Abstract
BackgroundThe outcomes and management of hepatocellular carcinoma (HCC) have undergone several evolutionary changes. This study aimed to analyze the outcomes of patients who had undergone liver resection for HCC with portal vein tumor thrombosis (PVTT) in terms of the evolving era of treatment.Materials and methodsA retrospective analysis of 157 patients who had undergone liver resection for HCC associated with PVTT was performed. The outcomes and prognostic factors related to different eras were further examined.ResultsOverall, 129 (82.1%) patients encountered HCC recurrence after liver resection, and the median time of recurrence was 4.1 months. Maximum tumor size ≥ 5 cm and PVTT in the main portal trunk were identified as the major prognostic factors influencing HCC recurrence after liver resection. Although the recurrence-free survival had no statistical difference between the two eras, the overall survival of patients in the second era was significantly better than that of the patients in the first era (p = 0.004). The 1-, 2-, and 3-year overall survival rates of patients in the second era were 60.0%, 45.7%, and 35.8%, respectively, with a median survival time of 19.6 months.ConclusionThe outcomes of HCC associated with PVTT remain unsatisfactory because of a high incidence of tumor recurrence even after curative resection. Although the management and outcomes of patients with HCC and PVTT have greatly improved over the years, surgical resection remains an option to achieve a potential cure of HCC in well-selected patients.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause for cancer-related deaths worldwide [1, 2]
The outcomes of hepatocellular carcinoma (HCC) associated with portal vein tumor thrombosis (PVTT) remain unsatisfactory because of a high incidence of tumor recurrence even after curative resection
The management and outcomes of patients with HCC and PVTT have greatly improved over the years, surgical resection remains an option to achieve a potential cure of HCC in wellselected patients
Summary
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the third leading cause for cancer-related deaths worldwide [1, 2]. Along with the advancement of surgical instruments and perioperative patient care, liver resection is considered as a safety procedure even in HCC patients with PVTT [9, 10]. This study gathered data on patients who had advanced HCC associated with PVTT to evaluate the therapeutic outcome and prognosis of liver resection. The treatment of advanced HCC has significantly changed because of the introduction of a novel therapeutic regimen, such as multikinase inhibitors, over the last decade. The outcomes and management of hepatocellular carcinoma (HCC) have undergone several evolu‐ tionary changes. This study aimed to analyze the outcomes of patients who had undergone liver resection for HCC with portal vein tumor thrombosis (PVTT) in terms of the evolving era of treatment
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