Influencing factors for prognosis of patients with hepatocellular carcinoma complicated with portal vein tumor thrombus after surgical treatment

Abstract

Objective To investigate the influencing factors for the prognosis of patients with hepatocellular carcinoma (HCC) complicated with portal vein tumor thrombus (PVTT) after surgical treatment. Methods Clinical data of 32 patients with HCC and PVTT who underwent surgical treatments in Tianjin Medical University Cancer Institute and Hospital between June 2010 and June 2013 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. There were 25 males and 7 females, aged from 35 to 75 years old with a median age of 66 years old. The 1-, 2-, 3-year cumulative survival and recurrence-free survival of the patients were observed, and independent risk factors for the overall and recurrence-free survival were analyzed. Survival analysis was conducted using Kaplan-Meier method and Log-rank test. Multivariate analysis was conducted using Cox proportional hazard regression model. Results The median survival time was 18 months, and the 1-, 2- , 3-year cumulative survival was respectively 62.5%, 43.5% and 33.5%. The median recurrence-free survival time was 6 months, and the 1-, 2-, 3-year recurrence-free survival was respectively 37.5%, 18.2% and 10.9%. Multivariate analysis revealed that PVTT staging (RR=4.632, 95%CI: 1.528-14.039; P<0.05), surgical procedure (RR=4.928, 95%CI:1.233-19.696; P<0.05) and treatments after recurrence (RR=21.069, 95%CI:3.529-125.806; P<0.05) were the independent influencing factors for postoperative overall survival. Treatments to prevent recurrence was the independent influencing factor for postoperative recurrence-free survival (RR=4.486, 95%CI: 1.807-11.138; P<0.05). Conclusions Surgical treatments has certain clinical application value for HCC complicated with PVTT. PVTT staging, surgical procedure and treatments after recurrence are the independent influencing factors for postoperative overall survival. And treatments to prevent recurrence is the independent influencing factor for postoperative recurrence-free survival. Key words: Carcinoma, hepatocellular; Neoplastic cells, circulating; Hepatectomy; Survival rate