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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2018; 24(40): 4527-4535
Published online Oct 28, 2018. doi: 10.3748/wjg.v24.i40.4527
Published online Oct 28, 2018. doi: 10.3748/wjg.v24.i40.4527
Better surgical treatment method for hepatocellular carcinoma with portal vein tumor thrombus
Shu-You Peng, Jiang-Tao Li, Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Xu-An Wang, Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
Cong-Yun Huang, Department of General Surgery, Yuebei People’s Hospital Affiliated to Shantou University School of Medicine, Shaoguan 512025, Guangdong Province, China
De-Fei Hong, Yi-Fang Wang, Bin Xu, Department of Hepatobiliary and Pancreatic Surgery, Sir Run Run Shaw Hospital Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310016, Zhejiang Province, China
Author contributions: Peng SY and Wang XA contributed equally to this work; Peng SY and Wang XA wrote and revised the manuscript; Peng SY designed the “thrombectomy first” approach. All the authors participated in the operations.
Supported by Shanghai Pujiang Program , No. 17PJD025 ; and Shanghai Natural Science Foundation , No. 17ZR1418500 .
Conflict-of-interest statement: All the authors deny any form of conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xu-An Wang, MD, PhD, Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, No. 1665, Kongjiang Road, Shanghai 200092, China. wangxuan@xinhuamed.com.cn
Telephone: +86-21-25078813
Received: August 21, 2018
Peer-review started: August 22, 2018
First decision: August 30, 2018
Revised: September 11, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 28, 2018
Processing time: 66 Days and 24 Hours
Peer-review started: August 22, 2018
First decision: August 30, 2018
Revised: September 11, 2018
Accepted: October 5, 2018
Article in press: October 5, 2018
Published online: October 28, 2018
Processing time: 66 Days and 24 Hours
Core Tip
Core tip: The treatments for hepatocellular carcinoma with portal vein tumor thrombus between Eastern and Western countries vary drastically. In Western countries, the first-line treatment is systemic therapy such as sorafenib, while studies from China and Japan suggest that surgical treatment results in better outcomes. We review the efficacy and principles of current surgical treatments and introduce our new, more effective surgical technique named “thrombectomy first”, which means the tumor thrombus would be removed prior to liver resection. We have performed this technique over approximately 15 years and achieved good results with the longest surviving time being 13 years and onward.