Tumor thrombus types influence the prognosis of hepatocellular carcinoma with the tumor thrombi in the portal vein

Abstract

Background/aims: To evaluate the benefits of the tumor thrombus types system on determining treatments and prognosis of hepatocellular carcinoma patients (HCC) with tumor thrombi in the portal vein.

Methodology: According to anatomic features of the portal vein in the liver and tumor thrombus of HCC developing modes, a uniform tumor thrombus types system (types I-IV) was first recommended. 84 HCC patients with portal vein tumor thrombi, which from January 2000 to January 2003 in the Eastern Hepatobiliary Surgery Hospital, were divided into I-IV groups according to types I-IV of the tumor thrombus system. The median survival periods and effectiveness of surgical resection or non-resection for I-IV groups were retrospectively observed.

Results: The median survival periods for patients of group I (n=17), II (n=26), III (n=35) and group IV (n=6) were 10.1, 7.2, 5.7 and 3.0 months, respectively (p = 0.0001). From tumor thrombus type I to type III, the patients received surgical resection were better than that of non-resection (P = 0.0006). Among the patients receiving resection treatment, resection of tumor thrombus type I had the best effects, while for patients with tumor thrombus type IV, the results were not good. In case of non-resection treatments, the survival periods of patients with tumor thrombi type I, II and III were similar, which supposed that TACE may be of little effects on tumor thrombi.

Conclusions: Types of tumor thrombus system suggested may be helpful to determine the treatments and prognosis of HCC patients with tumor thrombi in the portal vein.