Study of Combined Metallic Stent, Portal Vein Chemotherapy and Transcatheter Arterial Chemoemboization in Hepatocellular Carcinoma with Portal Vein Tumor Thrombi

Objective To evaluate the effect of combined metallic stent, portal vein chemotherapy (PVC) and transcatheter arterial chemoemboization (TACE) in treatment of hepatocellular carcinomas (HCC) with portal vein tumor thrombi.Methods Arteriography was performed to assess the feeding vessels and portal vein tumor thrombi. The stent was placed within the portal vein through transcutaneous and transhepatic direct puncture of the portal vein. Chemotherapy drugs, antitumor vascular therapy drugs by targeting the vascular endothelial growth factor, and embolic agents were then injected into the tumors and the feeding vessels through the portal vein and hepatic artery. Results In 12 patients with advanced tumors, the median period of the stent keeping patent was 5 months ranging from 2 months to 22 months. The 3-month survival rate, 6-month survival rate, 12-month survival rate, and survival rate up to 12 months was 91.7%, 83.3%, 50% and 25%, respectively. Conclusions Combined metallic stent, PVC and TACE could be an effective method for patients with HCC with portal vein tumor thrombi.