title: [Resection and postoperative multidisciplinary treatment for hepatocellular carcinoma with massive portal venous tumor thrombus-a single-center experience].
abstract: BACKGROUND
  Patients with advanced hepatocellular carcinoma( HCC) with massive portal venous tumor thrombus (PVTT) face a dismal prognosis as no standard therapy has been defined. A cancer board was established at our hospital 5 years ago.
  
  
  OBJECTIVE
  The aim of this retrospective study was to evaluate our surgical and multidisciplinary treatment for HCC with massive PVTT.
  
  
  METHODS
  From July 2007 to June 2012, 8 patients with HCC with PVTT extending into the main portal trunk were treated. Hemihepatectomy and PVTT removal were performed in 4 patients. Postoperative multidisciplinary treatment included transarterial chemoembolization, hepatic arterial infusion therapy, and administration of sorafenib. In 1 patient, intrahepatic recurrence and bilateral adrenal metastases were resected.
  
  
  RESULTS
  There was no in- hospital mortality. The median postoperative hospital stay was 30 days. The overall median survival for patients who underwent surgery and who did not undergo surgery was 344.5 days and 67 days, respectively.
  
  
  CONCLUSIONS
  Resection for HCC with PVTT extending into the main portal trunk is acceptable at medium-scale teaching hospitals in Japan. Surgery and postoperative multidisciplinary therapy may improve the outcome of patients with HCC with massive PVTT.
authors.affiliation: Dept. of Surgery, Hyogo Prefectural Nishinomiya Hospital.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kashiwazaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takiuchi
authors.forename: Kozo
authors.initials: K
authors.lastname: Noguchi
authors.forename: Tomoki
authors.initials: T
authors.lastname: Hata
authors.forename: Kei
authors.initials: K
authors.lastname: Asukai
authors.forename: Rie
authors.initials: R
authors.lastname: Hamano
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Miki
authors.forename: Masaki
authors.initials: M
authors.lastname: Tsujie
authors.forename: Koji
authors.initials: K
authors.lastname: Yano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy*