. 2022 Mar 17;11(4):315-328.

doi: 10.1159/000523997. eCollection 2022 Jul.

Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)

Juxian Sun¹, Rongping Guo², Xinyu Bi³, Mengchao Wu¹, Zhaoyou Tang⁴, Wan Yee Lau^{1

5}, Shusen Zheng⁶, Xuehao Wang⁷, Jinming Yu⁸, Xiaoping Chen⁹, Jia Fan⁴, Jiahong Dong¹⁰, Yongjun Chen¹¹, Yunfu Cui¹², Chaoliu Dai¹³, Chihua Fang¹⁴, Shuang Feng¹⁵, Zhili Ji¹⁶, Weidong Jia¹⁷, Ningyang Jia¹⁸, Gong Li¹⁹, Jing Li²⁰, Qiu Li²¹, Jiangtao Li²², Tingbo Liang²³, Lianxin Liu¹⁷, Shichun Lu²⁴, Yi Lv²⁵, Yilei Mao²⁶, Yan Meng¹⁵, Zhiqiang Meng²⁷, Feng Shen²⁸, Jie Shi¹, Huichuan Sun²⁹, Kaishan Tao³⁰, Gaojun Teng³¹, Xuying Wan³², Tianfu Wen³³, Liqun Wu³⁴, Jinglin Xia³⁵, Mingang Ying³⁶, Jian Zhai³⁷, Leida Zhang³⁸, Xuewen Zhang³⁹, Zhiwei Zhang⁴⁰, Haiping Zhao⁴¹, Donghai Zheng⁴², Xuting Zhi⁴³, Jie Zhou⁴⁴, Cuncai Zhou⁴⁵, Jian Zhou⁴, Zhaochong Zeng⁴⁶, Kangshun Zhu⁴⁷, Minshan Chen², Jianqiang Cai³, Shuqun Cheng¹

Affiliations

¹ Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
² Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
³ Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Fudan University, Shanghai, China.
⁵ Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
⁶ Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China.
⁷ Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁸ Department of Oncology, Clinical College of Weifang Medical University, Weifang, China.
⁹ Hepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
¹⁰ Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Chang Gung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China.
¹¹ Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹² Department of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
¹³ Department of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China.
¹⁴ Department of Hepatobiliary Surgery, Zhujiang Hospital, First Military Medical University, Guangzhou, China.
¹⁵ Department of Radiation Oncology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
¹⁶ Department of General Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
¹⁷ Department of General Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
¹⁸ Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
¹⁹ Department of Radiation Oncology, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China.
²⁰ Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
²¹ Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
²² Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
²³ Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
²⁴ Department of Hepatobiliary Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.
²⁵ Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
²⁶ Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China.
²⁷ Department of Oncology, Shanghai Medical College, Fudan University Shanghai, Shanghai, China.
²⁸ Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
²⁹ Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China.
³⁰ Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
³¹ Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
³² Department of Integrated Traditional Chinese and Western Medicine, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³³ Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
³⁴ Division of Hepatobiliary Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
³⁵ Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
³⁶ Department of Abdominal Surgery, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital, Fuzhou, China.
³⁷ Department of Interventional Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³⁸ Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
³⁹ Department of Hepatobiliary and Pancreas Surgery, The Second Hospital of Jilin University, Changchun, China.
⁴⁰ Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴¹ Department of Hepatobiliary and Pancreas Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, China.
⁴² Department of Traditional Chinese Medicine, Beijing Weida Traditional Chinese Medicine Tumor Hospital, Beijing, China.
⁴³ Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
⁴⁴ Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴⁵ Department of Hepatobiliary Surgery, Jiangxi Provincial Cancer Hospital, Nanchang, China.
⁴⁶ Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁴⁷ Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

PMID: 35978596
PMCID: PMC9294940
DOI: 10.1159/000523997

Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)

Juxian Sun et al. Liver Cancer. 2022.

. 2022 Mar 17;11(4):315-328.

doi: 10.1159/000523997. eCollection 2022 Jul.

Authors

Affiliations

¹ Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
² Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
³ Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.
⁴ Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of Education, Fudan University, Shanghai, China.
⁵ Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
⁶ Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital, Hangzhou, China.
⁷ Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁸ Department of Oncology, Clinical College of Weifang Medical University, Weifang, China.
⁹ Hepatic Surgery Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.
¹⁰ Department of Hepatobiliary and Pancreas Surgery, Beijing Tsinghua Chang Gung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China.
¹¹ Department of Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
¹² Department of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
¹³ Department of Hepatobiliary and Spleenary Surgery, The Affiliated Shengjing Hospital, China Medical University, Shenyang, China.
¹⁴ Department of Hepatobiliary Surgery, Zhujiang Hospital, First Military Medical University, Guangzhou, China.
¹⁵ Department of Radiation Oncology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
¹⁶ Department of General Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
¹⁷ Department of General Surgery, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China.
¹⁸ Department of Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
¹⁹ Department of Radiation Oncology, Beijing Tsinghua Changgung Hospital (BTCH), School of Clinical Medicine, Tsinghua University, Beijing, China.
²⁰ Department of Hepatobiliary Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
²¹ Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
²² Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
²³ Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
²⁴ Department of Hepatobiliary Surgery, First Medical Center of Chinese PLA General Hospital, Beijing, China.
²⁵ Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
²⁶ Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Beijing, China.
²⁷ Department of Oncology, Shanghai Medical College, Fudan University Shanghai, Shanghai, China.
²⁸ Department of Hepatic Surgery IV, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
²⁹ Department of Liver Surgery and Transplantation, Liver Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, China.
³⁰ Department of Hepatobiliary Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.
³¹ Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China.
³² Department of Integrated Traditional Chinese and Western Medicine, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³³ Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
³⁴ Division of Hepatobiliary Pancreatic Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
³⁵ Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
³⁶ Department of Abdominal Surgery, Fujian Provincial Cancer Hospital, Fujian Medical University Teaching Hospital, Fuzhou, China.
³⁷ Department of Interventional Radiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³⁸ Department of Hepatobiliary Surgery Institute, Southwest Hospital, Third Military Medical University, Chongqing, China.
³⁹ Department of Hepatobiliary and Pancreas Surgery, The Second Hospital of Jilin University, Changchun, China.
⁴⁰ Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴¹ Department of Hepatobiliary and Pancreas Surgery, The Affiliated Hospital of Inner Mongolia Medical University, Huhehot, China.
⁴² Department of Traditional Chinese Medicine, Beijing Weida Traditional Chinese Medicine Tumor Hospital, Beijing, China.
⁴³ Department of General Surgery, Qilu Hospital, Shandong University, Jinan, China.
⁴⁴ Department of Hepatobiliary Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁴⁵ Department of Hepatobiliary Surgery, Jiangxi Provincial Cancer Hospital, Nanchang, China.
⁴⁶ Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China.
⁴⁷ Department of Minimally Invasive Interventional Radiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

PMID: 35978596
PMCID: PMC9294940
DOI: 10.1159/000523997

Abstract

Portal vein tumor thrombus (PVTT) is very common and it plays a major role in the prognosis and clinical staging of hepatocellular carcinoma (HCC). We have published the first version of the guideline in 2016 and revised in 2018. Over the past several years, many new evidences for the treatment of PVTT become available, especially for the advent of new targeted drugs and immune checkpoint inhibitors which have further improved the prognosis of PVTT. So, the Chinese Association of Liver Cancer and Chinese Medical Doctor Association revised the 2018 version of the guideline to adapt to the development of PVTT treatment. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials.

Keywords: Guideline; Hepatocellular carcinoma; Multidisciplinary therapy; Portal vein tumor thrombus.

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Figures

**Fig. 1**
Diagnosis and treatment of HCC with PVTT.

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Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)

Affiliations

Guidelines for Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus in China (2021 Edition)

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