Effects of location and extension of portal vein tumor thrombus on long-term outcomes of surgical treatment for hepatocellular carcinoma

被引:188
作者
Chen, XP [1 ]
Qiu, FZ [1 ]
Wu, ZD [1 ]
Zhang, ZW [1 ]
Huang, ZY [1 ]
Chen, YF [1 ]
Zhang, BX [1 ]
He, SQ [1 ]
Zhang, WG [1 ]
机构
[1] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Hepat Surg Ctr, Wuhan 430030, Peoples R China
关键词
hepatocellular carcinoma; portal vein tumor thrombus; liver resection; survival; thrombectomy;
D O I
10.1245/ASO.2006.08.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 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.
引用
收藏
页码:940 / 946
页数:7
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