title: Portal Vein Thrombosis in Unresectable Hcc Cases: a Single Center Study of Prognostic Factors and Management in 140 Patients
abstract: Objective: Hepatocellular carcinoma with portal vein thrombosis is considered a relative contraindication for
  transarterial chemoembolization (TACE). The aim of our study was to evaluate the prognostic factors and management
  in patients with hepatocellular carcinoma with portal vein thrombosis (PVT). Methods: Between February 2011 and
  February 2015, 140 patients presented to our specialized multidisciplinary HCC clinic. All were assessed by imaging at
  regular intervals for tumor response and the data compared with baseline laboratory and imaging characteristics obtained
  before treatment. Results: At the end of the follow up in February 2015, 78 (55.7%) of the 140 patients had died,
  33.1% in the 1st year and 20.7% in the 2nd year. The overall median survival was 10 months from the date of diagnosis.
  Clinical progression was noted in 45 (32.1%). Univariate analysis revealed that, the Child-Pugh score, the performance
  states (Eastern Cooperative Oncology Group “ECOG” 0-1) and the presence of ascites exerted non-significant affects
  on survival. Similarly, the serum albumen level and AFP >400 ng/ml were without influence. However, patients with
  =>2 tumors, abdominal lymphadenopathy and serum bilirubin >2mg/dl had a significantly worse prognosis. Specific
  treatment significantly increased survival compared to patients left untreated (P value = 0.027). Conclusion: Application
  of specific treatments (curative or palliative) significantly increased survival in HCC patients with PVT. TACE can be
  considered as a promising procedure for unresectable PVT-associated HCCs. The main predictors of survival in our
  study were the serum bilirubin level and specific treatment application.
authors.affiliation: Diagnostic and Interventional Radiology Department, Faculty of medicine, Cairo University, Egypt. Email: hendshousha@
  yahoo.com
authors.forename: Ahmed Hosni
authors.initials: AH
authors.lastname: Abdelmaksoud
authors.forename: Safaa
authors.initials: S
authors.lastname: Mandooh
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Nabeel
authors.forename: Tamer Mahmoud
authors.initials: TM
authors.lastname: Elbaz
authors.forename: Hend Ibrahim
authors.initials: HI
authors.lastname: Shousha
authors.forename: Ashraf
authors.initials: A
authors.lastname: Monier
authors.forename: Inas Anwar
authors.initials: IA
authors.lastname: Elattar
authors.forename: Ashraf Omar
authors.initials: AO
authors.lastname: Abdelaziz
keywords: Hepatocellular carcinoma; portal vein thrombosis; TACE; HCC prognosis