Malignant portal vein thrombosis is a contraindication to liver transplantation for hepatocellular carcinoma because of the high
risk of its recurrence and the poor patient survival. With a newly developed immunosuppressant and a chemotherapeutic agent,
however, living donor liver transplantation can be considered for a patient of hepatocellular carcinoma, showing a slow growth
rate and good response for transarterial chemoembolization. We report a HBV related liver cirrhosis patient with HCC and portal
vein tumor thrombus who underwent living donor liver transplantation and survived without recurrence of hepatocellular
carcinoma for 18 months in our center.
A case of hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT) which was performed hepatectomy after
down-staging by proton therapy is reviewed. Generally, the recommended therapeutic strategy for this kind of HCC is radiation
therapy, systemic or infusion anticancer chemotherapy. However, the response of HCC and its PVTT of this 56 year-old male
patient was relatively good after 22 times of proton therapy, and we performed right hemihepatectomy on the concept of clinical
trial under the informed consent of patient and his families. He is still alive without recurrence 15 months after hepatectomy. We
suggest that hemihepatectomy with removal of PVTT could be an alternative strategy in the PVTT accompanied HCC cases who
show good responses after the above generally recommended therapies.
Jong Kyu Park, Young Seok Kim, Sang Gyune Kim, Seung Won Jeong, Jae Young Jang, Hyun Jong Choi, Jong Ho Moon, Hong Soo Kim, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim
Journal of the Korean Liver Cancer Study Group. 2009;9(1):49-52. Published online June 30, 2009
Recent progress in imaging techniques has permitted the diagnosis of hepatocelluar carcinoma (HCC) at an early stage.
However, portal vein invasion is still found in 12.5~39.7%. HCC with tumor thrombosis of the portal vein has a poor
prognosis. Previous studies showed that the median survival time of patients with HCC with involving portal vein was 2.7~4
months if effective treatment was not administered. Thus, for such HCC with portal vain invasion, an effective therapy that
will maintain quality of life is required. We report a case of HCC with portal vein tumor thrombus treated by intra-arterial
chemotherapy.