Among different treatment approaches for liver cancer with tumor invasion into the portal vein, the most comprehensive strategy combining surgery, post-operative chemoembolization, and thymosin alpha-1 yielded the best outcomes, with a 44.4% one-year survival rate. This compared favorably to surgery with chemoembolization alone (15%), surgery alone (14.3%), chemoembolization only (10.5%), and conservative treatment (0%).
Abstract
OBJECTIVE: To investigate the effects of different treatments for hepatocellular carcinoma (HCC) with tumor thrombus in the portal vein (PVTT).
METHODS: From Jan. 2000 to Jan. 2003, a total of 84 HCC patients with PVTT were divided into five groups based on methed of treatment: Group A (n = 9), HCC resection + PVTT removal + postoperative TACE + thymosin alpha(1); Group B (n = 20), HCC resection + PVTT removal + postoperative TACE; Group C (n = 7), HCC resection + PVTT removal; Group D (n = 38), TACE only; Group E (n = 10), conservative treatment only.
RESULTS: The rate of PVTT shrinkage or disappearance of groups A, B, C, D and E was 66.7%, 70.0%, 57.1%, 7.9% and 0, respectively with respective median survival time of 10.0, 7.0, 8.0, 5.0 and 2.0 months. The one year survival rate was 44.4%, 15.0%, 14.3%, 10.5% and 0.
CONCLUSION: Resection of HCC and removal of tumor thrombus in the portal vein may have the tumor thrombus cleared in most of the patients and postoperative TACE and thymisin alpha(1) treatment may improve their survival.