Comparison of survival and quality of life of hepatectomy and thrombectomy using total hepatic vascular exclusion and chemotherapy alone in patients with hepatocellular carcinoma and tumor thrombi in the inferior vena cava and hepatic vein

Abstract

Hepatectomy and thrombectomy using the total hepatic vascular exclusion, is a viable surgical management for patients with HCC and PVTT, and is associated with longer overall survival and recurrence-free survival and better QoL than chemotherapy alone.

Clinical outcomes of left hepatic trisectionectomy for hepatobiliary malignancy

“…The use of hepatic vascular exclusion may be related to advanced tumour stage, radicality of surgery and increased potential for postoperative complications, as its use can be associated with significant haemodynamic instability. The authors have used this approach in difficult procedures, but normally prefer to apply intrahepatic ligation and division of the major hepatic veins during parenchymal dissection in combination with inflow occlusion by means of an intermittent Pringle manoeuvre.…”

Cost-effectiveness of all-oral ledipasvir/sofosbuvir regimens in patients with chronic hepatitis C virus genotype 1 infection

“…Annual transition probabilities, presented in Figure and Table , were taken from published literature . After completion of treatment, patients who were treated at METAVIR fibrosis score F0–F2 and who achieved SVR were assumed to maintain SVR and to experience no further disease progression until their death.…”

“…Patients with a successful liver transplant remained in the post‐liver transplant health state until their death. Probabilities of HCV‐related death were taken from published literature on liver‐related mortality for the DCC, HCC and post‐liver transplant health states. For non‐HCV‐related causes of death, mortality was based on US general population probabilities by age …”

“…Annual transition probabilities, presented in Figure 1 and Table 1, were taken from published literature. 4,[39][40][41][42][43][44][45][46] After completion of treatment, patients who were treated at METAVIR fibrosis score F0-F2 and who achieved SVR were assumed to maintain SVR and to experience no further disease progression until their death. Patients who had a METAVIR fibrosis score of F3 or F4 at treatment initiation and who achieved SVR could still experience further disease progression, although at a reduced rate compared with those not achieving SVR.…”

Advanced hepatocellular carcinoma with hepatic vein tumor thrombosis and renal dysfunction after hepatic arterial infusion chemotherapy effectively treated by liver resection with active veno-venous bypass: report of a case

“…Surgical resection alone can provide long-term survival only in some HCC patients with HVTT [5, 6, 17]. Clinical trials of hepatic resection combined with chemotherapy, including HAIC, have been reported to improve the survival rate of HCC patients with macrovascular invasion [24–26].…”