Background
The incidence of biliary tumor thrombi (BTT) in hepatocellular carcinoma (HCC) is
very low and operative outcomes are poor. There is little information on the postoperative
prognostic factors for patients with HCC with BTT. We analyzed retrospectively the
clinicopathologic features of 22 patients with HCC with BTT to identify the prognostic
factors associated with operative outcome.
Methods
Of the 551 patients who underwent hepatic resection for HCC between 1988 and 2007,
22 (4.0%) had HCC with BTT. Their clinicopathologic features were compared with those
with HCC but no BTT. The survival rates were also calculated for various clinicopathologic
factors.
Results
Of the 22 patients, 13 (59%) also had portal or hepatic vein tumor thrombosis. Multiple
HCC tumors were identified in 91% of patients and 20 patients were classified as stage
IVA. The 1- and 3-year overall survival rates were 89% and 73% for patients with HCC
free of BTT, respectively, and 62% and 30%, respectively, for those of HCC with BTT
(P < .0001). Portal or hepatic vein tumor thrombosis was the only significant determinant
of poor prognosis in 22 patients with HCC with BTT. The 1- and 3-year cumulative survival
rates were 89% and 52%, respectively, for patients with only BTT but worse in those
of HCC with both BTT and portal or hepatic vein tumor thrombosis (43% and 17%, respectively).
Conclusion
The clinicopathologic features of HCC patients with BTT indicated advanced-stage disease
and poor operative outcomes. Portal or hepatic vein tumor thrombosis was the only
significant determinant of poor prognosis of HCC patients with BTT.
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Article info
Publication history
Published online: September 24, 2010
Accepted:
August 5,
2010
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
