Review
Copyright ©The Author(s) 2015.
World J Hepatol. Jun 18, 2015; 7(11): 1553-1561
Published online Jun 18, 2015. doi: 10.4254/wjh.v7.i11.1553
Table 1 Clinical outcomes for hepatocellular carcinoma patients accompanying portal vein tumor thrombosis following surgical resection
Ref.PVTT status1No. of patientsSurvival2
Median (mo)1-yr (%)3-yr (%)
Shi et al[49]Vp2139NR52.125.1
Vp316938.217.78
Vp47824.73.6
Beyond Vp42018.30
Lin et al[50]Vp2
Vp363NR52.116
Vp4533.10
Chen et al[78]Vp2-488931.115.2
Matono et al[79]Vp3-42916.962.124.1
Table 2 Comparing various treatment strategies for hepatocellular carcinoma patients accompanying portal vein tumor thrombosis
IndicationAdvantagesDisadvantages
SorafenibBCLC stage CShowing survival benefitModest efficacy compared to placebo control
in infiltrative type HCCHand-foot skin reaction
TACENodular type HCC up to Vp4Wide indicationPost TACE syndrome
Child A liver functionPotential risk of liver failure
TARETumor extension ≤ 50% of liver volumeDown-staging allowingRequiring additional lung shunt study
Unilobarliver transplantationdue to the risk of lung injury
Nodular type
Up to Vp4
RFASingle medium-sized HCCs (3-5 cm)Less invasiveIf the intraparenchymal tumor was not completely ablated by RFA, complete effects on the thrombus probably would not be produced
SurgeryUp to Vp4Less expensive technicInvasive and expensive technic
Single medium-sized HCCs ( ≤ 7 cm)Better outcomes than other patientsPotential risk of liver failure
Up to Vp4with HCC who are BCLC stage C
No HV/IVC invasionwith Child A liver function
External beamAFP ≤ 30 ng/mLCombined to multimodal strategiesPotential risk of radiation induced liver disease
radiotherapyTumor extension ≤ 60% of liver volumePotential risk of GI tract toxicities