Hepatectomy for hepatocellular carcinoma with portal vein tumor thrombus

Table 1 Surgical outcome of hepatectomy for hepatocellular carcinoma patients with portal vein thrombus

Ref.	Vp type	Patients	Child-Pugh A (%)	HBV (%)	OS, 1 yr (%)	OS, 3 yr (%)	OS, 5 yr (%)	Treatment
Ohkubo et al[11] 2000	Vp234	47	91.5	42.6	53.9	33.2	23.9
Minagawa et al[13] 2001	Vp234	18	NS	44.4	82	42	42	Preop TACE
Fan et al[26] 2003	Vp34	19	78.9	NS	14.2	0	0
	Vp34	64	78.1	NS	37.6	14	NS	Postop PVI HAI
Capussotti et al[42] 2004	Vp234	13	NS	NS	NS	18.5	18.5
Zhou et al[19] 2006	Vp234	381	NS	90	47	16	12
Ikai et al[27] 2006	Vp34	78	NS	30.8	45.7	21.7	10.9
Chen et al[49] 2006	Vp234	438	NS	NS	52.1	16	11.8
	Vp23	286	13.3	60.1	58.7	22.7	18.1
	Vp34	152	NS	62.5	39.5	5.7	0
Nagano et al[17] 2007	Vp3	15	NS	66.7	100	74	NS	Postop 5-FU/IFN
	Vp3	15	NS	40	41	22	NS
Kamiyama et al[12] 2007	Vp34	15	100	66.7	86.2	43.5	34.8	Preop radiation
	Vp34	28	85.7	64.3	39	13.1	13.1
Liang et al[20] 2008	Vp34	33	54.5	93.9	46.8	14.4	NS	Postop PIAF
	Vp34	53	69.8	92.5	23.4	5.8	NS
Peng et al[22] 2009	Vp34	51	86.3	NS	50.9	33.8	21.5	Postop TACE
	Vp34	53	86.8	NS	33.3	17	8.5
Ban et al[57] 2009	Vp34	45	66.7	42.2	69.6	37.4	22.4
Shi et al[48] 2010	Vp3	169	99.4	81.1	38.2	17.7	NS
	Vp4	78	97.4	87.2	24.7	3.6	NS
	Vp41	20	95	90	18.3	0	NS
Zhou et al[21] 2011	Vp34	21	NS	NS	47	22	NS
	Vp34	38	NS	NS	70	20	NS	Adjuvant chemotherapy via portal vein
Matono et al[45] 2012	Vp34	19	NS	55.2	62.1	24.1	17.2
	Vp342	10	NS	NS	38.5	0	0
Chen et al[50] 2012	Vp34	88	84.1	89.8	31.1	18.3	15.2
Peng et al[46] 2012	Vp3	68	NS	NS	46.3	17.2	17.2
	Vp4	83	NS	NS	32.5	3.6	3.6
	Vp41	23	NS	NS	21.7	0	0
Tang et al[43] 2013	Vp234	186	91.9	85.5	40.1	17	13.6
Li et al[58] 2013	Vp3	10	100	100	43	16	NS
	Vp33	20	100	90	32	11	NS
Chok et al[47] 2014	Vp3	71	95.8	90.1	45.8	22.7	11.2
	Vp34	10	90	100	50	12.5	12.5
	Vp345	7	85.7	100	28.6	14.3	14.3
Fukumoto et al[25] 2014	Vp234	41	NS	NS	80.5	32.4	NS	Postop PIHP
Yamamoto et al[44] 2015	Vp34	10	NS	NS	NS	NS	30
Pesi et al[59] 2015	Vp3	21	NS	NS	60	39	10
Kojima et al[18] 2015	Vp34	27	92.6	33.3	77.8	48.2	25.9	Postop HAIC (FP, epi-ADM)
	Vp34	25	88	32	68	32	12
Xiao et al[60] 2015	Vp2	28	NS	NS	53.6	25	25
	Vp3	38	NS	NS	39.5	15.8	5.3
Bai et al[23] 2016	Vp23	51	92.2	22	19.6	NS	NS
	Vp23	31	96.8	19	53.3	NS	NS	Postop TACE
	Vp23	10	100	30	71.1	NS	NS	Postop radiation
Zheng et al[51] 2016	Vp234	96	78.1	58.3	86.5	60.4	33.3
Li et al[30] 2016	Vp4	39	88.9	82.2	69	NS	NS	Preop radiation
	Vp23	50	84	88	35.6	NS	NS
Ye et al[24] 2016	Vp4	54	NS	85.2	0	NS	NS	Postop TACE
Hamaoka et al[33] 2017	Vp34	7	100	NS	100	71	NS	Preop radiation, HAIC (FP, IFN/5-FU)

¹Tumor thrombi involving the superior mesenteric vein;

²Non-curative resection;

³Hepatectomy with caudate lobe;

⁴PVTT extending to or beyond the portal vein bifurcation, treated by en bloc resection followed by portal vein reconstruction;

⁵PVTT extending to or beyond the portal vein bifurcation, treated by thrombectomy. OS: Overall survival; HBV: Hepatitis B virus; Vp2: Tumor thrombus in the second branches of the portal vein; Vp3: Tumor thrombus in the first branch of the portal vein; Vp4: Tumor thrombus extension to the trunk or the opposite-side branch of the portal vein; TACE: Transarterial chemoembolization; PVI: Portal vein infusion; HAI: Hepatic arterial infusion; PIAF: Cisplatin, doxorubicin and 5-fluorouridine (5-FU) locally administered in the portal vein with subcutaneous injection of interferon-α; PIHP: Percutaneous isolated hepatic perfusion; FAIT: FU arterial infusion and interferon therapy; HAIC: Hepatic arterial infusion chemotherapy; FP: Cisplatin+5-FU; ADM: Adriamycin; NS: Not stated.

Table 2 Patient mortality

	Ref.	Patient number or percent	Cause of death
Within 30 d
	Ikai et al[27]	3	Pulmonary bleeding
			Extrahepatic growth
	Yamamoto et al[44]	1	Renal failure
	Ohkubo et al[11]	1	Liver failure
	Capussotti et al[42]	2	Postoperative bleeding
			Liver failure
	Liang et al[20]	2
	Tang et al[43]	2	Decompensation
38 d
	Capussotti et al[42]	1	Sepsis
58 d
	Minagawa et al[13]	1	Liver failure
Operative mortality
	Fan et al[26]	4.80%
	Peng et al[22]	2	Operative complication
	Matono et al[45]	1
	Peng et al[46]	1	Liver failure
	Chock et al[47]	3.40%
	Shi et al[48]	1	Postoperative bleeding
	Zheng et al[51]	1	Serious postoperative infection
	Ye et al[24]	9.30%	Liver failure, serious infection, heart failure
Mortality
	Chen et al[49]	0%
		2.60%
	Nagano et al[17]	0%
	Kamiyama et al[12]	0%
	Ban et al[57]	0%
	Chen et al[50]	4.50%
	Fukumoto et al[25]	0%
	Li et al[30]	0%