Thrombus-First Surgery for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus

Sun, Jianzhong; Wu, Jiayi; Shi, Jie; Liu, Chang; Yue, Wei; Zhou, Jianyin; Zhang, Zhibo; Yan, Mao-Lin; Cheng, Shuqun

doi:10.1007/s11605-020-04813-1

Cited by 6 publications

(6 citation statements)

References 13 publications

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“…Regarding our literature review, we have extrapolated 20 articles with a total population of 890 patients [ 8 , 9 , 17 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] ( Table 1 and Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…Concerning baseline characteristics, our patient is 47 years old, which is in line with the literature mean age (55.35 ± 9.49). As shown in Table 1 , males are more frequently affected by this pathology than females (82.80% vs. 17.20%) [ 8 , 9 , 17 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

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Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Report and Literature Review of 890 Patients Affected by Uncommon Primary Liver Tumor Presentation

Conticchio

Maggialetti

Rescigno

et al. 2023

JCM

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Bile duct tumor thrombus (BDTT) is an uncommon finding in hepatocellular carcinoma (HCC), potentially mimicking cholangiocarcinoma (CCA). Recent studies have suggested that HCC with BDTT could represent a prognostic factor. We report the case of a 47-year-old male patient admitted to the University Hospital of Bari with abdominal pain. Blood tests revealed the presence of an untreated hepatitis B virus infection (HBV), with normal liver function and without jaundice. Abdominal ultrasonography revealed a cirrhotic liver with a segmental dilatation of the third bile duct segment, confirmed by a CT scan and liver MRI, which also identified a heterologous mass. No other focal hepatic lesions were identified. A percutaneous ultrasound-guided needle biopsy was then performed, detecting a moderately differentiated HCC. Finally, the patient underwent a third hepatic segmentectomy, and the histopathological analysis confirmed the endobiliary localization of HCC. Subsequently, the patient experienced a nodular recurrence in the fourth hepatic segment, which was treated with ultrasound-guided percutaneous radiofrequency ablation (RFA). This case shows that HCC with BDTT can mimic different types of tumors. It also indicates the value of an early multidisciplinary patient assessment to obtain an accurate diagnosis of HCC with BDTT, which may have prognostic value that has not been recognized until now.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Report and Literature Review of 890 Patients Affected by Uncommon Primary Liver Tumor Presentation

Conticchio

Maggialetti

Rescigno

et al. 2023

JCM

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“…As is known to all, most HCC patients with BDTT are hospitalized for obstructive jaundice, and this type of HCC is often called “icteric hepatoma” ( 28 ). A serum total bilirubin level higher than 51 μmol/L is always considered a relative contraindication for chemoembolization or hepatectomy ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Comparison Between Liver Resection and Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma Patients With Bile Duct Tumor Thrombus: A Propensity-Score Matching Analysis

et al. 2022

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BackgroundHepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of this study is to evaluate the long-term prognosis of liver resection (LR) versus transcatheter arterial chemoembolization (TACE) in these patients.MethodsData from HCC patients with BDTT who underwent liver resection and TACE were analyzed respectively. Propensity score matching (PSM) analysis was performed in these patients.ResultsA total of 145 HCC patients with BDTT were divided into two groups: the LR group (n = 105) and the TACE group (n = 40). The median OS in the LR group was 8.0 months longer than that in the TACE group before PSM (21.0 vs. 13.0 months, P <0.001) and 9.0 months longer after PSM (20.0 vs. 11.0 months, P <0.001). The median DFS in the LR group was 3.5 months longer than that in the TACE group before PSM (7.0 vs. 3.5 months, P = 0.007) and 5 months longer after PSM (7.0 vs. 2.0 months, P = 0.007).ConclusionIf surgery is technically feasible, liver resection provides better prognosis for HCC patients with BDTT compared with TACE.

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“…It is estimated that the prevalence rate of obstructive jaundice in HCC induced by BDTT ranges from 26.7% to 72.5%. 6,[24][25][26][27] Thus, HCC with BDTT is termed "icteric type of HCC" or "cholestatic type of HCC". Surgical resection is currently the first-line treatment when HCC and BDTT are both resectable and the liver function is well preserved.…”

Section: Discussionmentioning

confidence: 99%

“…3 Of these causes, BDTT is a rare but special clinical feature of HCC, with the incidence rate of only 1-9%. [4][5][6] With regard to the management of HCC with BDTT, surgical resection has become the main treatment method. Numerous literature have reported that surgical resection can result in better curative effect and improve long-term survival of patients compared to other palliative-intent therapy.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Transarterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma Associated with Bile Duct Tumor Thrombus: A Real-World Retrospective Cohort Study

Feng

Sun

Liu

et al. 2021

CMAR

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Background The occurrence of hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) is rare. The aim of the study was to evaluate the effectiveness and safety of transarterial chemoembolization (TACE) for patients with unresectable HCC with BDTT. Methods This retrospective study was conducted on newly diagnosed HCC and BDTT patients who were initially treated with TACE or conservative management (CM) from 2009 to 2018. Survival outcomes of patients treated with TACE were compared with those of patients given CM. Multivariate analyses were performed to identify independent prognostic factors related to survival. Results Out of 100 patients included in this study, 40 patients underwent TACE, while the remaining 60 received CM. The median survival time of the TACE group was 8.0 months longer than that of the CM group (13.0 versus 5.0 months, P < 0.001). The 6-, 12-, 18-, 24-month overall survival (OS) rates were 90.0%, 52.5%, 22.5%, and 12.5%, respectively, for the TACE group compared with 26.7%, 8.3%, 5.0%, and 3.3%, respectively, for the CM group. Multivariate analyses showed that treatment allocation (hazard ratio [HR], 0.421; 95% confidence interval [CI], 0.243–0.730; P = 0.002), Child–Pugh status (HR, 2.529; 95% CI, 1.300–4.920; P = 0.006) and total bilirubin level (HR, 1.007; 95% CI, 1.004–1.009; P < 0.001) on first admission were independent predictors of OS. There was no procedure-related mortality within one month after TACE treatment. Conclusion TACE is a safe and effective treatment method that may improve the OS of patients with unresectable HCC with BDTT.

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Thrombus-First Surgery for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus

Cited by 6 publications

References 13 publications

Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Report and Literature Review of 890 Patients Affected by Uncommon Primary Liver Tumor Presentation

Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Report and Literature Review of 890 Patients Affected by Uncommon Primary Liver Tumor Presentation

Prognostic Comparison Between Liver Resection and Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma Patients With Bile Duct Tumor Thrombus: A Propensity-Score Matching Analysis

Efficacy and Safety of Transarterial Chemoembolization for the Treatment of Unresectable Hepatocellular Carcinoma Associated with Bile Duct Tumor Thrombus: A Real-World Retrospective Cohort Study

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