Jung Min Lee, Byoung Kuk Jang, Yoo Jin Lee, Wang Yong Choi, Sei Myong Choi, Woo Jin Chung, Jae Seok Hwang, Koo Jeong Kang, Young Hwan Kim, Anil Kumar Chauhan, Soo Young Park, Won Young Tak, Young Oh Kweon, Byung Seok Kim, Chang Hyeong Lee
Clin Mol Hepatol 2016;22(1):160-167. Published online March 28, 2016
Background/Aims Treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) remains controversial. We compared the outcomes of hepatic resection (HR), transarterial chemoembolization (TACE), and sorafenib therapy as treatments for HCC with PVTT.
Methods Patients diagnosed as HCC with PVTT between January 2000 and December 2011 who received treatment with sorafenib, HR, or TACE were included. Patients with main PVTT, superior mesenteric vein tumor thrombosis, or Child-Turcotte-Pugh (CTP) class C were excluded. The records of 172 patients were analyzed retrospectively. HR, TACE, and sorafenib treatment were performed is 40, 80, and 52 patients respectively. PVTT was classified as either involving the segmental branch (type I) or extending to involve the right or left portal vein (type II).
Results The median survival time was significantly longer in the HR group (19.9 months) than in the TACE and sorafenib groups (6.6 and 6.2 months, respectively; both P<0.001), and did not differ significantly between the latter two groups (P=0.698). Among patients with CTP class A, type I PVTT or unilobar-involved HCC, the median survival time was longer in the HR group than in the TACE and sorafenib groups (P=0.006). In univariate analyses, the initial treatment method, tumor size, PVTT type, involved lobe, CTP class, and presence of cirrhosis or ascites were correlated with overall survival. The significant prognostic factors for overall survival in Cox proportional-hazards regression analysis were initial treatment method (HR vs. TACE: hazard ratio=1.750, P=0.036; HR vs. sorafenib: hazard ratio=2.262, P=0.006), involved lobe (hazard ratio=1.705, P=0.008), PVTT type (hazard ratio=1.617, P=0.013), and CTP class (hazard ratio=1.712, P=0.012).
Conclusions Compared with TACE or sorafenib, HR may prolong the survival of patients with HCC in cases of CTP class A, type I PVTT or unilobar-involved HCC.
Citations
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Seung Kew Yoon, M.D., Chan Kwon Jung, M.D.1, Eun Sun Jung, M.D.1
Korean J Hepatol 2008;14(4):525-531. Published online December 31, 2008
Epithelioid hemangioendothelioma is a neoplasm of vascular origin with a low-to-intermediate malignant potential and is one of the rare sarcomas arising from the liver. Its etiology is unknown and its clinical outcome is unpredictable. There is no generally accepted therapeutic strategy because of its rarity and the variable natural course between hemangioma and angiosarcoma. We report a case of a 64-year old woman who underwent hepatic resection due to epithelioid hemangioendothelioma in the right lobe that progressed to extrahepatic metastases of the bone, pleura, and peritoneum 22 months later. However, after resection there was no primary hepatic recurrence. (Korean J Hepatol 2008;14:525-531)
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