Correspondence to letter to the editor on “Transarterial radioembolization versus tyrosine kinase inhibitor in hepatocellular carcinoma with portal vein thrombosis” Moon Haeng Hur, Yoon Jun Kim Clinical and Molecular Hepatology.2025; 31(1): e93. CrossRef
Locoregional Therapies for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus Ramanpreet Singh, Mina S. Makary Journal of Gastrointestinal Cancer.2025;[Epub] CrossRef
Atezolizumab Plus Bevacizumab for Advanced Hepatocellular Carcinoma with Macroscopic Vascular Invasion: An Inverse Probability of Treatment Weighted Analysis Jihoon Kim, Jin-Hyoung Kim, Byung Soo Im, Gun Ha Kim, Hee Ho Chu, Dong Il Gwon, Ji Hoon Shin, Ju Hyun Shim, Sang Min Yoon, Sehee Kim Cancers.2025; 18(1): 33. CrossRef
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.
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Hwan Hoon Chung, M.D.1, Hong Sik Lee, M.D., Sang Woo Lee, M.D.,
Jai Hyun Choi, M.D.
Korean J Hepatol 2009;15(1):90-95. Published online March 31, 2009
Portal vein invasion is a grave prognostic indicator in the setting of hepatocellular carcinoma (HCC). There is currently no effective method for preventing the invasion of HCC into the main portal vein. We report here a case of advanced HCC with portal vein tumor thrombosis that was effectively treated with percutaneous ethanol injection (PEI), having previously enabled subsequent successive transarterial chemoembolization (TACE). A 60-year-old male patient was diagnosed with a huge HCC, based on computed tomography and angiographic findings. Despite two sessions of TACE, the tumor invaded the right portal vein. PEI was performed on the malignant portal vein thrombosis, and three sessions thereof reduced the extent of tumor thrombi in the portal vein. Successive TACEs were performed to treat the HCC in the hepatic parenchyma. The patient was still living 19 months after the first PEI with no evidence of tumor recurrence, and his liver function remained well preserved. (Korean J Hepatol 2008;15:90-95)
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The safety and efficacy of percutaneous ethanol injection in the treatment of tumor thrombus in advanced hepatocellular carcinoma with portal vein tumor thrombus Bo Sun, Weihua Zhang, Lei Chen, Tao Sun, Yanqiao Ren, Licheng Zhu, Kun Qian, Chuansheng Zheng Abdominal Radiology.2022; 47(2): 858. CrossRef
Chan Ran You, M.D., Jeong Won Jang, M.D., Seok Hui Kang, M.D., Si Hyun Bae, M.D.,
Jong Young Choi, M.D., Seung Kew Yoon, M.D., Ihl Bhong Choi, M.D.1,
Dong Hoon Lee, M.D.2, Ho Jong Chun, M.D.2, Byung Gil Choi, M.D.2
Korean J Hepatol 2007;13(3):378-386. Published online September 20, 2007
Background/Aims The treatment efficacy for advanced hepatocellular carcinoma is poor. This study examined the efficacy and toxicity of 3-dimensional conformal radiotherapy (3D-CRT) in combination with transarterial chemolipiodolization (TACL) for a huge hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods: From March 2001 to November 2004, 49 patients with advanced HCC with PVTT (size>8 cm, modified UICC stage IVa) were enrolled in this retrospective study. Twenty two patients underwent more than 2 cycles of TACL (adriamycin 50 mg/m2, cisplatin 60 mg/m2, 5-fluorouracil 200 mg/m2 every 4-6 weeks) without 3D-CRT, while 27 patients underwent consecutive TACL with 3D-CRT (40-45 Gy for 4-5 weeks) that was started one week after the 1st TACL. The response was assessed by a computed tomography (CT) and the serum alpha-fetoprotein (AFP) level at 1-2 month intervals. Results: The objective response rates in the TACL group and TACL with 3D-CRT group were 18% and 48% at 3 months (P=0.051), and 10.5% and 42% at 6 months (P=0.024) respectively. The median survival time was 13 months and 13.5 months in TACL and TACL with 3D-CRT groups, respectively (P=0.502). The treatment response was better in the TACL with 3D-CRT group but there was no significant difference in survival between the two groups. Most toxicities in the two groups were mild, not exceeding grade 1 according to the WHO criteria. Conclusions: For patients with a huge HCC with PVTT, TACL with 3D-CRT achieved some meaningful clinical benefit. Prospective controlled trials will be needed to confirm the real benefit of TACL combined with 3D-CRT. (Korean J Hepatol 2007;13:378-386)
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