Hamaoka M, et al. – Authors undertook this work to assess the survival benefit and safety of hepatectomy after down–staging by 3–dimensional conformal radiation therapy (3D–CRT) for major portal vein tumor thrombus (PVTT) combined with hepatic arterial infusion chemotherapy (HAIC) for advanced hepatocellular carcinoma (HCC). As per findings, hepatectomy in aforementioned condition proved safe and resulted in good long term outcome.

Methods

• In this retrospective study, authors analyzed 52 patients with unresectable advanced HCC treated with HAIC combined with 3D-CRT for PVTT, from January 2002 to March 2015.
• They performed hepatectomy on patients if, based on radiologic findings, all gross lesions were considered resectable.
• The resection group (n = 7) and non-resection group (n = 43) were investigated regarding the safety of hepatectomy and were compared regarding overall survival (OS).

Results

• In the resection group, OS seemed significantly higher than in the non-resection group.
• Multivariate analysis suggested conversion to surgery (hazard ratio, 0.35; 95% confidence interval, 0.10–0.99; P = 0.048) as an independent factor influencing OS.
• No serious postoperative complications and no case of mortality in patients who underwent hepatectomy were observed.