Abstract

Background

Hepatocellular carcinoma (HCC) with tumour thrombus (TT) in the inferior vena cava (IVC) or right atrium (RA) is a rare advanced disease state with a poor prognosis. The aim of this study was to examine survival after surgical resection.

Methods

Patients with HCC and TT of either the IVC or RA, who underwent liver resection between February 1997 and July 2017, were included. Their short‐ and long‐term outcomes and surgical details were analysed retrospectively.

Results

Thirty‐seven patients were included; 16 patients had TT in the IVC below the diaphragm, eight had TT in the IVC above the diaphragm, and 13 had TT entering the RA. Twelve patients had advanced portal vein TT (portal vein invasion (Vp) greater than Vp3 and Vp4), ten had bilobar disease, and 12 had extrahepatic disease. There were no in‐hospital deaths, although two patients died within 90 days. Median survival did not differ between patients who had resection with curative intent (18·7 months) and those with residual tumour in the lung only (20·7 months), but survival was poor for patients with residual tumour in the liver (8·3 months).

Conclusion

Liver resection with thrombectomy for advanced HCC with TT in the IVC or RA is safe and feasible, leading to moderate survival.

Details

Title
Liver resection with thrombectomy for patients with hepatocellular carcinoma and tumour thrombus in the inferior vena cava or right atrium
Author
Matsukuma, S 1   VIAFID ORCID Logo  ; Eguchi, H 2   VIAFID ORCID Logo  ; Wada, H 3 ; Noda, T 2 ; Shindo, Y 1 ; Tokumitsu, Y 1 ; Matsui, H 1 ; Takahashi, H 3 ; Kobayashi, S 2 ; Nagano, H 1 

1  Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan 
2  Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan 
3  Department of Digestive Surgery, Osaka International Cancer Institute, Osaka, Japan 
Pages
241-251
Section
Original articles
Publication year
2020
Publication date
Apr 2020
Publisher
Oxford University Press
e-ISSN
24749842
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1002/bjs5.50258
ProQuest document ID
2382000301
Copyright
© 2020. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.