Chemoembolization for unresectable hepatocellular carcinoma in patients with or without portal vein thrombosis

Chemoembolization in the presence of portal vein thrombosis (PVT) is thought to be hazardous and such patients are regarded as prognostically poor.

One hundred sixty two patients with biopsy-proven and unresectable HCC were treated with chemoembolization (TACE). We retrospectively analyzed these patients according to presence or absence of PVT.

We found the 2 groups were similar with respect to tumor and liver parameters. Survival was 22.3 months in responders and 6.6 months in non-responders, p < or = 0.0001. Patients with PVT who responded had a 24 mo median survival and without PVT who responded had a 30 month median survival. These 2 groups were thus similar, p = 0.817. Patients who did not respond had a survival of only 5 and 7 months, for presence or absence of PVT, respectively. Responders had significantly lower blood AFP and GGTP levels, lower DCP levels and better liver function.

In this series, response was a major determinant of survival, regardless of the presence or absence of PVT. Thus, branch PVT was not a contraindication to chemoembolization.