title: The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus.
abstract: OBJECTIVE
  To further improve the effectiveness and prognosis of primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), the current status of treatment for HCC with PVTT was reviewed.
  
  
  METHODS
  A Medline search was undertaken to identify articles using the keywords "HCC", "PVTT" and "therapy". Additional papers were identified by a manual search of the references from the key articles.
  
  
  RESULTS
  PVTT, as a common complication of HCC, was divided into type I ∼ IV. The therapeutic approach is mainly composed of five types: surgical resection, regional interventional therapy, radiotherapy, combination therapy, targeted therapy. All of these therapeutic approaches were separately evaluated in detail.
  
  
  CONCLUSIONS
  For those resectable tumors, the better choice for treatment of HCC with PVTT should be hepatectomy and removal of PVTT. For those unresectable tumors, TACE (especially the super-selective TACE) has been the preferred palliative treatment, the other regional interventional therapy and/or radiotherapy could improve the therapeutic effects. The multidisciplinary treatments may further improve the quality of life and prolong the survival period for the HCC patients associated with PVTT.
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Zong-ming
authors.initials: ZM
authors.lastname: Zhang
authors.affiliation: Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chaiwan, Hong Kong, China.
authors.forename: Eric C H
authors.initials: EC
authors.lastname: Lai
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Bo-jiang
authors.initials: BJ
authors.lastname: Wan
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Li-min
authors.initials: LM
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Zu-hao
authors.initials: ZH
authors.lastname: Tian
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Deng
authors.affiliation: Department of General Surgery, Beijing Electric Power Hospital, Capital Medical University, Beijing, China.
authors.forename: Qiu-hong
authors.initials: QH
authors.lastname: Sun
authors.affiliation: Department of General Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China. Electronic address: chenxpchenxp@163.com.
authors.forename: Xiao-ping
authors.initials: XP
authors.lastname: Chen
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006498:Hepatectomy / Q000379:methods; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D011169:Portal Vein / Q000473:pathology; D011379:Prognosis; D011788:Quality of Life; D020266:Radiotherapy, Conformal; D013927:Thrombosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hepatocellular carcinoma (HCC); Portal vein tumor thrombus (PVTT); Therapeutic strategy