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Review
. 2020 Oct;20(4):101.
doi: 10.3892/ol.2020.11962. Epub 2020 Aug 7.

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus

Yinchuan Xia  1 , Junqi Zhang  1 , Xiaoling Ni  1
Affiliations
Review

Diagnosis, treatment and prognosis of hepatocellular carcinoma with inferior vena cava/right atrium tumor thrombus

Yinchuan Xia et al. Oncol Lett. 2020 Oct.

Abstract

Although tumor thrombus (TT) infringement of the inferior vena cava (IVC) and right atrium (RA) is rarely observed in hepatocellular carcinoma (HCC), the prognosis for this condition is extremely poor, with a median survival time of several months, given that the condition is often diagnosed at an advanced tumor stage or combined with multiple systemic metastases. Furthermore, there is no established effective treatment for the condition. However, some investigators insist that active treatment, including surgery, chemotherapy (systemic or intra-arterial), radiation therapy, best supportive care or a combination of these, may help prolong overall survival time in these patients. The management of patients with advanced HCC and a TT extending into the RA and IVC is extremely difficult and risky. To this end, the present review assessed the literature on the clinical features and treatments of this condition in recent years, with the aim of providing assistance for clinical work.

Keywords: hepatocellular carcinoma; inferior vena cava; right atrium; treatment; tumor thrombus.

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Figures

Figure 1.
Figure 1.
Representative CT and MRI images of hepatocellular carcinoma with IVC TT and RA TT. CT images of TT in the (A) IVC and (B) RA (white arrow). MR images of TT in the (C) IVC and (D) RA (white arrow). The TT margins and irregular internal structures are demonstrated more clearly in the MRI compared with the CT scan. TT, tumor thrombus; IVC, inferior vena cava; RA, right atrium.
See this image and copyright information in PMC

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