Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2005; 11(8): 1215-1219
Published online Feb 28, 2005. doi: 10.3748/wjg.v11.i8.1215
Efficacy of different treatment strategies for hepatocellular carcinoma with portal vein tumor thrombosis
Jia Fan, Jian Zhou, Zhi-Quan Wu, Shuang-Jian Qiu, Xiao-Ying Wang, Ying-Hong Shi, Zhao-You Tang
Jia Fan, Jian Zhou, Zhi-Quan Wu, Shuang-Jian Qiu, Xiao-Ying Wang, Ying-Hong Shi, Zhao-You Tang, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Jia Fan, Liver Cancer Institute, Zhongshan Hospital, Fudan University, 136 Yixueyuan Road, Shanghai 200032, China. jiafan99@yahoo.com
Telephone: +86-21-64037181 Fax: +86-21-64037181
Received: July 28, 2004
Revised: July 30, 2004
Accepted: September 4, 2004
Published online: February 28, 2005
Abstract

AIM: To evaluate the efficacy of different treatment strategies for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) and investigate factors influencing prognosis.

METHODS: One hundred and seventy-nine HCC patients with macroscopic PVTT were enrolled in this study. They were divided into four groups and underwent different treatments: conservative treatment group (n = 18), chemotherapy group (n = 53), surgical resection group (n = 24) and surgical resection with postoperative chemotherapy group (n = 84). Survival rates of the patients were analyzed by the Kaplan-Meier method. A log-rank analysis was performed to identify group differences. Cox’s proportional hazards model was used to analyze variables associated with survival.

RESULTS: The mean survival periods of the patients in four groups were 3.6, 7.3, 10.1, and 15.1 mo respectively. There were significant differences in the survival rates among the groups. The survival rates at 0.5-, 1-, 2-, and 3-year in surgical resection with postoperative chemotherapy group were 55.8%, 39.3%, 30.4%, and 15.6% respectively, which were significantly higher than those of other groups (P<0.001). Multivariate analysis revealed that the strategy of treatment (P<0.001) and the number of chemotherapy cycles (P = 0.012) were independent survival predictors for patients with HCC and PVTT.

CONCLUSION: Surgical resection of HCC and PVTT combined with postoperative chemotherapy or chemoembolization is the most effective therapeutic strategy for the patients who can tolerate operation. Multiple chemotherapeutic courses should be given postoperatively to the patients with good hepatic function reserve.

Keywords: Hepatocellular carcinoma; Portal vein tumor thrombosis; Surgical resection; Chemotherapy; Chemoembolization