Medicine

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Observational Study

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Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus Ninggang Zheng (MS)a, Xiaodong Wei (BS, Med)b, Dongzhi Zhang (MS)b, Wenxiao Chai (MS)a, Ming Chea, ∗ Jiangye Wang (MS)a, Binbin Du (MS)c, Abstract The role of hepatic resection in hepatocellular carcinoma (HCC) with accompanying portal vein tumor thrombus (PVTT) remains controversial. This study aimed to evaluate the surgical outcomes of hepatic resection compared with those of transarterial chemoembolization (TACE) in HCC patients. A retrospective study was conducted using the medical records of 230 HCC patients with portal vein invasion who underwent hepatic resection (96 patients) or TACE (134 patients). The baseline characteristics, tumor characteristics, clinicopathological parameters, and overall survival rates were compared between the 2 groups. The baseline and tumor characteristics were comparable between the hepatic resection and TACE groups. The overall complication rate was 35.4% in the hepatic resection group, which was significantly lower than that in the TACE group (73.0%, P 10 cm) AFP level ≥400 ng/mL (yes/no) Tumor location (edge/center) PVTT type (I/II/III/IV) NLR ≥4 (yes/no) Creatinine level ≥100 mmol/L (yes/no) ALB level ≥35 g/L (yes/no) Hb level ≥120 g/L (yes/no) PLT level ≥100  109/L (yes/no) Treatment protocol (resection/TACE)

Overall survival rate P value

N 75/155 173/57 31/199 218/12 203/27 143/87 129/101 176/54 142/88 200/30 167/63 184/46 114/116 101/129 56/55/56/63 141/89 24/206 159/71 156/74 148/82 96/134

0.273 0.518 0.402 0.448 0.589 0.688 0.313 0.748 0.349 0.603 0.884 0.024

Hepatic resection or transarterial chemoembolization for hepatocellular carcinoma with portal vein tumor thrombus.

The role of hepatic resection in hepatocellular carcinoma (HCC) with accompanying portal vein tumor thrombus (PVTT) remains controversial. This study ...
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