title: [Successful Surgical Treatment for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus after Favorable Response to Irradiation and Transcatheter Arterial Chemoembolization].
abstract: Here, we describe the surgical treatment of a patient with hepatocellular carcinoma(HCC)with portal vein tumor thrombus (PVTT) after irradiation and transcatheter arterial chemoembolization (TACE). A 51-year-old man was being followed-up for HBV-related liver cirrhosis and HCC that was previously treated by radio-frequency ablation (RFA) and TACE. A follow up CT study revealed recurrence of HCC in segment 6 of the liver with PVTT extending to the right branch. As early recurrence was likely after resection and due to insufficient hepatic functional reserve, primary radiotherapy for PVTT was performed followed by TACE. After non-surgical treatment, a favorable tumor response was observed with no evidence of intrahepatic disease within the left lobe of the liver, and the volume of the future liver remnant increased, allowing us to perform splenectomy and right hemihepatectomy combined with portal vein resection/reconstruction.
authors.affiliation: Dept. of Surgery, Matsudo City Hospital.
authors.forename: Yoji
authors.initials: Y
authors.lastname: Miyahara
authors.forename: Dan
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okabe
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kaneko
authors.forename: Seiki
authors.initials: S
authors.lastname: Miura
authors.forename: Junichiro
authors.initials: J
authors.lastname: Kamiya
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Ashizawa
authors.forename: Akira
authors.initials: A
authors.lastname: Ogata
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology*; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*