title: Hepatic Resection for Hepatocellular Carcinoma with Tumor Thrombus in the Major Portal Vein.
abstract: BACKGROUND
  The prognosis of hepatocellular carcinoma (HCC) with tumor thrombus in the major portal vein has been extremely poor. We investigated the outcome of hepatic resection in HCC with major portal vein tumor thrombus (PVTT).
  
  
  METHODS
  We retrospectively evaluated 52 consecutive patients who underwent hepatic resection for HCC with tumor thrombi in the first branch or trunk of the portal vein. Factors related to disease-free survival (DFS) and overall survival (OS) were analyzed.
  
  
  RESULTS
  The median DFS and OS times were 8.9 and 27.6 months for the whole cohort, respectively. Multiple tumors (hazard ratio 2.12; 95% CI 1.11-4.33; p = 0.023), positive surgical margins (hazard ratio 2.45; 95% CI 1.19-4.81; p = 0.016), and non-adjuvant hepatic arterial infusion chemotherapy (HAIC; hazard ratio 2.07; 95% CI 1.11-3.90; p = 0.023) were independent risk factors for DFS. Non-adjuvant HAIC (hazard ratio 1.84; 95% CI 1.01-3.37; p = 0.047) was an independent risk factor for OS.
  
  
  CONCLUSIONS
  Macroscopically curative resection seems to be of benefit to HCC patients with PVTT, even with tumor thrombi in the first branch or trunk of the portal vein. Adjuvant postoperative HAIC might improve DFS and OS in such patients.
authors: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors: Hidenobu
authors: H
authors: Kojima
authors: Etsuro
authors: E
authors: Hatano
authors: Kojiro
authors: K
authors: Taura
authors: Satoru
authors: S
authors: Seo
authors: Kentaro
authors: K
authors: Yasuchika
authors: Shinji
authors: S
authors: Uemoto
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D009378:Neoplasms, Multiple Primary / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011169:Portal Vein; D012189:Retrospective Studies; D015996:Survival Rate; D017131:Thrombectomy; D013927:Thrombosis / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*
chemical_list: D000970:Antineoplastic Agents