Abstract
Management of hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) is complex and requires an understanding of multiple therapeutic options. PVT is present in 10%-40% of HCC at the time of diagnosis, and is an adverse prognostic factor. Management options are limited, as transplantation is generally contraindicated, and surgical resection is only rarely performed in select centers. Systemic medical therapy with sorafenib has been shown to modestly prolong survival. Transarterial chemoembolization has been performed in select cases but has shown a high incidence of complications. Emerging data on treatment of PVT with Y-90 radioembolization suggest that this modality is well-tolerated and associated with favorable overall survival. Current society guidelines do not yet specifically recommend radioembolization for patients with PVT, but this may change with the development of newer staging systems and treatment algorithms. In this comprehensive literature review, we present current and available management options with the relative advantages, disadvantages and contraindications of these treatment options with summarized data on overall survival.
| Original language | English |
|---|---|
| Pages (from-to) | 3462-3471 |
| Number of pages | 10 |
| Journal | World Journal of Gastroenterology |
| Volume | 21 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 2015 Jan 1 |
Fingerprint
Keywords
- Hepatocellular carcinoma
- Management
- Portal vein thrombosis
- Selective internal radiation therapy
- Yttrium 90
ASJC Scopus subject areas
- Gastroenterology
Cite this
Management of hepatocellular carcinoma with portal vein thrombosis. / Quirk, Matthew; Kim, Yun Hwan; Saab, Sammy; Lee, Edward Wolfgang.
In: World Journal of Gastroenterology, Vol. 21, No. 12, 01.01.2015, p. 3462-3471.Research output: Contribution to journal › Review article
}
TY - JOUR
T1 - Management of hepatocellular carcinoma with portal vein thrombosis
AU - Quirk, Matthew
AU - Kim, Yun Hwan
AU - Saab, Sammy
AU - Lee, Edward Wolfgang
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Management of hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) is complex and requires an understanding of multiple therapeutic options. PVT is present in 10%-40% of HCC at the time of diagnosis, and is an adverse prognostic factor. Management options are limited, as transplantation is generally contraindicated, and surgical resection is only rarely performed in select centers. Systemic medical therapy with sorafenib has been shown to modestly prolong survival. Transarterial chemoembolization has been performed in select cases but has shown a high incidence of complications. Emerging data on treatment of PVT with Y-90 radioembolization suggest that this modality is well-tolerated and associated with favorable overall survival. Current society guidelines do not yet specifically recommend radioembolization for patients with PVT, but this may change with the development of newer staging systems and treatment algorithms. In this comprehensive literature review, we present current and available management options with the relative advantages, disadvantages and contraindications of these treatment options with summarized data on overall survival.
AB - Management of hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) is complex and requires an understanding of multiple therapeutic options. PVT is present in 10%-40% of HCC at the time of diagnosis, and is an adverse prognostic factor. Management options are limited, as transplantation is generally contraindicated, and surgical resection is only rarely performed in select centers. Systemic medical therapy with sorafenib has been shown to modestly prolong survival. Transarterial chemoembolization has been performed in select cases but has shown a high incidence of complications. Emerging data on treatment of PVT with Y-90 radioembolization suggest that this modality is well-tolerated and associated with favorable overall survival. Current society guidelines do not yet specifically recommend radioembolization for patients with PVT, but this may change with the development of newer staging systems and treatment algorithms. In this comprehensive literature review, we present current and available management options with the relative advantages, disadvantages and contraindications of these treatment options with summarized data on overall survival.
KW - Hepatocellular carcinoma
KW - Management
KW - Portal vein thrombosis
KW - Selective internal radiation therapy
KW - Yttrium 90
UR - http://www.scopus.com/inward/record.url?scp=84926341363&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84926341363&partnerID=8YFLogxK
U2 - 10.3748/wjg.v21.i12.3462
DO - 10.3748/wjg.v21.i12.3462
M3 - Review article
C2 - 25834310
AN - SCOPUS:84926341363
VL - 21
SP - 3462
EP - 3471
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 12
ER -