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논문 기본 정보

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학술저널
저자정보
Chang Young (Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea) Yu Su Jong (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Kim Hyo-Cheol (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.) Lee Yun Bin (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Cho Eun Ju (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Lee Jeong-Hoon (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Kim Yoon Jun (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Chung Jin Wook (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.) Yoon Jung-Hwan (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea)
저널정보
거트앤리버 발행위원회 Gut and Liver Gut and Liver Vol.18 No.1
발행연도
2024.1
수록면
156 - 164 (9page)
DOI
10.5009/gnl230057

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Background/Aims: This study aimed to assess whether hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) could have favorable prognoses with proper treatment under selective conditions. Methods: This retrospective, single-center study involved 1,168 patients diagnosed with HCC between January 2005 and December 2006, before the introduction of sorafenib. Overall survival (OS) was estimated using the Kaplan-Meier method, and the Cox proportional hazards model was used to identify and adjust the variables associated with OS. Results: In nodular-type HCC, the OS differed significantly according to the presence of PVTT (log-rank p<0.001), and the level of PVTT, not only its presence, was a major independent factor affecting OS. PVTT at the Vp1-3 branch was associated with significantly longer OS than was PVTT at the Vp4 level (hazard ratio [HR], 1.82; 95% confidence interval [CI], 1.04 to 3.21). In multivariate analysis, the OS was further stratified according to the PVTT level and tumor type, representing that nodular HCC without PVTT exhibited the best OS, whereas nodular HCC with Vp4 PVTT (adjusted HR, 2.59; 95% CI, 1.57 to 4.28) showed a poor prognosis similar to that of infiltrative HCC. The PVTT level was consistently correlated with OS in patients treated with transarterial chemoembolization. Nodular HCC without PVTT showed the best prognosis, while nodular HCC with Vp1-3 PVTT also exhibited a favorable OS, although inferior to that without PVTT (adjusted HR, 1.47, 95% CI, 0.92 to 2.36). Conclusions: Active treatment such as transarterial chemoembolization can be considered for selected PVTT cases. The level of PVTT and type of HCC were independent prognostic factors.
#Hepatocellular carcinoma #Thrombosis #Therapeutic chemoembolization

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