[Comparison of the results and therapies for hepatocellular carcinoma with tumor thrombosis in portal vein].
OBJECTIVE
To compare the clinical effects of different therapies on hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT), and to study the factors that affected the prognosis.


METHODS
One hundred and thirty eight HCC with PVTT patients, whose liver function was compensatory and both tumor and PVTT could probably be resected together as evaluated by preoperative examinations, were divided into four groups: 1. conservative treatment group (n = 14); 2. chemotherapy group (n = 41); 3. surgical resection group (n = 19); 4. surgical resection with postoperative chemotherapy group (n = 64).


RESULTS
The median survival periods in four groups were 3.5, 7.1, 10.1 and 13.4 months, respectively. The half a year-, 1-, 2-, 3-year survival rates in the surgical resection with postoperative chemotherapy group were 53.7%, 37.6%, 30.7% and 14.0%, respectively, which were significantly higher than those of the other three groups (P < 0.05). Univariate and multivariate analysis both revealed that the number of chemotherapy courses affected the effect of surgical resection.


CONCLUSIONS
1. If patients' liver function is compensatory and tumors with PVTT can be removed together, exploration should be done. Surgical resection followed by postoperative chemotherapy would produce the best clinical result. 2. If patients' liver function is permissible, multiple chemotherapeutic courses should be given after resection of HCC with PVTT.
Fan
Jia
J
Institute of Liver Cancer, Zhongshan Hospital of Fudan University, Shanghai 200032, China.
Wu
Zhi-quan
ZQ
Zhou
Jian
J
Qiu
Shuang-jian
SJ
Chen
Rong-xin
RX
Shi
Ying-hong
YH
Tang
Zhao-you
ZY
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011169:Portal Vein