Case 33441

BackgroundTo investigate the surgical outcome of hepatocellular carcinoma (HCC) patients with biliary tumor thrombi (BTT).MethodsSurgical outcome of 27 HCC patients with BTT (group I) were compared with randomly selected HCC patients without BTT (group II; n = 270).ResultsOne patient in group I died of hepatic failure within 30 days after resection. The 1-, 3- and 5-year cumulative survival rates of group I were 70.3%, 25.9%, and 7.4%, respectively; these were significantly lower than those of group II (90.6%, 54.0%, and 37.7%) (P <0.001). The rates of early recurrence (≤ 1 year) after resection were significantly higher in group I than group II (70.3% vs. 34.8%) (P < 0.001).ConclusionHCC patients with BTT had a worse prognosis after resection than those without BTT. Resection should be considered for these tumors given the lack of effective alternative therapies.

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“…[15] described a single case of HCC invading the gall bladder and obstructing extrahepatic bile ducts. In 1975 Lin et al .…”

Section: Discussionmentioning

confidence: 99%

Surgical outcome of hepatocellular carcinoma patients with biliary tumor thrombi

et al. 2011

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“…Icteric HCC has been rarely reported in the past. In 1947, Clark and Schulz [ 2 ] first reported 12 cases of icteric HCC caused by tumor invasion to extrahepatic bile duct. Edmondson [ 3 ] encountered common bile duct (CBD) tumor thrombus causing icteric HCC in 1950.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment for hepatocellular carcinoma with bile duct invasion

Mao

Hong

et al. 2016

Ann Surg Treat Res

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PurposeThere is still some debate on surgical procedures for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombi (BDTT, Ueda type 3 or 4). What is adequate extent of liver resection for curative treatment? Is extrahepatic bile duct resection mandatory for cure? The aim of this study is to answer these questions.MethodsBetween February 1994 and December 2012, 877 consecutive HCC patients underwent hepatic resection at Ajou University Hospital. Thirty HCC patients (3.4%) with BDTT (Ueda type 3 or 4) were retrospective reviewed in this study.ResultsIn total, 20 patients enrolled in this study were divided into 2 groups: patients who underwent hemihepatectomy with extrahepatic bile duct resection (group 1, n = 10) and with only removal of BDTT (group 2, n = 10). The 1-, 3- and 5-year overall survival rates were 75.0%, 50.0%, and 27.8%, respectively. The 1-, 3-, and 5-year survival rates of group 1 were 100.0%, 80.0%, and 45.7%, and those of group 2 were 50.0%, 20.0%, and 10.0%, respectively (P = 0.014). The 1-, 3-, and 5-year recurrences free survival rates of group 1 were 90.0%, 70.0%, and 42.0%, and those of group 2 were 36.0%, 36.0%, and 0%, respectively (P = 0.014). Thrombectomy and infiltrative growth type (Ig) were found as independent prognostic factors for recurrence free survival by multivariate analysis. Thrombectomy, Ig, and high indocyanine green retention rate at 15 minutes were found as independent prognostic factors for overall survival by multivariate analysis.ConclusionWe suggest that the appropriate surgical procedure for icteric HCC patients should be comprised of ipsilateral hemihepatectomy with caudate lobectomy and extrahepatic bile duct resection.

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“…The first case of HCC patient presenting with “obstructive jaundice” was reported in 1947 as a consequence of tumor invasion and thrombosis in bile duct [1]. Thereafter, Tien Yu Lin et al categorized this type of HCC as “icteric-type hepatoma” [2].…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Surgical Prognosis of Hepatocellular Carcinoma with Bile Duct Invasion

Meng

Dong

Zhang

et al. 2014

Gastroenterology Research and Practice

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Objectives. Bile duct invasion (BDI) is a rare event in hepatocellular carcinoma (HCC). The present study aimed at investigating clinical characteristics and surgical outcome of HCC patients with bile duct invasion. Methods. 413 patients with HCC undergoing curative surgery were divided into two groups with (B+) and without BDI (B−). BDI was further classified as central type (B1) and peripheral type (B2). Survival was compared, and risk factors affecting prognosis were identified. Results. 35 (8.5%) patients were diagnosed BDI. Total bilirubin was significantly higher in B+ group than in B− group (P < 0.001). Multiple lesions and large nodules (>5 cm) were predominantly identified in B+ group (P < 0.01, resp.). Portal vein invasion was more frequently observed in B+ than in B− group (P = 0.003). Univariate and multivariate analyses identified central BDI as a significant factor affecting prognosis of HCC patients (risk 1.3, 95% CI 1.1–2.2, P = 0.015). The gross overall survival of patients in B+ was significantly worse than in B− (P = 0.001), which, however, was not different between B2 and B− (P > 0.05). Conclusions. Central but not peripheral BDI was associated with poorer prognosis of HCC patients. Curative surgical resection of tumors and invaded bile duct supplies the only hope for long-term survival of patients.

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Case 33441

Cited by 30 publications

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Surgical outcome of hepatocellular carcinoma patients with biliary tumor thrombi

Surgical outcome of hepatocellular carcinoma patients with biliary tumor thrombi

Surgical treatment for hepatocellular carcinoma with bile duct invasion

Clinical Characteristics and Surgical Prognosis of Hepatocellular Carcinoma with Bile Duct Invasion

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