Treatment of hepatocellular carcinoma with portal vein tumor thrombus: advances and challenges
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Jin-Fang Jiang1, Yong-Cong Lao1, Bao-Hong Yuan2, Jun Yin3, Xin Liu1, Long Chen4 and Jian-Hong Zhong5
1 Department of Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
2 Department of General Surgery, Yan’An Hospital Affiliated to Kunming Medical University, Kunming, China
3 Department of Radiation Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
4 Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
5 Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
Jian-Hong Zhong, email:
Long Chen, email:
Keywords: hepatic resection; hepatocellular carcinoma; portal vein tumor thrombosis; transarterial chemoembolization
Received: December 28, 2016 Accepted: February 02, 2017 Published: February 16, 2017
Portal vein tumor thrombus is a frequent, challenging complication in hepatocellular carcinoma. Hepatocellular carcinoma patients with portal vein tumor thrombus may show worse liver function, less treatment tolerance and worse prognosis than patients without portal vein tumor thrombus, and they may be at higher risk of comorbidity related to portal hypertension. Western and some Asian guidelines stratify hepatocellular carcinoma with portal vein tumor thrombus together with metastatic hepatocellular carcinoma and therefore recommend only palliative treatment with sorafenib or other systemic agents. In recent years, more treatment options have become available for hepatocellular carcinoma patients with portal vein tumor thrombus, and an evidence-based approach to optimizing disease management and treatment has become more widespread. Nevertheless, consensus policies for managing hepatocellular carcinoma with portal vein tumor thrombus have not been established. This comprehensive literature review, drawing primarily on studies published after 2010, examines currently available management options for patients with hepatocellular carcinoma and portal vein tumor thrombus.
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