title: Hepatic resection versus transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma with hepatic vein tumor thrombus.
abstract: OBJECTIVE
  To compare the outcomes of hepatic resection and transcatheter arterial chemoembolization for resectable hepatocellular carcinoma with hepatic vein tumor thrombus.
  
  
  METHODS
  From January 2006 to November 2013, 28 patients initially diagnosed with resectable hepatocellular carcinoma combined with hepatic vein tumor thrombus received hepatic resection. These patients were compared with 56 case-matched controls (1:2 ratio) selected from a pool of 91 patients who received transcatheter arterial chemoembolization as an initial treatment during the same period. Clinical characteristics, adverse events, overall survival and survival-related factors were analyzed.
  
  
  RESULTS
  The 1-, 2- and 3-year overall survival rates were 66.5, 37.4 and 28.5% for the hepatic resection group and 32.3, 18.7 and 15.6% for the transcatheter arterial chemoembolization group (P = 0.015), respectively. No significant difference was found between the two groups in terms of complications and mortality. Multivariate analyses revealed combined portal vein tumor thrombosis (HR = 2.116; 95% CI: 1.26-3.57; P = 0.005) and treatment allocation (hepatic resection = 2.289; 95% CI, 1.30-4.02; P = 0.004) as risk factors for overall survival.
  
  
  CONCLUSIONS
  Hepatic resection provides a good prognosis for hepatocellular carcinoma patients with hepatic vein tumor thrombus compared with patients undergoing transcatheter arterial chemoembolization, and the most important factor related to survival was co-existence with portal vein invasion.
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060.
authors.forename: Yong-Fa
authors.initials: YF
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060 Department of Ultrasonography, Sun Yat-sen University Cancer Center, Guangzhou, P.R. China.
authors.forename: Zhi-Xing
authors.initials: ZX
authors.lastname: Guo
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060.
authors.forename: Ming
authors.initials: M
authors.lastname: Shi
authors.affiliation: Department of Hepatobiliary Oncology, Sun Yat-sen University Cancer Center, Guangzhou State Key Laboratory of Oncology in South China, Guangzhou Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060 guorongp@mail.sysu.edu.cn.
authors.forename: Rong-Ping
authors.initials: RP
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016022:Case-Control Studies; D016461:Chemoembolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006503:Hepatic Veins; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011169:Portal Vein; D012307:Risk Factors; D015996:Survival Rate; D020246:Venous Thrombosis / Q000150:complications*
keywords: hepatic resection; hepatic vein tumor thrombus; hepatocellular carcinoma; overall survival; transcatheter arterial chemoembolization