Abstract
In recent years, various treatment options have become available for patients with hepatocellular carcinoma (HCC) according to the degree of background liver damage, tumor diameter and other factors associated with disease progression. Therapy has also shifted toward evidence-based treatment. Policies for the management of HCC with portal vein tumor thrombus, which has been considered an intractable condition, have not been established. Surgical resection was previously positioned as the treatment of choice, but the outcomes after resection alone were found to be disappointing. At present, multiple interdisciplinary treatments, combining resection with intra-arterial chemotherapy, radiotherapy, systemic chemotherapy and/or immunotherapy, are used on a trial-and-error basis since no standard regimens have been developed. Clinical trials of surgery combined with transarterial chemoembolization, hepatic arterial infusion of chemotherapy and radiation have obtained improved 5-year survival rates of 21.5–56 %. The safety of surgical resection in HCC with major portal vein tumor thrombus has improved, but the optimal type(s) and timing of auxiliary therapy to use in combination with resection remain to be defined.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide [1]
This review summarizes the current knowledge regarding multiple interdisciplinary treatments for hepatocellular carcinoma (HCC) with major portal vein tumor thrombus (PVTT)
Vp1 tumor thrombus distal to the second-order branches of the portal vein, but not involving the second-order branches; Vp2 tumor thrombus in the second-order branches of the portal vein; Vp3 tumor thrombus in the first-order branches of the portal vein; Vp4 tumor thrombus in the main trunk of the portal vein and/or contralateral portal vein branch to the primarily involved lobe; HAI hepatic arterial infusion; CDDP cisplatin; 5FU 5-fluorouracil; NA not available; mo, months; GIA-TAE transcatheter arterial embolization with gelatin sponge immersed in an anticancer agent; RT radiation therapy; TACE transcatheter arterial chemoembolization appeared after 2000
Summary
Multidisciplinary treatments for hepatocellular carcinoma with major portal vein tumor thrombus. This article is published with open access at Springerlink.com
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have