Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Surgical outcome and risk scoring to predict survival after hepatic resection for hepatocellular carcinoma with portal vein tumor thrombosis

  • Tae-Seok Kim (Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Hospital) ;
  • Kwangho Yang (Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine) ;
  • Gi Hong Choi (Division of Hepatopancreaticobiliary Surgery, Yonsei University College of Medicine) ;
  • Hye Yeon Yang (Division of Hepatopancreaticobiliary Surgery, Yonsei University College of Medicine) ;
  • Dong-Sik Kim (Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine) ;
  • Hye-Sung Jo (Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine) ;
  • Gyu-Seong Choi (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwan Woo Kim (Department of Surgery, Dong-A University College of Medicine) ;
  • Young Chul Yoon (Division of Hepatobiliary, Pancreas, and Abdominal Organ Transplant, Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Jaryung Han (Department of Surgery, Daegu Catholic University School of Medicine) ;
  • Doo Jin Kim (Department of Surgery, Gacheon University Gil Medical Center) ;
  • Shin Hwang (Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Koo Jeong Kang (Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Hospital)
  • Received : 2024.02.23
  • Accepted : 2024.04.02
  • Published : 2024.05.31
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Abstract

Backgrounds/Aims: The hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is classified as the advanced stage (BCLC stage C) with extremely poor prognosis, and in current guidelines is recommended for systemic therapy. This study aimed to evaluate the surgical outcomes and long-term prognosis after hepatic resection (HR) for patients who have HCC combined with PVTT. Methods: We retrospectively analyzed 332 patients who underwent HR for HCC with PVTT at ten tertiary referral hospitals in South Korea. Results: The median overall and recurrence-free survival after HR were 32.4 and 8.6 months, while the 1-, 3-, and 5-year overall survival rates were 75%, 48%, and 39%, respectively. In multivariate analysis, tumor number, tumor size, AFP, PIVKA-II, neutrophil-to-lymphocyte ratio, and albumin-bilirubin (ALBI) grade were significant prognostic factors. The risk scoring was developed using these seven factors-tumor, inflammation and hepatic function (TIF), to predict patient prognosis. The prognosis of the patients was well stratified according to the scores (log-rank test, p < 0.001). Conclusions: HR for patients who have HCC combined with PVTT provided favorable survival outcomes. The risk scoring was useful in predicting prognosis, and determining the appropriate treatment strategy for those patients who have HCC with PVTT.

Keywords

Acknowledgement

This study was supported by the Research Program of the Korean Association for Hepatobiliary-Pancreatic Surgery for 2021 (KAHPBS-21-01).

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