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Recurrence and survivals following hepatic resection for hepatocellular carcinoma with major portal/hepatic vein tumor thrombus
Author(s) -
Zhang Tao,
Huang JiWei,
Bai Yannan,
Wu Hong,
Zeng Yong
Publication year - 2014
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12185
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , cirrhosis , thrombus , portal vein , vein , incidence (geometry) , hepatectomy , liver function , carcinoma , hepatic function , survival rate , surgery , resection , physics , optics
Aim To compare the recurrence and survivals between hepatocellular carcinoma ( HCC ) with major portal vein tumor thrombus ( TT ) and major hepatic vein TT after hepatic resection ( HR ). Methods A retrospective study was carried out with the medical records of 272 patients who underwent hepatic resection and thrombectomy for HCC with major portal vein (group A) or hepatic vein (group B) TT . The clinicopathological parameters, recurrence, survivals and prognostic significance associated with major portal or hepatic vein TT were analyzed. Results Patients in group A had a better median survival compared with their counterparts in group B (52 vs 38 weeks; P < 0.001). One‐, 2‐ and 3‐year survival rates were markedly greater in group A than in group B (50% vs 38.8%, 26% vs 15.9% and 11.4% vs 6.1%, respectively). There was no statistical difference in recurrence‐free survival rate but extrahepatic recurrences were more often seen in group B. In multivariate analysis, TT location (hepatic veins vs portal veins), type of resection (anatomical vs non‐anatomical) and liver cirrhosis (none/mild vs moderate/severe) were significant prognostic factors. Conclusion Patients with HCC and major hepatic vein TT had higher incidence of extrahepatic metastases and worse overall survival after hepatic resection compared with patients with major portal vein TT . With preserved liver function, patients can receive aggressive treatments and survivals could be prolonged.