Chemoembolization for Unresectable Hepatocellular Carcinoma in Patients with or Without Portal Vein Thrombosis

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

Methodology: 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.

Results: 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.

Conclusions: 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.