Therapeutic Research Of Sixty-three Cases Of Hepatocellular Carcinoma With Portal Vein Tumor Thrombus

Background Hepatocellular carcinoma(HCC) is one of the most common malignant tumor worldwide, especially in Asia. China is developing one of the highest incidence of hepatocellular carcinoma (HCC). In China, about110,000people died of HCC every year,which composed about45%of death cases worldwide. The prognosis for patients with HCC is very poor, especially for those with portal vein tumor thrombus(PVTT). HCC has malignant biological characteristics, and easily invades the vascular system of the liver, especially the portal venous system, leading to the formation of portal vein tumor thrombus.Without medical treatment, the Median Survival Time of HCC patients with PVTT is only2.4to2.7months.PVTT was considered as the contraindication of surgical resection of HCC before. The prognosis of conservative treatment was extremely poor.Nowadays, increasing therapies are applied to treating HCC with PVTT.Objective To evaluate the efficacy of different treatment strategies for primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) through sixty-three cases of HCC with PVTT.Methods Sixty-three HCC patients with PVTT in the first branch and/or main trunk of the portal vein were enrolled in this study. Sixty-three patients were divided into four groups and underwent four different treatment. Group A, conservative treatment group,(n=7).Group B,TACE treatment group (n=19);Group C, surgical resection group,(n=12);Group D, surgical resection and TACE group(n=25). Results The Median Survival Time and the survival rates at0.5-,1-,2-, and3-year of Group A were2months、14%、0、0、0;The Median Survival Time and the survival rates at0.5-,1-,2-, and3-year of Group B were6months-、56%、12%、0、0; The Median Survival Time and the survival rates at0.5-,1-，2-, and3-year of Group C were10months、74%、37%、9%、0; The Median Survival Time and the survival rates at0.5-,1-,2-, and3-year of Group D were16months、80%、52%、20、12%.Conclusion Resection of HCC and removal of PVTT may prolong the survival period of patients with HCC and PVTT. Treatment of postoperative TACE may improve their survival.