Liver resection for hepatocellular carcinoma associated with hepatic vein invasion

A Japanese nationwide survey

Takashi Kokudo, Kiyoshi Hasegawa, Yutaka Matsuyama, Tadatoshi Takayama, Namiki Izumi, Masumi Kadoya, Masatoshi Kudo, Shoji Kubo, Michiie Sakamoto, Osamu Nakashima, Takashi Kumada, Norihiro Kokudo

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Because of the rarity of hepatic vein tumor thrombus (HVTT) compared with portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma, little is known about this disease entity. The aim of this study was to evaluate the prognosis of each treatment modality for HVTT through an analysis of data collected in a Japanese nationwide survey. We analyzed data for 1,021 Child-Pugh A hepatocellular carcinoma patients with HVTT without inferior vena cava invasion registered between 2000 and 2007. Of these patients, 540 who underwent liver resection (LR) and 481 who received other treatments were compared. Propensity scores were calculated, and we successfully matched 223 patients (49.0% of the LR group). The median survival time in the LR group was 2.89 years longer than that in the non-LR group (4.47 versus 1.58 years, P < 0.001) and 1.61 years longer than that in the non-LR group (3.42 versus 1.81 years, P = 0.023) in a propensity score-matched cohort. After curative resection, median survival times were similar between patients with HVTT in the peripheral hepatic vein and those with HVTT in the major hepatic vein (4.85 versus 4.67 years, P = 0.974). In the LR group, the postoperative 90-day mortality rate was 3.4% (16 patients). In patients without PVTT, the median survival time was significantly better than that in patients with PVTT (5.67 versus 1.88 years, P < 0.001). Conclusion: LR is associated with a good prognosis in hepatocellular carcinoma patients with HVTT, especially in patients without PVTT.

Original languageEnglish
JournalHepatology
DOIs
Publication statusAccepted/In press - 2017

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Hepatic Veins
Hepatocellular Carcinoma
Thrombosis
Liver
Neoplasms
Portal Vein
Propensity Score
Survival
Surveys and Questionnaires
Inferior Vena Cava

ASJC Scopus subject areas

  • Hepatology

Cite this

Kokudo, T., Hasegawa, K., Matsuyama, Y., Takayama, T., Izumi, N., Kadoya, M., ... Kokudo, N. (Accepted/In press). Liver resection for hepatocellular carcinoma associated with hepatic vein invasion: A Japanese nationwide survey. Hepatology. https://doi.org/10.1002/hep.29225

Liver resection for hepatocellular carcinoma associated with hepatic vein invasion : A Japanese nationwide survey. / Kokudo, Takashi; Hasegawa, Kiyoshi; Matsuyama, Yutaka; Takayama, Tadatoshi; Izumi, Namiki; Kadoya, Masumi; Kudo, Masatoshi; Kubo, Shoji; Sakamoto, Michiie; Nakashima, Osamu; Kumada, Takashi; Kokudo, Norihiro.

In: Hepatology, 2017.

Research output: Contribution to journalArticle

Kokudo, T, Hasegawa, K, Matsuyama, Y, Takayama, T, Izumi, N, Kadoya, M, Kudo, M, Kubo, S, Sakamoto, M, Nakashima, O, Kumada, T & Kokudo, N 2017, 'Liver resection for hepatocellular carcinoma associated with hepatic vein invasion: A Japanese nationwide survey', Hepatology. https://doi.org/10.1002/hep.29225
Kokudo, Takashi ; Hasegawa, Kiyoshi ; Matsuyama, Yutaka ; Takayama, Tadatoshi ; Izumi, Namiki ; Kadoya, Masumi ; Kudo, Masatoshi ; Kubo, Shoji ; Sakamoto, Michiie ; Nakashima, Osamu ; Kumada, Takashi ; Kokudo, Norihiro. / Liver resection for hepatocellular carcinoma associated with hepatic vein invasion : A Japanese nationwide survey. In: Hepatology. 2017.
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abstract = "Because of the rarity of hepatic vein tumor thrombus (HVTT) compared with portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma, little is known about this disease entity. The aim of this study was to evaluate the prognosis of each treatment modality for HVTT through an analysis of data collected in a Japanese nationwide survey. We analyzed data for 1,021 Child-Pugh A hepatocellular carcinoma patients with HVTT without inferior vena cava invasion registered between 2000 and 2007. Of these patients, 540 who underwent liver resection (LR) and 481 who received other treatments were compared. Propensity scores were calculated, and we successfully matched 223 patients (49.0{\%} of the LR group). The median survival time in the LR group was 2.89 years longer than that in the non-LR group (4.47 versus 1.58 years, P < 0.001) and 1.61 years longer than that in the non-LR group (3.42 versus 1.81 years, P = 0.023) in a propensity score-matched cohort. After curative resection, median survival times were similar between patients with HVTT in the peripheral hepatic vein and those with HVTT in the major hepatic vein (4.85 versus 4.67 years, P = 0.974). In the LR group, the postoperative 90-day mortality rate was 3.4{\%} (16 patients). In patients without PVTT, the median survival time was significantly better than that in patients with PVTT (5.67 versus 1.88 years, P < 0.001). Conclusion: LR is associated with a good prognosis in hepatocellular carcinoma patients with HVTT, especially in patients without PVTT.",
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T1 - Liver resection for hepatocellular carcinoma associated with hepatic vein invasion

T2 - A Japanese nationwide survey

AU - Kokudo, Takashi

AU - Hasegawa, Kiyoshi

AU - Matsuyama, Yutaka

AU - Takayama, Tadatoshi

AU - Izumi, Namiki

AU - Kadoya, Masumi

AU - Kudo, Masatoshi

AU - Kubo, Shoji

AU - Sakamoto, Michiie

AU - Nakashima, Osamu

AU - Kumada, Takashi

AU - Kokudo, Norihiro

PY - 2017

Y1 - 2017

N2 - Because of the rarity of hepatic vein tumor thrombus (HVTT) compared with portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma, little is known about this disease entity. The aim of this study was to evaluate the prognosis of each treatment modality for HVTT through an analysis of data collected in a Japanese nationwide survey. We analyzed data for 1,021 Child-Pugh A hepatocellular carcinoma patients with HVTT without inferior vena cava invasion registered between 2000 and 2007. Of these patients, 540 who underwent liver resection (LR) and 481 who received other treatments were compared. Propensity scores were calculated, and we successfully matched 223 patients (49.0% of the LR group). The median survival time in the LR group was 2.89 years longer than that in the non-LR group (4.47 versus 1.58 years, P < 0.001) and 1.61 years longer than that in the non-LR group (3.42 versus 1.81 years, P = 0.023) in a propensity score-matched cohort. After curative resection, median survival times were similar between patients with HVTT in the peripheral hepatic vein and those with HVTT in the major hepatic vein (4.85 versus 4.67 years, P = 0.974). In the LR group, the postoperative 90-day mortality rate was 3.4% (16 patients). In patients without PVTT, the median survival time was significantly better than that in patients with PVTT (5.67 versus 1.88 years, P < 0.001). Conclusion: LR is associated with a good prognosis in hepatocellular carcinoma patients with HVTT, especially in patients without PVTT.

AB - Because of the rarity of hepatic vein tumor thrombus (HVTT) compared with portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma, little is known about this disease entity. The aim of this study was to evaluate the prognosis of each treatment modality for HVTT through an analysis of data collected in a Japanese nationwide survey. We analyzed data for 1,021 Child-Pugh A hepatocellular carcinoma patients with HVTT without inferior vena cava invasion registered between 2000 and 2007. Of these patients, 540 who underwent liver resection (LR) and 481 who received other treatments were compared. Propensity scores were calculated, and we successfully matched 223 patients (49.0% of the LR group). The median survival time in the LR group was 2.89 years longer than that in the non-LR group (4.47 versus 1.58 years, P < 0.001) and 1.61 years longer than that in the non-LR group (3.42 versus 1.81 years, P = 0.023) in a propensity score-matched cohort. After curative resection, median survival times were similar between patients with HVTT in the peripheral hepatic vein and those with HVTT in the major hepatic vein (4.85 versus 4.67 years, P = 0.974). In the LR group, the postoperative 90-day mortality rate was 3.4% (16 patients). In patients without PVTT, the median survival time was significantly better than that in patients with PVTT (5.67 versus 1.88 years, P < 0.001). Conclusion: LR is associated with a good prognosis in hepatocellular carcinoma patients with HVTT, especially in patients without PVTT.

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DO - 10.1002/hep.29225

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