Hepatocellular Carcinoma With Cirrhosis: Are Patients With Neoplastic Main Portal Vein Invasion Eligible for Percutaneous Radiofrequency Ablation of Both the Nodule and the Portal Venous Tumor Thrombus?

2009 ◽  
Vol 193 (4) ◽  
pp. 948-954 ◽  
Author(s):  
Antonio Giorgio ◽  
Antonella Di Sarno ◽  
Giorgio de Stefano ◽  
Nunzia Farella ◽  
Umberto Scognamiglio ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Portal Vein ◽  
Tumor Thrombus ◽  
Percutaneous Radiofrequency Ablation ◽  
Main Portal Vein ◽  
Portal Vein Invasion ◽  
Venous Tumor Thrombus

scholarly journals Transarterial Chemoembolization in Unresectable Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: A Tertiary Care Center Experience

2021 ◽  
Author(s):  
Yashwant Patidar ◽  
Amar Mukund ◽  
Shiv K. Sarin ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prognostic Factors ◽  
Liver Function ◽  
Portal Vein ◽  
Transarterial Chemoembolization ◽  
Tumor Thrombus ◽  
Portal Vein Tumor Thrombosis ◽  
Main Portal Vein ◽  
Portal Vein Invasion ◽  
Tumor Thrombosis

Abstract Background Portal vein tumor thrombosis (PVTT) is a common complication of hepatocellular carcinoma (HCC) occurring in 30 to 40% of cases. The presence of PVTT in HCC is regarded as an advanced disease that confers poor prognosis and survival. Transarterial chemoembolization (TACE) has traditionally been considered to be contraindicated in cases of PVTT, due to the risk of hepatic infarction, and further deteriorate liver function. We evaluated safety, technical efficacy, and outcomes of TACE in HCC with PVTT. Methods From search results of the hospital database, out of 652 patients who underwent TACE for HCC, 73 patients of HCC with PVTT were retrospectively evaluated. Post-TACE tumor response by computed tomography (CT)/magnetic resonance imaging (MRI) imaging as per modified response evaluation criteria in solid tumors (mRECIST) criteria, if any occurrence of acute hepatic failure was assessed. Prognostic factors influencing survival were also determined. Results In our study population, the mean age of the patients was 58 years. The 12- and 24-month survival rates were 59 and 14%, respectively, with an overall median survival of 12.3 months. A total of 58.9% patients had branch portal vein tumor thrombus and 41.1% had tumor thrombus in the main portal vein. We did not encounter any mortality or acute liver failure following TACE in a 30-day period. Both univariate and multivariate analysis revealed Child–Pugh score (p = 0.01) and the extent of tumoral thrombus (p 0.004) as a significant prognostic factor. Patients with branch PVTT, no ascites, and Child–Pugh A had better survival than those having main portal vein tumor thrombus, ascites, and Child–Pugh B. Conclusion Our study concluded that TACE can achieve good disease control and improved survival in HCC with portal vein invasion despite being considered as a relative contraindication. Technical expertise, selection of patients, such as superselective catheterization and preserved liver function, are the key factors for a safe therapeutic procedure. Child–Pugh score and extent of portal vein invasion were the significant prognostic factors determining survival.

Novel Percutaneous Radiofrequency Ablation of Portal Vein Tumor Thrombus: Safety and Feasibility

2012 ◽  
Vol 36 (1) ◽  
pp. 245-248 ◽  
Author(s):  
Malkhaz Mizandari ◽  
Guokun Ao ◽  
Yaojun Zhang ◽  
Xi Feng ◽  
Qiang Shen ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Portal Vein ◽  
Tumor Thrombus ◽  
Portal Vein Tumor Thrombus ◽  
Percutaneous Radiofrequency Ablation
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