Abstract

Hepatocellular carcinoma (HCC) is one of most prevalent cancer and is a serious healthcare issue worldwide. Portal vein tumor thrombus (PVTT) is a frequent complication and remains as the blockage in the treatment of HCC with high recurrence rate and poor prognosis. There is still no global consensus or standard guideline on the management of HCC with PVTT. In western countries, Sorafenib and Lenvatinib are recommended as the first-line treatment options for HCC patients with PVTT where this condition is now regarded as BCLC Stage C regardless of PVTT types. However, there is growing evidence that supports the close relationship of the extent of PVTT to the prognosis of HCC. Besides the targeted therapy, more aggressive treatment modalities have been proposed and practiced in the clinic which may improve the prognosis of HCC patients with PVTT and prolong the patients’ survival time, such as transarterial chemoembolization, radiotherapy, hepatic resection, liver transplantation, and various combination therapies. Herein, we aim to review and summarize the advances in the treatment of HCC with PVTT.

Highlights

  • Liver cancer is the sixth most commonly diagnosed cancer and the fourth cause of cancer-related deaths worldwide [1]

  • The results showed that 484 patients presented with Portal vein tumor thrombus (PVTT) and it counted for 36.8% of the cases

  • According to the Barcelona Clinic for Liver Cancer (BCLC) staging system and treatment guidelines which are widely used in Europe and America, Hepatocellular carcinoma (HCC) patients with PVTT are regarded as BCLC Stage C which strongly indicates an advanced stage of the disease [7, 14,15,16,17]

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Summary

INTRODUCTION

Liver cancer is the sixth most commonly diagnosed cancer and the fourth cause of cancer-related deaths worldwide [1]. According to the Barcelona Clinic for Liver Cancer (BCLC) staging system and treatment guidelines which are widely used in Europe and America, HCC patients with PVTT are regarded as BCLC Stage C which strongly indicates an advanced stage of the disease [7, 14,15,16,17]. These guidelines recommend Sorafenib as the standard first-line treatment option but the effect is modest [18].

DIAGNOSIS AND CLASSIFICATION OF PVTT
Progress of HCC With PVTT B
Targeted Therapy
Radiation Therapy
External Radiotherapy
Internal Radiotherapy
Surgical Resection
Liver Transplantation
Case report
Type II
NA NA NA
Other Strategies
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
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