Comprehensive interventional treatment of hepatocellular carcinoma with portal vein tumor thrombosis

• Main Author: ZHU Xiaoli
• Format: Article
• Language: zho
• Published: Editorial Department of Journal of Clinical Hepatology 2015-06-01
• Series: Linchuang Gandanbing Zazhi
• Subjects: carcinoma; hepatocellular；portal vein tumor thrombosis; combined modality therapy
• Online Access: http://www.lcgdbzz.org/qk_content.asp?id=6552&ClassID=58143821

Portal vein tumor thrombosis (PVTT) often occurs in advanced hepatocellular carcinoma (HCC) patients. PVTT may cause tumor dissemination, liver failure, and portal hypertension, thus leading to intractable ascites, variceal rupture, and hepatic encephalopathy, which will result in a poor prognosis. According to the Barcelona Clinic Liver Cancer Staging System, sorafenib is recommended as the first-line treatment for advanced HCC with PVTT, but its application in China has been limited due to its mild efficacy and high price. Nowadays, interventional treatment is widely used in the treatment of advanced HCC with PVTT due to the advantages of minimal invasiveness and repeatability and shows good efficacy. At present, the main methods of interventional treatment include hepatic arterial infusion chemotherapy, transcatheter arterial chemoembolization (TACE), TACE combined with sorafenib, TACE combined with ablation, TACE combined with three-dimensional conformal radiotherapy, TACE combined with portal vein stent placement, endovascular implantation of iodine-125 seeds strand, and transjugular intrahepatic portosystemic shunt. It is pointed out that multimodality treatment is expected to achieve good efficacy in the treatment of advanced HCC with PVTT.