title: Recurrence and survivals following hepatic resection for hepatocellular carcinoma with major portal/hepatic vein tumor thrombus.
abstract: OBJECTIVE
  To compare the recurrence and survivals between hepatocellular carcinoma (HCC) with major portal vein tumor thrombus (TT) and major hepatic vein TT after hepatic resection (HR).
  
  
  METHODS
  A retrospective study was carried out with the medical records of 272 patients who underwent hepatic resection and thrombectomy for HCC with major portal vein (group A) or hepatic vein (group B) TT. The clinicopathological parameters, recurrence, survivals and prognostic significance associated with major portal or hepatic vein TT were analyzed.
  
  
  RESULTS
  Patients in group A had a better median survival compared with their counterparts in group B (52 vs 38 weeks; P < 0.001). One-, 2- and 3-year survival rates were markedly greater in group A than in group B (50% vs 38.8%, 26% vs 15.9% and 11.4% vs 6.1%, respectively). There was no statistical difference in recurrence-free survival rate but extrahepatic recurrences were more often seen in group B. In multivariate analysis, TT location (hepatic veins vs portal veins), type of resection (anatomical vs non-anatomical) and liver cirrhosis (none/mild vs moderate/severe) were significant prognostic factors.
  
  
  CONCLUSIONS
  Patients with HCC and major hepatic vein TT had higher incidence of extrahepatic metastases and worse overall survival after hepatic resection compared with patients with major portal vein TT. With preserved liver function, patients can receive aggressive treatments and survivals could be prolonged.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Huang
authors.forename: Yan-Nan
authors.initials: YN
authors.lastname: Bai
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
keywords: hepatic resection; hepatocellular carcinoma; recurrence and survival; tumor thrombus