The strategies for treating primary hepatocellular carcinoma with portal vein tumor thrombus
Zong-ming Zhang, Eric C H Lai, Chong Zhang, Hong-wei Yu, Zhuo Liu, Bo-jiang Wan, Li-min Liu, Zu-hao Tian, Hai Deng, Qiu-hong Sun, Xiao-ping Chen, Zong-ming Zhang, Eric C H Lai, Chong Zhang, Hong-wei Yu, Zhuo Liu, Bo-jiang Wan, Li-min Liu, Zu-hao Tian, Hai Deng, Qiu-hong Sun, Xiao-ping Chen
Abstract
Purpose: To further improve the effectiveness and prognosis of primary hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT), the current status of treatment for HCC with PVTT was reviewed.
Methods: A Medline search was undertaken to identify articles using the keywords "HCC", "PVTT" and "therapy". Additional papers were identified by a manual search of the references from the key articles.
Results: PVTT, as a common complication of HCC, was divided into type I ∼ IV. The therapeutic approach is mainly composed of five types: surgical resection, regional interventional therapy, radiotherapy, combination therapy, targeted therapy. All of these therapeutic approaches were separately evaluated in detail.
Conclusions: For those resectable tumors, the better choice for treatment of HCC with PVTT should be hepatectomy and removal of PVTT. For those unresectable tumors, TACE (especially the super-selective TACE) has been the preferred palliative treatment, the other regional interventional therapy and/or radiotherapy could improve the therapeutic effects. The multidisciplinary treatments may further improve the quality of life and prolong the survival period for the HCC patients associated with PVTT.
Keywords: Hepatocellular carcinoma (HCC); Portal vein tumor thrombus (PVTT); Therapeutic strategy.
Copyright © 2015. Published by Elsevier Ltd.
Source: PubMed