Chinese Expert Consensus on Multidisciplinary Diagnosis and Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombus (2018 Edition)

Abstract

Portal vein tumor thrombus (PVTT) is very common, and it plays a major role in the prognosis and clinical staging of hepatocellular carcinoma (HCC). We have published the first version of the Consensus in 2016. Over the past several years, many new evidences for the treatment of PVTT become available especially for the advent of new targeted drugs which have further improved the prognosis of PVTT. So, the Chinese Association of Liver Cancer revised the 2016 version of consensus to adapt to the development of PVTT treatment. Future treatment strategies for HCC with PVTT in China would depend on new evidences from more future clinical trials.

<p>Safety and Efficacy of Camrelizumab Combined with Apatinib for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Multicenter Retrospective Study</p>

“…32,33 The recommended treatment strategies for PVTT patients are sorafenib and TACE according to BCLC. 8 However, both therapies remained unsatisfactory in our daily clinical application. Currently, a series of clinical trials have shown that anti-PD-1 monotherapy is effective in treating advanced HCC patients with an ORR of 10-20%.…”

“…6,7 In China, the incidences of PVTT have been reported to range from 44% to 62.2%. 8,9 The treatment of HCC patients with PVTT is based on the patients' liver function, the stage of hepatic lesion, and the extent of PVTT. For example, transcatheter arterial chemoembolization (TACE) is recommended as the primary treatment for PVTT patients with Child-Pugh A liver function, while its efficacy in these patients still remained unsatisfactory.…”

Development and Validation of a Nomogram for Patients with Nonmetastatic BCLC Stage C Hepatocellular Carcinoma after Stereotactic Body Radiotherapy

“…MVI is not uncommon in patients with large tumors and highly associated with systemic dissemination and dismal outcome [20,21]. Compared to other criteria for BCLC stage C, MVI has an independent impact on survival.…”

Percutaneous Radiofrequency Ablation Combined With Transarterial Chemoembolization Plus Sorafenib for Large Hepatocellular Carcinoma Invading the Portal Venous System: A Prospective Randomized Study

“…Approximately 357,800 new cases of liver cancer were reported in China in 2020 (1). Moreover, 44% to 62% of patients with HCC progress to portal vein invasion, namely portal vein tumor thrombus (PVTT), which has a worse prognosis (2). Previous findings revealed that the median survival time of untreated PVTT patients is only 2.7 to 4.0 months (3).…”