Management of hepatocellular carcinoma with portal vein thrombosis

Matthew Quirk, Yun Hwan Kim, Sammy Saab, Edward Wolfgang Lee

Research output: Contribution to journalReview article

50 Citations (Scopus)

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 languageEnglish
Pages (from-to)3462-3471
Number of pages10
JournalWorld journal of gastroenterology
Volume21
Issue number12
DOIs
Publication statusPublished - 2015 Mar 28

Keywords

  • Hepatocellular carcinoma
  • Management
  • Portal vein thrombosis
  • Selective internal radiation therapy
  • Yttrium 90

ASJC Scopus subject areas

  • Gastroenterology

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