Resectable Hepatocellular Carcinoma With Portal Vein Tumor Thrombus Clinical Trial
Official title:
Efficacy of Preoperative Transarterial Chemoembolization for Resectable Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis: A Prospective Non-Randomized Comparative Study
Whether preoperative transarterial chemoembolization can prolong survival for the resectable hepatocellular carcinoma remains controversial, particularly in patients with portal vein tumor thrombi. This study designs to systematically identify and summarize the effect of preoperative TACE for resectable HCC with portal venous invasion.
With various improvements in interventional radiology, since the 2005 practice guidelines
issued by the American Association for the Study of Liver Diseases , transcatheter arterial
chemoembolization has become one of the available locoregional therapies for HCC.
Transcatheter arterial chemoembolization, which generally performed in intermediate-stage HCC
patients, involves injection of an embolizing agent into the hepatic artery to deprive the
tumor of its major nutrient source via embolization of the nutrient artery, resulting in
ischemic necrosis of the tumor. To prevent intrahepatic recurrence due to portal vein
invasion of the HCC tumor, therapeutic strategies such as preoperative TACE, and
postoperative adjuvant chemotherapy have been tried. According to the latest and the most
powerful evidence, however, preoperative TACE is not routinely recommended for patients
undergoing hepatectomy to treat resectable HCC , and TACE may delay surgical treatment or
decrease the resection volume of the liver, or it also may create a missed opportunity for
surgical treatment.
Rather than subject all these patients to such an invasive procedure and put them at risk for
missing opportunity for surgical treatment, it may be better to select optimal candidates to
receive surgical resection. Recent studies have even shown favorable long-term survival
outcomes of HR in well-selected cases of HCC with PVTT. About whether preoperative
transarterial chemoembolization is available for the resectable hepatocellular carcinoma with
portal vein tumor thrombi, so far, has hardly been reported.
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