Portal vein tumor thrombosis in hepatocellular carcinoma patients: Is it the end?

Abstract

Hepatocellular carcinoma (HCC) is the sixth most prevalent form of cancer globally and the third leading cause of cancer-related mortality. The incidence of portal vein tumor thrombosis (PVTT) in HCC patients is 21% at one year and 46% at three years. The presence of PVTT has consistently been associated with a poor prognosis for HCC patients over the past decades. Notably, HCC prognosis is influenced not only by the presence of PVTT but also by the degree or extent of PVTT. Currently, there is a lack of global consensus or established protocols regarding the optimal management of HCC with associated PVTT. The Barcelona Clinic for Liver Cancer classifies HCC patients with PVTT as stage C, indicating an advanced stage, and limiting treatment recommendations for these patients to systemic therapy. In recent years, there has been an increase in the availability of therapeutic options for HCC patients with PVTT. Treatment modalities include systemic therapy, transarterial chemoembolization, surgical resection, stereotactic body radiotherapy, transarterial radioembolization, and liver transplantation. An ideal therapy for each patient necessitates a multidisciplinary approach. This review article presents the latest updates in managing HCC patients with PVTT.

Keywords

Hepatocellular carcinoma (HCC) / Portal vein tumor thrombosis (PVTT) / Staging / Systemic therapies / Locoregional treatment / Immunotherapy

Authors’ contributions

Walaa Abdelhamed: Writing e original draft, Data curation. Hend Shousha: Writing e review & editing, Data curation. Mohamed El-Kassas: Writing e review & editing, Conceptualization.

Declaration of competing interest

The authors declare that there is no conflicts of interest.

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