publications

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“…To date, the clinical benefit of anatomical resection even for early HCC remains controversial. For HCC patients with PVTT, anatomical resection showed no advantage compared with non-anatomical resection regarding postoperative outcomes in our study, consistent with previous studies [31, 32]. The resection margin has also been evaluated as a prognostic factor for long-term outcomes after HCC resection; however, the significance of this variable also remains controversial [19, 32, 33].…”

Section: Discussionsupporting

confidence: 88%

Optimal surgical strategy for hepatocellular carcinoma with portal vein tumor thrombus: A propensity score analysis

Zhang

Wei

et al. 2016

Oncotarget

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ObjectivesThe optimal surgical resection method for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) that maximizes both safety and long-term outcome has not yet been determined. The aim of this study was to compare the clinical outcomes following peeling off versus en bloc resection for PVTT.MethodsFrom 2005 to 2012, 252 patients with HCC and type I/II PVTT who underwent hepatic resection were divided into two groups according to whether they received en bloc resection (n = 113) or peeling off resection (n = 139). The clinical outcomes were compared before and after propensity score matching.ResultsThe propensity model matched 113 patients with en bloc resection for further analyses. After matching, overall survival (OS) and disease-free survival (DFS) rates were significantly increased in the en bloc group compared with the peeling off group (p = 0.011 and p = 0.015). A multivariate analysis indicated that en bloc resection independently improved both OS and DFS (HR = 1.471, 95% CI: 1.071-2.018, p = 0.017 and HR = 1.415, 95% CI: 1.068-1.874, P=0.016). The adverse events were not significantly different between the two groups. However, the peeling off group showed a significantly increased recurrence rate of vascular invasion compared with the en bloc group (23.9% vs. 9.7%, p = 0.005). Similar results were also demonstrated prior to the matched analysis.ConclusionsAn en bloc resection is safe and confers a survival advantage compared with a peeling off resection in HCC patients with PVTT; thus, en bloc resection should be recommended as a standard treatment for these patients when possible.

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Section: Discussionsupporting

confidence: 88%

Optimal surgical strategy for hepatocellular carcinoma with portal vein tumor thrombus: A propensity score analysis

Zhang

Wei

et al. 2016

Oncotarget

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“…Because of its rarity, compared with PVTT, little is known about HVTT. As a result of recent advances in surgical techniques and perioperative management, aggressive surgical resection for HCC with HVTT has been proposed by several tertiary centers . Recently, a member of our group reported the largest single‐center case series of patients with HVTT who had undergone LR, resulting in an MST of longer than 4 years .…”

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confidence: 99%

Liver resection for hepatocellular carcinoma associated with hepatic vein invasion: A Japanese nationwide survey

et al. 2017

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“…Thus, there is no consensus for the role of surgical intervention. Studies of hepatectomy and portal vein thrombectomy, without mention of cardiac involvement, suggest survival benefit and improved quality of life compared to chemotherapy [9]. With regard to right atrial involvement, case reports on resection validate surgical feasibility, but the survival benefit is less clear.…”

Section: Discussionmentioning

confidence: 99%

A Case of Right Atrial Obliteration Caused by Intracardiac Extension of Hepatocellular Carcinoma

et al. 2017

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As the fifth most common malignancy worldwide, hepatocellular carcinoma (HCC) is a frequently encountered clinical entity. Symptomatology associated with the diagnosis includes hepatic dysfunction and pain from capsular spread. Additionally, due to its propensity for vascular spread, extrahepatic intravascular involvement can also be seen. We present a unique case of intracardiac involvement of HCC. Originally diagnosed as acute on chronic heart failure, echocardiography revealed the symptom source – tumor obliteration of the right atrium. Clinical case presentation and management, along with radiographic images are presented. A review of the current literature highlights this uncommon presentation and the need for clinical suspicion of cardiac involvement in patients with a history of HCC presenting with heart failure.

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Liver resection with thrombectomy as a treatment of hepatocellular carcinoma with major vascular invasion: results from a retrospective multicentric study

Cited by 42 publications

References 74 publications

Optimal surgical strategy for hepatocellular carcinoma with portal vein tumor thrombus: A propensity score analysis

Optimal surgical strategy for hepatocellular carcinoma with portal vein tumor thrombus: A propensity score analysis

Liver resection for hepatocellular carcinoma associated with hepatic vein invasion: A Japanese nationwide survey

A Case of Right Atrial Obliteration Caused by Intracardiac Extension of Hepatocellular Carcinoma

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