Hepatectomy combined with intraarterial and intraportal chemotherapy for the treatment of hepatocellular carcinoma

Objective To evaluate irregular hepatectomy combined with removal of tumor thrombi, postoperative hepatic artery chemotherapy(HAC) and portal vein chemotherapy (PVC) for the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT). Methods From Jan. 1987 to Dec. 1996, 62 HCC cases with PVTT underwent the combined therapy. Among them HAC and PVC were given in 40 cases. 59 patients were followed up for over 3 years. Results 6 cases died of postoperative hepatic and renal failure in 3 months. Recurrent rate and survival rate at 1, 2, 3 year was 46%(18/39), 59%(23/39),79%(31/39)and 69%(27/39),51%(20/39), 31%(12/39) respectively in group of combined HAC and PVC compared with 80%(16/20),90%(18/20),100%(20/20)and 30%(6/20),10%(2/20), 5%(1/20)in group without postoperative HAC and PVC. Conclusions Irregular hepatectomy with removal of tumor thrombi is an effective treatment for HCC with PVTT. Postoperative use of HAC and PVC significantly reduces the recurrence rate and improves survival.