title: Treatment outcomes of surgical resection for hepatocellular carcinoma with inferior vena cava invasion and/or thrombosis.
abstract: OBJECTIVE
  Advanced hepatocellular carcinoma with either an invasion of the inferior vena cava or thrombosis is rare, and its prognosis is extremely poor. There is no established treatment. The purpose of this study was to evaluate the efficacy of surgical resection and its prognosis in 5 recent cases.
  
  
  METHODS
  From January 2005 to December 2008, 5 patients diagnosed with advanced hepatocellular carcinoma with inferior vena cava invasion and/or thrombosis underwent surgical resection. These patients were retrospectively reviewed.
  
  
  RESULTS
  The mean age at diagnosis was 54 years. There were 4 men and 1 woman. According to the Child-Pugh classification, all patients were class A. One case had 2 hepatic masses, and the others had a solitary hepatic mass. The mean tumor size was 5.53cm. All 5 patients underwent partial hepatectomy and inferior vena cava resection or thrombosis removal. Among these, 4 cases needed a cardiopulmonary bypass. Four patients survived and 1 patient expired at the point of analyzing. Four cases experienced recurrences. The mean disease-free survival time was 19.6 months. One patient has been followed-up for 43 months without any recurrences up to now.
  
  
  CONCLUSIONS
  Concurrent en-bloc resection of the liver and inferior vena cava for progressive HCC accompanying IVC invasion or thrombosis can be considered as a curative treatment.
authors.affiliation: Department of Surgery, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyemin
authors.initials: H
authors.lastname: Jung
authors.forename: Kuhn Uk
authors.initials: KU
authors.lastname: Lee
authors.forename: Woo Young
authors.initials: WY
authors.lastname: Shin
authors.forename: Hyuk
authors.initials: H
authors.lastname: Ahn
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000821:virology; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000473:pathology / Q000601:surgery*; D020246:Venous Thrombosis / Q000473:pathology / Q000601:surgery*