Abstract No. 476 Clinical significance of liver vein infiltration in patients with hepatocellular carcinoma

Abstract

Portal vein tumor thrombosis (PVTT) significantly impairs the prognosis of patients with hepatocellular carcinoma (HCC) and classifies them as advanced stage (BCLC-C). However, the relevance of liver vein infiltration (LVI) remains unclear. Aim of this study is to compare the prognosis of patients with different forms of macrovascular infiltration as this might influence the choice of treatment. 1378 HCC-patients were extracted from the clinical registry of our tertiary referral center treated between 01/2005-01/2017. Macrovascular infiltration was diagnosed by re-evaluation of all available CT- or MRI-studies by two experienced radiologists in consensus reading. Overall survival (OS) was calculated from the date of initial diagnosis for all subgroups (no infiltration, PVTT, and LVI). In case of macrovascular infiltration, OS was additionally calculated from the date of its first appearance. 1341 patients could finally be included. 807 patients had no infiltration, 491 showed PVTT, and 43 an isolated LVI. OS from initial diagnosis was: 37.29, 6.53, and 16.03 months, respectively (p<0.001). The OS calculated from the first appearance of macrovascular invasion was 4.90 months for PVTT, and 7.33 months for isolated LVI. The difference in OS was significantly different between these subgroups (p = 0.018). Isolated LVI showed significantly better survival compared to patients with PVTT. This renders the question if patients with isolated LVI should be treated by means of systemic therapy, like BCLC-C patients, or if a local approach might also be justified.Tabled 1No InfiltrationLV InfiltrationPVTTpn80743491Survival from initial diagnosis (months)37.2916.046.53<0.001Survival from first appearance of vascular invasion (months)n.a.7.334.900.018 Open table in a new tab