Surgical results for hepatocellular carcinoma with bile duct invasion: A clinicopathologic comparison between macroscopic and microscopic tumor thrombus

Minoru Esaki, Kazuaki Shimada, Tsuyoshi Sano, Yoshihiro Sakamoto, Tomoo Kosuge, Hidenori Ojima

Research output: Contribution to journalArticle

30 Citations (Scopus)


Background: The aim of this study was to evaluate the prognostic factors and long-term results after surgery in patients with hepatocellular carcinoma (HCC) with bile duct invasion. Methods: The records of 38 HCC patients with microscopic (tumor thrombus was found in more than the second order branch of the biliary tree; n = 19) and macroscopic (tumor thrombus was found in no more than the second order branch of the biliary tree; n = 19) bile duct invasion were reviewed in this study. Survival rates were calculated with regard to 18 clinicopathological factors. A log-rank analysis was performed to identify which factors predict the prognosis. The relationships between the degree of bile duct invasion and 17 clinicopathologic factors were also compared. Results: The overall 1-, 3-, and 5-year survival rates were 79%, 45%, and 33%, respectively. The indicators of a favorable prognosis included no intrahepatic metastases, curative surgical resection, and macroscopic bile duct invasion. Conclusion: We found a favorable long-term postoperative result for HCC patients with macroscopic bile duct invasion. Even if HCC tumor thrombus is recognized in the major branches of bile duct, extensive and curative surgical treatment should be recommended when hepatic functional reserve is satisfactory without intrahepatic metastases.

Original languageEnglish
Pages (from-to)226-232
Number of pages7
JournalJournal of Surgical Oncology
Issue number4
Publication statusPublished - 2005 Jun 15
Externally publishedYes



  • Bile duct tumor thrombus
  • Hepatocellular carcinoma
  • Surgical resection

ASJC Scopus subject areas

  • Surgery
  • Oncology

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