A retrospective study on two surgical techniques in the treatment of hepatocellular carcinoma with portal vein tumor thrombus and to determine the prognostic factors of overall survival
10.3760/cma.j.issn.1007-8118.2014.10.003
- VernacularTitle:肝细胞癌伴门脉癌栓两种手术方式的疗效及预后因素
- Author:
Sheng GAO
;
Jianyong LIU
;
Zhiming ZHANG
;
Yinnong ZHAO
;
Feixiang WU
- Publication Type:Journal Article
- Keywords:
Hepatocellular carcinoma;
Portal vein tumor thrombus;
Hepatectomy;
Prognostic factors
- From:
Chinese Journal of Hepatobiliary Surgery
2014;20(10):700-704
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the impact of two surgical techniques in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).Methods A retrospective study was conducted on 143 patients with HCC with PVTT who underwent hepatectomy from January 1995 to December 2010 at the Affiliated Tumor Hospital of Guangxi Medical University.The patients were divided into two groups:group A,115 patients who underwent resection of HCC with PVTT; group B,28 patients who underwent HCC resection but the PVTT was extracted from the cut opening of the portal vein or the transected liver parenchyma.Results The median overall survival of group A was 18.0 months and the cumulative 1-,2-,3-year survival rates were 60.6％,41.0％,25.6 ％,respectively; the median overall survival of group B was 7.0 months and the cumulative 1-,2-,3-year survival rates were 35.1％,13.6％,9.1％,respectively.The differences between the 2 groups were statistically significant (P ＜ 0.001).Univariate analysis showed tumor number,PVTT types,prophylactic transcatheter arterial chemoembolization (TACE),and surgical technique to be significant risk factor of postoperative overall survival (P ＜ 0.05).Cox multivariate analysis indicated prophylactic TACE and surgical technique to be independent prognostic factor (P ＜ 0.05).Conclusions When compared with group B patients,group A patients had significantly better overall survival.Postoperative prophylactic TACE further improved survival of these patients.
