Treatments of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus:Current Status and Controversy

The proportions of patients with hepatocellular carcinoma(HCC)involving portal vein tumor thrombus(PVTT)varies greatly in different countries or regions,ranging from 13%to 45%.The treatment regimens for PVTT recommended by HCC guidelines in different countries or regions also vary greatly.In recent years,with the progress and development of surgical concepts,radiotherapy techniques,systematic therapies(for example,VEGF inhibitors,tyrosine kinase inhibitors and immune checkpoint inhibitors),patients with HCC involving PVTT have more treatment options and their prognoses have been significantly improved.To achieve the maximum benefit,both clinicians and patients need to think rationally about the indications of treatment modalities,the occurrence of severe adverse events,and the optimal fit for the population.In this review,we provide an update on the treatment modalities available for patients with HCC involving PVTT.Trials with large sample size for patients with advanced or unresectable HCC are also reviewed.

Analysis of Clinicopathological Characteristics and Prognosis of Young Patients with Hepatocellular Carcinomaafter Hepatectomy

Background and Aims:This study was designed to analyze the effects of age and clinicopathological characteristics on prognosis of Chinese patients with hepatocellular carcinoma(HCC).Methods:The clinical data of 2032 HCC patients who were first diagnosed with HCC and underwent curative hepatectomy in our hospital between January 2006 and January 2011 were retrospectively analyzed.Results:Younger HCC patients(age<40 years,n=465)had a significantly higher hepatitis B infection rate,larger tumors,higher alpha-fetoprotein levels,higher preoperative liver function,and more frequent vascular invasions than older patients.Most younger patients were suitable for anatomical hepatectomy,and their tumors were found to be at a highly advanced stage.The recurrence-free survival and overall survival rates of younger HCC patients were significantly worse than those of older patients but this difference disappeared after propensity score matching.Multivariate analysis of pre-matched samples showed that age≤40 years was one of the independent risk factors associated with poor overall survival.Conclusions:Younger patients showed different clinicopathological characteristics than older patients,such as higher rates of hepatitis B infection and advanced tumors.The recurrence-free survival and overall survival rates of younger HCC patients after hepatectomy may be similar to those of older patients.