Comparison Of Surgical Resection Versus Transarterial Chemoembolization In Hepatocellular Carcinoma Patients With Portal Vein Tumor Thrombosis

Objective The objective of this study was to determine whether surgicalresection and TACE confers a survival benefit to patients with hepatocellularcarcinoma and portal vein tumor thrombosis, and to uncover prognostic factors.Methods Review the medical record of102hepatocellular carcinomapatients associated with portal vein tumor thrombosis retrospectively.Patientswere divide into3group，A,transcatheter arterial chemoembolization therapygroup(n=43);B,surgical resection group(n=29);C, surgical resection withtranscatheter arterial chemoembolization therapy group(n=30).Results1.the median survival of the3groups were10,20and25months in groupA，B，C,respectively.The1-,2-,3-year cumulative survival rates of group C were56.7%,36.7%,20.0%, in group B；37.9%，20.7%，10.3%. in group A；20.1%，0.0%，0.0%.group C were significantly higher than group A and B (p＜0.05).group B were significantly higher than group A (p＜0.05).2.Univariate analysis:age,liver function,tumor size,tumor thrombus site, theconcentration of serum ALT, portal vein diameter, different treatmentmethods such as the survival time of patients with hepatocellular carcinoma withportal vein tumor thrombus influential (P <0.05). AFP concentration andhepatitis B surface antigen carrier status of hepatocellular carcinoma with portalvein tumor thrombus in patients with survival time were no significantdifferences (P>0.05). Multivariate analysis: treatment (surgical resection) istheindependent prognostic factors of the impact of hepatocellular carcinomawithportal vein tumor thrombus in patients with survival time.Conclusion(1) hepatocellular carcinoma with portal vein tumor thrombus in patientswith hepatocellular carcinoma doors vein tumor thrombus surgical resection ofliver function in decompensated+TACE were significantly better than surgeryalone. Treated with surgery alone was superior to TACE alone treatment. Portalvein tumor thrombus in the best patient outcomes. II, patients with type IIIportal vein tumor thrombus should also take an active treatment, postoperativeadjuvant TACE and other treatment can enhance the efficacy.(2) Liver function grade, tumor size, tumor thrombus site, serum ALT levels,and portal vein diameter and survival time were negatively correlated riskfactors. Age <40years of age and risk factors affect the survival time of patientswith hepatocellular carcinoma with portal vein tumor thrombus. AFPconcentration and whether the hepatitis B surface antigen-positive does notaffect the prognosis of hepatocellular carcinoma with portal vein tumor thrombus.(3) Type of portal vein tumor thrombus on clinical outcome, guiding role inthe formulation of treatment options for hepatocellular carcinoma with portalvein tumor thrombus.