Surgical results for hepatocellular carcinoma with macroscopic portal vein tumor thrombosis

Background: The longterm results after liver resection for hepatocellular carcinoma with macroscopic tumor thrombus of the portal vein are unclear. Study Design: The records of 47 HCC patients with tumor thrombus in the segmental portal branch (n = 33) and the first portal branch or portal vein trunk (n = 14) were reviewed in this study. Survival rates of the patients were calculated with regard to 14 clinico-pathologic variables. A log-rank analysis was performed to identify which variables predicted the prognosis. Results: Overall 1-, 3-, and 5-year survival rates were 53.9%, 33.2%, and 23.9%, respectively. The indicators of a favorable prognosis included curative liver resection, tumor size less than 10 cm in diameter, and absence of intrahepatic metastases. Conclusions: Liver resection should be considered a therapeutic option for hepatocellular carcinoma with macroscopic portal vein tumor thrombus when the tumor is small and curative liver resection can be expected. (J Am Coll Surg 2000;191:657-660. (C) 2000 by the American College of Surgeons).