Surgical treatment of hepatocellular carcinoma with portal vein tumor thrombi

Objective To evaluate the effects of continous portal vein infusion chemotherapy combined with hepatectomy for treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombi(PVTT) during operation.Methods From Apr 2001 to Apr 2004, 38 patients with HCC and PVTT were randomly divided into two groups:19 patients(group A) received continous portal vein infusion chemotherapy combined with hepatectomy, and removal of tumor thrombi;19 patients(group B) underwent only hepatectomy and removal of tumor thrombi. After operation, the two groups had treatment with hepatic artery chemotherapy (HAC) and / or portal vein chemotherapy(PVC).Results The AFP negative rate of group A at 7 d and 30 d after operation was significantly higher than that of group B(P0.05). The 1- and 3-year recurrence rate of group A was significantly lower than that of group B (P0.05), and the 1- and 3-year survival rate of group A was significantly higher than that of group B (P0.05).Conclusions Continuous portal vein chemotherapy with hepatectomy and removal of tumor thrombi during operation, and postoperative HAC with or without PVC is an effective approach for treatment of HCC with poratal vein tumor thrombi.