Curative Analysis Of Several Therapeutic Methods For Hepatocellular Carcinoma With Tumor Thombosis In Portal Vein (Following 85 Cases)

Objective : To evaluate the efficacy of several therapeutic methods for hepatocellular carcinoma with portal vein tumor thrombosis and to clarify the prognostic factors affecting the survival time after surgical therapy.Methods:85 cases of hepatocellular carcinoma with portal vein tumor thombosis admitted from December 2003 to April 2008 in our hospital were retrospectively revie- wed, which were divided into three groups according to the different treatment: chemo- therapy group (Group A, n = 22) , surgical resection group (Group C, n = 24) , and seq- uential comprehensive treatments group (Group D, n = 55).Results:1. We analyzed the clinical information(based on the number of tumor, the tumor size, the state of PVTT)of the three groups ,and data show that there was no significant differences(P>0.05)between the three groups.The median survival period was 4,11 and 16 months in group A , B and C , respectively. Their 0.5-,1-,2-and 3-year survival rates was 35.0%,15.2%,0 and 0 in group A;52.9%,35.3%,20.2% and 7.6% in group B;89.7%,57.4%,34.0% and 13.9% in group C , respectively. The survival rates differed significantly between the 3 groups ( P<0.05).2. In the univairate analysis,variables that showed significant difference in survival for patients who underwent su- rgical resection were tumor size(P=0.042) and whether received postoperative tran- shepatic arterial chemoembolization and/ or portal vein chemotherapy(P=0.039). Multivariate analysis revealed that they were independent survival predictors for patie- nts who underwent surgical resection.Conclusion:1. Sequential comprehensive treatments group can markedly elevate the survival rate of the patients than chemotherapy group and surgical resection group.2. The tumor size and the strategy of treatment were independent survival predictors for patients with hepatocellular carcinoma with tumor thombi in portal vein. 3.Surgical resection of hepatocellular carcinoma united portal vein tumor thrombus removed is the most effective therapeutic strategy for the patients with tumor thombi in portal vein. Surgical resection combined with postoperative chemotherapy or chemoembolization can enhance the efficacy of operation, and extende the survival.