The impact of portal vein tumor thrombus on long-term survival after liver resection for primary hepatic malignancy

Fan Zhang; Chong-De Lu; Xiu-Ping Zhang; Zhen-Hua Chen; Cheng-Qian Zhong; Yi-Ren Hu; Xu-Biao Wei; Bin Zhou; Kang Wang; Zong-Tao Chai; Meng-Chao Wu; Wan Y Lau; Shu-Qun Cheng

doi:10.1016/j.hpb.2019.10.2439

The impact of portal vein tumor thrombus on long-term survival after liver resection for primary hepatic malignancy

HPB (Oxford). 2020 Jul;22(7):1025-1033. doi: 10.1016/j.hpb.2019.10.2439. Epub 2019 Nov 13.

Authors

Fan Zhang¹, Chong-De Lu², Xiu-Ping Zhang³, Zhen-Hua Chen², Cheng-Qian Zhong⁴, Yi-Ren Hu⁵, Xu-Biao Wei², Bin Zhou², Kang Wang², Zong-Tao Chai², Meng-Chao Wu², Wan Y Lau⁶, Shu-Qun Cheng⁷

Affiliations

¹ The Medical College of Soochow University, Jiangsu, China; Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
² Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
³ Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China; Department of Hepatobiliary and Pancreatic Surgical Oncology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
⁴ LongYan First Hospital, Affiliated to Fujian Medical University, FuJian, China.
⁵ Department of General Surgery, Wenzhou People's Hospital, Zhejiang, China.
⁶ Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China; Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China.
⁷ The Medical College of Soochow University, Jiangsu, China; Department of Hepatic Surgery VI, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China. Electronic address: [email protected].

PMID: 31732465
DOI: 10.1016/j.hpb.2019.10.2439

Abstract

Background: The aim of this study was to evaluate the effect of portal vein tumor thrombus (PVTT) on the prognosis of patients undergoing liver resection (LR) for primary liver malignancies (PLC).

Methods: The recurrence-free survival (RFS) and overall survival (OS) for patients undergoing LR with and without PVTT for three primary liver malignancies, including hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC) and hepato-cholangio carcinoma (CHC) were compared using the Kaplan-Meier method and Cox regression analysis.

Results: In total, 3775 patients with PLC who underwent LR were included in this study. The incidence of PVTT in patients undergoing LR with HCC, IHC and CHC were 46%, 20%, and 17%, respectively. The median RFS and OS were significantly better for patients with HCC as compared to ICC or CHC (16 vs 11 vs 13 months; 21 vs 16 vs 18 months, respectively; P < 0.001). However, the presence of PVTT resulted in similarly poor RFS and OS in these 3 subgroups of patients (9 vs 8 vs 8 months, P = 0.062; 14 vs 13 vs 12 months, respectively, P = 0.052).

Conclusion: Although the prognosis of patients with PLC varied by histological subtype, once PVTT occurred, survival outcomes after LR were similarly poor across all three subgroups.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bile Duct Neoplasms* / diagnostic imaging
Bile Duct Neoplasms* / surgery
Bile Ducts, Intrahepatic
Carcinoma, Hepatocellular* / surgery
Humans
Liver Neoplasms* / surgery
Portal Vein / diagnostic imaging
Portal Vein / surgery
Retrospective Studies
Thrombosis* / diagnostic imaging
Thrombosis* / etiology
Thrombosis* / surgery