title: Clinicopathologic characteristics and surgical outcomes of hepatocellular carcinoma with portal vein tumor thrombosis.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) has a high predilection for portal vein invasion. Furthermore, the treatment of HCC with portal vein tumor thrombosis (PVTT) is controversial. The objective of this study was to investigate clinicopathologic characteristics and surgical outcomes of HCC patients with PVTT.
  
  
  METHODS
  The clinicopathologic data and surgical outcomes of 88 patients HCC with PVTT and 211 patients without PVTT who underwent surgery were retrospectively reviewed. The risk factors and the prognosis of HCC patients with PVTT were determined.
  
  
  RESULTS
  Cirrhosis, serum alkaline phosphatase (ALP) > 100 IU/L, tumor size > 8 cm, incomplete tumor capsule, and adjacent organ invasion were risk factors for PVTT in HCC on multivariate analysis. Furthermore, HCC patients with PVTT received more major hepatectomies, had more intraoperative blood loss and greater blood transfusion requirements, and higher incidence of postoperative mortality compared with HCC patients without PVTT. The median overall survival of HCC patients with PVTT after surgery was 9 mo, with the 1-, 2-, and 3-y overall survival rates of 31.1%, 18.3%, and 15.2 %, respectively. AFP level, adjacent organ invasion, and PVTT location predicted overall survival of HCC patients with PVTT.
  
  
  CONCLUSIONS
  High serum ALP level, cirrhosis, large tumor, incomplete tumor capsule and adjacent organ invasion are predictors of PVTT in HCC. Surgery is a valid therapy for selected HCC patients with PVTT.
authors: Department of General Surgery, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China.
authors: Jing-Song
authors: JS
authors: Chen
authors: Qian
authors: Q
authors: Wang
authors: Xi-Lin
authors: XL
authors: Chen
authors: Xiao-Hui
authors: XH
authors: Huang
authors: Li-Jian
authors: LJ
authors: Liang
authors: Jian
authors: J
authors: Lei
authors: Jiong-Qiang
authors: JQ
authors: Huang
authors: Dong-Ming
authors: DM
authors: Li
authors: Zhi-Xiang
authors: ZX
authors: Cheng