Abstract
Background. Prognosis of hepatocellular carcinoma (HCC) with tumor thrombus in the main portal
vein (MPV), inferior vena cava (IVC), or extrahepatic bile duct (EBD) treated by conventional
therapies has been considered poor. This study aimed to evaluate the efficacy of hepatic
arterial infusion chemotherapy after surgical resection as an adjuvant therapy or
as a treatment for intrahepatic recurrence of HCC with tumor thrombus in MPV, IVC,
or EBD. Methods. Nineteen patients with HCC and tumor thrombus in the MPV, IVC, or EBD who underwent
hepatectomy with thrombectomy were reviewed retrospectively. Results. The overall 3-year survival rate was 48.5%. Two patients with postoperative residual
tumor thrombus died within 6 months owing to rapid progression of the residual tumor
thrombus. Five patients survived more than 5 years after their operations. Tumors
disappeared completely in 3 patients after hepatic arterial infusion chemotherapy
with a combination of cisplatinum and 5-fluorouracil, and the longest survival period
was 17 years and 11 months in a patient with EBD thrombus. Conclusions. If hepatic reserve is satisfactory, an aggressive surgical approach combined with
chemotherapy seems to be of benefit for patients having HCC with tumor thrombus in
the MPV, IVC, or EBD. (Surgery 2002;131:300-10.)
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Article info
Publication history
Accepted:
September 22,
2001
Footnotes
*Reprint requests: Shuichi Fukuda, Department of Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, Japan 830-0011.
Identification
Copyright
© 2002 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
