Objective: To evaluate the benefit of typing of tumor thrombi in determining treatment plan and assessing prognosis of hepatocellular carcinoma (HCC) with tumor thrombi in the portal vein.
Methods: The clinical data of 84 patients of HCC with portal vein tumor thrombi admitted from Jan. 2000 to Jan. 2003 were analyzed retrospectively. The patients, 75 males and 9 females, aged 47 (28 - 70), were divided into 4 groups, groups I - IV, according to imaging examination of the tumor thrombi. The median survival periods and effectiveness of treatment, including surgical resection and non-surgical treatment, were observed.
Results: The surgical resection rates were 64.7%, 83.8%, 31.4%, and 0 in the groups I - IV respectively (P = 0.912). The general median survival period of the patients undergoing surgery was 8.0 months, significantly longer than that of the patients receiving non-surgical treatment (4.0 months, P = 0.000 6). In different group of tumor thrombi type, the general median survival period of the patients undergoing surgery was significantly longer than that of the patients receiving non-surgical treatment. The median survival periods were 10.1, 7.2, 5.7 and 3.0 months for groups I (n = 17), II (n = 26), III (n = 35) and groups IV (n = 6) respectively, with significant difference between any 2 groups (all P = 0.000 1).
Conclusion: Typing of tumor thrombi helps determine the treatment plan and assess the prognosis of hepatocellular carcinoma patients with tumor thrombi in the portal vein.