Surgical Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Shi, Jie; Lai, Eric C. H.; Li, Nan; Guo, Wei-Xing; Xue, Jie; Lau, Wan Yee; Wu, Mengchao; Cheng, Shuqun

doi:10.1245/s10434-010-0940-4

Cited by 255 publications

(242 citation statements)

References 19 publications

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“…HCC patients with various PVTT types had different prognoses. Patients with PVTT located in the segmental, sectoral, or right and or left portal veins (type I and II) showed significantly better survival rates than those with PVTT that extended to the main trunk of the portal vein or the superior mesenteric vein (type III and IV), which is in accordance with the literature (Shi et al, 2010). Therefore, we divided the 260 patients with different PVTT types in our study into two groups, using type II as a cutoff value.…”

Section: Discussionsupporting

confidence: 80%

“…The exclusion criteria included (a) extra hepatic spread and (b) prior anticancer treatments before liver resection. Curative resection of HCC was performed as described (Shi et al, 2010;Li et al, 2012). First, all detected lesions were resected, and intraoperative ultrasound examinations revealed no remnant tumor.…”

Section: Patients and Tissue Samplesmentioning

confidence: 99%

“…The classification of PVTT was as previously described (Shi et al, 2010). These patients underwent curative liver resections for primary tumors between January, 2000 and January, 2004 at the Eastern Hepatobiliary Surgery Hospital.…”

Section: Tmas and Immunohistochemistry Analysismentioning

confidence: 99%

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Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

Hu²,

Shi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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The prognostic value of the fibroblast growth factor-inducible 14 (Fn14) expression in hepatocellular carcinoma (HCC) is unknown. Real-time PCR (RT-PCR), western blot assays and immunohistochemistry analysis were here performed in order to compare Fn14 expressios in paired liver samples of HCC and normal liver tissue. Most of the tumor tissues expressed significantly higher levels of Fn14 compared to adjacent non-tumor tissues, with Fn14High accounting for 54.6% (142/260) of all patients. The Pearson χ 2 test indicated that Fn14 expression was closely associated with serum alpha fetal protein (AFP) (P=0.002) and tumor number (p=0.019). Univariate and multivariate analyses revealed that along with tumor diameter and portal vein tumor thrombosis (PVTT ) type, Fn14 was an independent prognostic factor for both overall survival (OS) (HR=1.398, p=0.008) and recurrence (HR=1.541, p=0.001) rates. Fn14 overexpression HCC correlated with poor surgical outcome, and this molecule may be a candidate biomarker for prognosis as well as a target for therapy.

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Section: Discussionsupporting

confidence: 80%

Section: Patients and Tissue Samplesmentioning

confidence: 99%

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Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

Hu²,

Shi³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…[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%

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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“…In theory, surgical resection is the only single method that can cure PVTT, but the requirements of surgical indications and the high rate of recurrence are important restricting factors. 5 This leaves TACE as the most common treatment strategy for PVTT, followed surgical resection. 6 Due to tumor thrombosis in the hepatic artery, TACE can cause not only lord tumor necrosis, but also tumor thrombosis necrosis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of therapy for hepatocellular carcinoma with portal vein tumor thrombus

et al. 2011

Cancer Biology & Therapy

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The purpose of this study is to analyze the safety and clinical efficacy of transcatheter arterial chemoembolization (TACE) combined with portal vein stent and 125 I implantation for the treatment of portal vein tumor thrombus (PVTT) in hepatocellular carcinoma. Fifty-six patients from our department diagnosed with advanced hepatocellular carcinoma with PVTT between January 2008 and December 30, 2010 were divided into two groups. Patients in Group A were treated with TACE and portal vein stent; patients in Group B were treated with TACE, portal vein stent and 125 I implantation. The success rate of TACE with portal vein stent and 125 I implantation was 100%, with no severe surgeryrelated complications. After an 8 mo follow-up, the total clinical benefit rates were 56.7 and 88.5% for Groups A and B, respectively (p , 0.05). The median survival times (mOS) for the two groups were 5.7 and 8.9 mo, respectively (p , 0.05). The median time of progression (mTTP) of the two groups were 5.3 and 7.9 mo, respectively (p , 0.05). The 2, 6, 8, 12 and 18 mo patency rates in Group A were 100, 93.3, 83.3, 53.3 and 36.6%. Those in Group B were 100, 100, 92.3, 84.6 and 80.7%. The 2, 6 and 8 mo patency rates showed no statistical differences (p . 0.05), but the 12 and 18 mo rates did (p , 0.05). Our results suggest that TACE combined with portal vein stent and 125 I implantation are both safe and effective, and 125

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Surgical Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Abstract: Liver resection is justified in selected patients with PVTT located in the segmental or sectoral branches of the portal vein. However, surgical resection for PVTT involving the portal bifurcation or the main trunk is still controversial.

Cited by 255 publications

References 19 publications

Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

Roles of Fibroblast Growth Factor-inducible 14 in Hepatocellular Carcinoma

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

Efficacy of therapy for hepatocellular carcinoma with portal vein tumor thrombus

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