Analysis Of Curative Effects Of The Treatment Of Hepatocellular Carcinoma With Portal Vein Tumor Thrombus

Objective Study of primary hepatocellular carcinoma(HCC) patients with portal vein tumor thrombus(PVTT) surgical resection alone and after surgical treatment combined with transcatheter arterial chemoembolization(TACE), analysis of curative effect of two kinds of treatment after operation.Methods Retrospective analysis of 37 cases surigical treatment of patients hepatocellular carcinoma(HCC) with portal vein tumor thrombus(PVTT) in Zhangzhou hospital of Fujian Medical University cluring January 2010 to December 2014.those cases of patients all underwent complete resection of tumor(Surgical resection margin pathological negative) and portal vein tumor thrombus.Those modes of operations are right liver half resection in 9 cases, the left half liver resection in 7 cases, middle region liver resection in 2 cases, partial liver resection in 19 cases, all patients were under the exaumination of preoperative color Doppler ultrasound, upper abdominal enhanced CT and MRI and postoperative pathological diagnosis. 37 patients were divided into the control group, only 21 cases were treated with simple operation, and the remaining 16 cases were treated with transcatheter arterial chemoembolization(TACE) three times after the surgical therapy. Followed up by out-patient clinic and telephone. Analy and compare the survival time and draw the survival function of the two groups by SPSS 22 statistical software to analyze and compare the survival time of different types of portal vein tumor thrombus.Results 37 selected cases, by the end of follow-up, with no lost cases, four patients were still alive. The median survival time of 37 cases of hepatocellular carcinoma(HCC) with portal vein(PVTT) patients and 1-year, 2-year, 3-year survival rates were: 21.0 months and 62.1%(23/37), 37.8%(14/37), 8.1%(3/37); surgery after giving hepatic arterial chemoembolization median survival(TACE) patients and 1 year, 2 years, 3-year survival rates were: 29 months and 75.0 %(12/16), 50.0%(8/16), 18.8%(3/16) was significantly higher than the median survival time of surgery alone group and 1-year, 2-year, 3-year survival: 13 months and 52.0%(11/21), 28.6%(6/21), 4.8%(1/21), The difference was statistically significant(P<0.05). The average survival time poot-surgicalof portal vein thrombosis after different type and 1-year, 2-year, 3-year survival rates were Type I portal vein thrombosis: 26.1 months and 86.0%(13/15), 40.0%(6/15)., 20.0%(3/15); type II portal vein thrombosis: 17.3 months and 50.0%(8/16), 31.3%(5/16), 6.3%(1/16); III type of portal vein thrombosis: 11.0 months and 33.3%(2/6) 0%(0/6) 0%(0/6).Conclusion As for those patients whose liver fuction were better the acceptable range without obvious cardiorespiratory dysfunction and regional lymph node metastasis and distant metastasis. hepatocellular carcinoma without tumor thrombi in the bile duct and hepatic vein but with Portal Vein Tumor Thrombus(PVTT).These kinds of patients surviual time could be significantly prolonged by the post-surgical transcatheter arterial chemoembolization(TACE).Furthermore,the smaller branches of the portal vein tumor thrombus invasion would get the longer survival time.