Treatment of hepatocellular carcinoma in patients with portal vein tumor thrombosis: Beyond the known frontiers

作     者：Lucia Cerrito Brigida Eleonora Annicchiarico Roberto Iezzi Antonio Gasbarrini Maurizio Pompili Francesca Romana Ponziani 

作者机构：Division of Internal MedicineGastroenterology and Hepatology UnitFondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Department of Bioimaging and Radiological SciencesInstitute of RadiologyFondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第31期

页      面：4360-4382页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Portal vein tumor thrombosis Sorafenib Systemic chemotherapy Transarterial chemoembolization Transarterial radioembolization Percutaneous ablation therapies Combined therapies Surgery Liver transplantation 

摘      要：Hepatocellular carcinoma is one of the most frequent malignant tumors worldwide:Portal vein tumor thrombosis(PVTT)occurs in about 35%-50%of patients and represents a strong negative prognostic factor,due to the increased risk of tumor spread into the bloodstream,leading to a high recurrence *** this reason,it is a contraindication to liver transplantation and in several prognostic scores sorafenib represents its standard of care,due to its antiangiogenetic action,although it can grant only a poor prolongation of life *** scientific evidences lead to consider PVTT as a complex anatomical and clinical condition,including a wide range of patients with different prognosis and new treatment possibilities according to the degree of portal system involvement,tumor biological aggressiveness,complications caused by portal hypertension,patient’s clinical features and tolerance to antineoplastic *** median survival has been reported to range between 2.7 and 4 mo in absence of therapy,but it can vary from 5 mo to 5 years,thus depicting an extremely variable *** this reason,it is extremely important to focus on the most adequate strategy to be applied to each group of PVTT patients.