Hepatocellular carcinoma with tumor thrombus in bile duct: A proposal of new classification according to resectability of primary lesion

Table 4 Summary of studies focused on misdiagnosis of hepatocellular carcinoma with bile duct tumor thrombi

No.	Ref.	Time period	No. of included patients of HCC with BDTT	No. of misdiagnosed patients, %	Diagnostic method	Misdiagnosed as	Treatment	Prognosis
1	Zhou et al[12], 2020	2011/01-2018/08	58	32 (55.2)	CT	Hilar cholangiocarcinoma	Hepatectomy	DFS: 16.1 mo
							Hepatectomy with bile duct excision	DFS: 7.3 mo
2	Zheng et al[13], 2014	2007/01-2012/12	-	5 (-)	CT/MRI/ERCP	Choledocholithiasis and cholangitis	ENBD and choledochojejunostomy	POS: 6-22 mo1 alive4 dead
							thrombus extraction
							ENBD
3	Long et al[14], 2010	2000/01-2008/11	61	4 (66.7)1	US/CT/MRI/ERCP	Choledocholithiasis and cholangiocarcinoma	Hepatectomy	Not mentioned
							thrombus extraction
4	Peng et al[15], 2005	1984/07-2002/12	53	3 (5.7)	US/CT/MRI	Hilar cholangiocarcinoma	PTCD + biliary stent	Median survival of 2-17 mo
							Hepatectomy with thrombus extraction
							TACE
							thrombus extraction
							Hepatectomy
5	Qin et al[16], 2004	1987/06-2003/01	34	9 (26.5)	US/CT	Cholangiocarcinoma	liver resection and thrombus extraction	Survival ≤ 1 yr 10Survival > 1 yr 20Survival > 3 yr 3Survival > 15 yr 1
							thrombus extraction combined with TACE

¹All of the patients had bile duct tumor thrombi without obvious intrahepatic hepatocellular carcinoma mass. BDTT: Bile duct tumor thrombi; CT: Computed tomography; DFS: Disease free survival; ENBD: Endoscopic nasobiliary drainage; ERCP: Endoscopic retrograde cholangiopancreatography; HCC: Hepatocellular carcinoma; MRI: Magnetic resonance imaging; POS: Postoperative survival; PTCD: Percutaneous transhepatic cholangio drainage; TACE: Transhepatic arterial chemotherapy and embolization; US: Ultrasound.