Resection of Hepatocellular Carcinoma with Tumor Thrombus in the Major Vasculature. A European Case-Control Series

Treut, Yves Patrice Le; Hardwigsen, Jean; Ananian, Priscilla; Saïsse, Jean; Grégoire, Émilie; Richa, Hubert; Campan, P.

doi:10.1016/j.gassur.2005.12.011

Cited by 111 publications

(89 citation statements)

References 27 publications

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“…A median survival ranging from 8.9 to 33 months was reported for HCC with PVTT with surgical treatment. [13][14][15][16][17][18][19] Although these results seems to be superior to TACE, patients who received HR were highly selected. We, therefore, conducted this casematch-control study comparing HR with TACE in the treatment of HCC with PVTT.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, after HR, there was one postoperative in-hospital death caused by postoperative liver failure (0.5%), and the major complication rate was 4.0% (8 of 201), our results were similar to the studies reported previously. [13][14][15][16][17][18][19][20][21][22] Therefore, HR is still a safe treatment for HCC with PVTT.…”

Section: Discussionmentioning

confidence: 99%

“…[9][10][11][12] To improve on the results of treatment of HCC with PVTT, attempts have been made to perform HR for these patients. [13][14][15][16][17][18][19][20][21][22] HCC with PVTT remains a contraindication to liver transplantation because of the high rate of tumor recurrence, and because of the severe shortage of donor organs. HR remains the only therapeutic option that may still offer a chance of cure.…”

Section: Introductionmentioning

confidence: 99%

“…More HCC with PVTT, which previously were considered as unresectable, have become resectable. [13][14][15][16][17][18][19][20][21][22] Recent studies have even shown favorable long-term survival outcomes of HR in well-selected cases of HCC with PVTT. 21,22 However, the survival outcomes of patients with HCC with PVTT treated with HR or with TACE have not been properly compared.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus

Peng

Guo

Zhang

et al. 2012

Cancer

144

163

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BACKGROUND:The long‐term survival outcomes of hepatic resection (HR) compared with transcatheter arterial chemoembolization (TACE) for resectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) are unclear.MATERIALS AND METHODS:Between December 2002 and December 2007, 201 consecutive patients diagnosed with resectable HCC with PVTT received HR as an initial treatment in our center. These patients were compared with 402 case‐matched controls selected from a pool of 1798 patients (with a 1:2 ratio) who received TACE as an initial treatment during the study period. PVTT was classified to 4 types: PVTT involving the segmental branches of the portal vein or above (type I), PVTT extending to involve the right/left portal vein (type II), the main portal vein (type III), or the superior mesenteric vein (type IV).RESULTS:The 1‐, 3‐, and 5‐year overall survivals for the HR and TACE groups were 42.0%, 14.1%, and 11.1% and 37.8%, 7.3%, and 0.5%, respectively (P < .001). On subgroup analyses, the overall survivals for the HR group were better than the TACE group for type I PVTT, type II PVTT, single tumor, and tumor size >5 cm (P < .001, P = .002, P < .001, P < .001, respectively), but not for type III PVTT, type IV PVTT, multiple tumors, and tumor size <5 cm (P = .541, P = .371, P = .264, P = .338, P = .125, respectively). Multivariate analysis showed the type of PVTT and initial treatment allocation were significant prognostic factors for overall survival.CONCLUSIONS:Compared with TACE, HR provided survival benefits for patients with resectable HCC with PVTT, especially for those with a type I PVTT or a type II PVTT. Cancer 2012. © 2012 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus

Peng

Guo

Zhang

et al. 2012

Cancer

144

163

View full text Add to dashboard Cite

show abstract

“…Although TACE appears to have potential for providing a survival benefit for HCC patients with PVTT, with a median PFS of 3.6-5.1 months (54,55), the deteriorating liver function caused by TACE limits its application (56,57). By contrast, hepatic resection may produce superior survival benefits for HCC patients with PVTT, with a 1-year overall survival rate of 34.4-42.0% (58)(59)(60)(61), and radiotherapy may have superior local effects in these patients (62,63). The prognosis of HCC patients with PVTT is dismal.…”

Section: Univariate Analysismentioning

confidence: 99%

Sorafenib therapy following resection prolongs disease-free survival in patients with advanced hepatocellular carcinoma at a high risk of recurrence

Liao

Zheng

et al. 2016

Oncology Letters

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Abstract. Sorafenib is the standard systemic treatment for patients with advanced hepatocellular carcinoma (HCC); however, its therapeutic value in patients with HCC following resection remains controversial. The current retrospective study was undertaken to assess the effects of sorafenib treatment following surgical resection in patients with advanced HCC disease who were at a high risk for recurrence. Between July 2010 and July 2013, a consecutive cohort of 42 patients with advanced HCC and at a high risk of recurrence (i.e., those with portal vein tumor thrombosis, adjacent organ involvement or tumor rupture) who underwent resection were analyzed. The patients were categorized into the sorafenib group (n=14) or the best supportive care (BSC) group (n=28). Although the histological grade, Barcelona Clinic Liver Cancer Stage, tumor size, nodule number and proportion of patients with high serum α-fetoprotein levels were comparable between the sorafenib and BSC groups, those receiving sorafenib following resection had significantly longer disease-free survival (DFS) of 5.2 months [95% confidence interval (CI), 1.2-9.2 months] compared with the BSC group [1.8 months (95% CI, 0.6-3.0 months)]. No differences in overall survival were noted between the groups. Furthermore, no drug-related adverse events resulted in discontinuation of sorafenib therapy. Univariate log-rank analysis revealed that sorafenib treatment (P=0.002) and treatment prior to resection (P=0.012) were significantly associated with longer DFS; however, sorafenib therapy (P= 0.027) and tumor size (P= 0.028) were associated with longer DFS by multivariate analysis. Furthermore, sorafenib was well-tolerated and improved DFS in patients with advanced HCC who underwent hepatic resection. Thus, tumor resection followed by sorafenib therapy may represent an effective therapeutic strategy for patients with advanced HCC. This possibility should be confirmed in larger, multicenter studies.

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Primary Malignant Neoplasms of the Liver

BCh

Frcp²

2011

Sherlock's Diseases of the Liver and Biliary System

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Resection of Hepatocellular Carcinoma with Tumor Thrombus in the Major Vasculature. A European Case-Control Series

Cited by 111 publications

References 27 publications

Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus

Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with portal vein tumor thrombus

Sorafenib therapy following resection prolongs disease-free survival in patients with advanced hepatocellular carcinoma at a high risk of recurrence

Primary Malignant Neoplasms of the Liver

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