Analysis of Surgical Treatment for Primary Liver Cancer with Portal Vein Tumor Thrombus_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIN Xinju ^1,2 , TANG Yangyang ^1,2 , PENG Minhao ¹ , QIN Xiao ¹ , PENG Tao ¹ , GUO Ya ¹ , CHEN Xigang ¹ , XIAO Kaiyin. ¹

1.Department of Hepatobiliary Surgery, The First Affiliated Hospital, Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China;;
2.Graduate Academe of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China;

Corresponding author：

Keywords：

Primary liver cancer; Portal vein tumor thrombus; Hepatectomy; Curative effect

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Objective 　To explore the curative effect of surgical treatment for primary liver cancer with portal vein tumor thrombus（PVTT）.
Methods 　The clinical data of 227 patients who were performed surgical treatment because of primary liver cancer with PVTT were analyzed retrospectively.
Results 　Two hundreds and seventeen cases were performed surgical resection, 14 cases died from postoperative complications. The median survival time was 17.7 months, and the l-, 2-, 3-, and 5-year survival rates were 61.9%, 37.2%, 21.7%, and 4.0% respectively. There were 40 cases with PVTT ofⅠtype, the l-, 2-, 3-, and 5-year survival rates were 82.3% , 61.7%, 38.6%, and 6.6% respectively，which was obviously higher than those with PVTT of Ⅱ type （n=129, 61.1%, 34.3%, 20.8%, and 5.3%） and PVTT of Ⅲ type （n=48, 46.8%, 24.0%, 9.6%, and 0）, P＜0.05. There were 84 cases whose PVTT and tumor were resected together, the l-, 2-, 3-, and 5-year survival rates were 67.3%, 43.2%, 28.1%, and 7.9% respectively，which were obviously higher than those patients whose PVTT were removed from cross-section of liver （n= 85, 65.1%, 38.8%, 22.3%, and 3.4%） and patients whose PVTT were removed by cutting the portal vein （n=48, 46.8%, 24.0%, 9.6%, and 0）, P＜0.05. The l-, 2-, 3-, and 5-year survival rates of 76 cases who received postoperative therapy of TACE/TAI were 75.3%, 53.2%, 33.1%, and 5.7% respectively, which were obviously higher than those patients who were not received any postoperative therapy （n=141, 54.8%, 29.1%, 15.9%, and 3.2%）, P＜0.05.
Conclusions 　Surgical treatment is an effective treatment for primary liver cancer with PVTT. Surgery should strive for resecting the tumor and PVTT together, and postoperative therapy of TACE/TAI may have a favorable effect on the long term survival rate.

Citation： LIN Xinju,TANG Yangyang,PENG Minhao,QIN Xiao,PENG Tao,GUO Ya,CHEN Xigang,XIAO Kaiyin.. Analysis of Surgical Treatment for Primary Liver Cancer with Portal Vein Tumor Thrombus. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(4): 382-386. doi: Copy

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2. Kumar S， Gao L， Yeagy B， et al. Virus combinations and chemotherapy for the treatment of human cancers [J]. Curr Opin Mol Ther， 2008， 10(2)：371-379.
3. Lau WY， Lai EC， Yu SC. Hepatocellular carcinoma [M]. Singapore：World Sientific Publishing Co， 2008：1-24.
4. 程树群，吴孟超，陈汉，等. 癌栓分型对肝细胞性肝癌合并门静脉癌栓治疗及预后的指导意义 [J]. 中华医学杂志， 2004，84(1)：7-9．.
5. Luo J， Guo RP， Lai EC， et al. Transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis：a prospective comparative study [J]. Ann Surg Oncol，2011， 18(2)：413-420.
6. 曾昭冲. 肝细胞肝癌放射治疗中山医院10 年总结，现状与展望 [J]. 中华肿瘤防治杂志， 2009， 16(13)：43-48．.
7. 王晓颖，樊嘉. 肝癌合并门静脉癌栓的治疗方法及价值 [J].肝胆外科杂志， 2009， 17(1)：9-11．.
8. Georgiades CS， Hong K， D’angelo M, et al. Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis [J]. J Vasc Interv Radiol， 2005， 16(12)：1653-1659.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Surgical Treatment for Primary Liver Cancer with Portal Vein Tumor Thrombus

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