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Updated: Oct 31, 2025
Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Twelve-Year Survival After Resection of Hepatocellular Carcinoma with Right Atrial Tumor Thrombus
Sadiq S Sikora1, Kishore G S Bharathy2, Prasad Krishnan3
1Department of Surgical Gastroenterology & Liver Transplantation, Sakra World Hospital, Bangalore, India. drsadiqs@gmail.com.
Insights
Aggressive surgical resection of hepatocellular carcinoma (HCC) with right atrial tumor thrombus can lead to long-term survival. This case highlights successful treatment for advanced HCC, offering hope for similar complex presentations.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Cardiovascular Surgery
Background:
- Hepatocellular carcinoma (HCC) with macrovascular invasion typically carries a poor prognosis.
- Patients with advanced HCC and right atrial tumor thrombus are often limited to palliative care options.
Introduction:
A large hepatocellular carcinoma (HCC) with macrovascular invasion is generally considered to have poor prognosis due to unfavorable tumor biology andsuch patients are relegated to palliative options. This report describes long term survival after surgery in a patient with HCC and tumor thrombus in the rightatrium.
Methods:
Case records of the patient, details of follow up visits and surveillance computed tomography scans performed were reviewed. A brief discussion of thesurgical strategy adopted along with outcome of similar cases in literature is presented.
Results:
A 60 year old man presented with a HCC in segments 4, 5 with extension of tumor into the middle, left hepatic veins, inferior vena cava and right atrium.Patient underwent extraction of the tumor thrombus from the right atrium under cardiopulmonary bypass along with extended left hepatectomy. He receivedthree cycles of adjuvant chemotherapy with Gemcitabine, Oxaliplatin and Interferon. There was a parietal wall recurrence after 1 year and 10 months whichwas excised. Since then he remains well and is on regular follow up for more than 12 years from his index surgery with no evidence of disease, making himthe longest known survivor with such an advanced presentation.
Conclusion:
This is an unusual instance where aggressive resection for HCC with right atrial tumor thrombus has resulted in an exceptionally long survival.
