Maehringer-Kunz, Aline, Steinle, Verena, Dueber, Christoph, Weinmann, Arndt ORCID: 0000-0003-1198-1716, Koch, Sandra, Schmidtmann, Irene, Schotten, Sebastian ORCID: 0000-0003-3359-0732, Hinrichs, Jan B., Graafen, Dirk, dos Santos, Daniel Pinto, Galle, Peter R. and Kloeckner, Roman ORCID: 0000-0001-5492-4792 (2019). Extent of portal vein tumour thrombosis in patients with hepatocellular carcinoma: The more, the worse? Liver Int., 39 (2). S. 324 - 332. HOBOKEN: WILEY. ISSN 1478-3231

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Abstract

Background & Aims Portal vein tumour thrombosis (PVTT) has a significant impact on the prognosis of patients with hepatocellular carcinoma (HCC). The degree of PVTT varies from sub-/segmental invasion to complete occlusion of the main trunk. Aim of this study was to evaluate whether the degree of PVTT correlates with prognosis. Methods A total of 1317 patients with HCC treated at our tertiary referral centre between January 2005 and December 2016 were included. PVTT was diagnosed by contrast-enhanced computed tomography or magnetic resonance imaging. The extent of PVTT was documented according to the Liver Cancer Study Group of Japan classification: Vp0 = no PVTT, Vp1 = segmental portal vein invasion, Vp2 = right anterior/posterior portal vein, Vp3 = right/left portal vein and Vp4 = main trunk. Median overall survival (OS) was calculated for each group. Results Portal vein tumour thrombosis was present in 484 (36.8%) patients. Median OS without PVTT was 35.7 months, significantly longer than in patients with PVTT (7.2 months, P < 0.001). The patients with PVTT were subclassified as follows: 103 Vp1, 87 Vp2, 143 Vp3 and 151 Vp4. The corresponding median OS yielded 14.6, 9.4, 5.8 and 4.8 months for Vp1-Vp4, respectively (P < 0.001). Conclusions Portal vein tumour thrombosis in patients with HCC is associated with a dismal prognosis. The results indicate an association between the extent of PVTT and OS. However, the extent of PVTT is not that decisive, as even minor PVTT leads to a very poor prognosis. Therefore, meticulous evaluation of cross-sectional imaging is crucial for the clinical management of patients with HCC.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Maehringer-Kunz, AlineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steinle, VerenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dueber, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weinmann, ArndtUNSPECIFIEDorcid.org/0000-0003-1198-1716UNSPECIFIED
Koch, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidtmann, IreneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schotten, SebastianUNSPECIFIEDorcid.org/0000-0003-3359-0732UNSPECIFIED
Hinrichs, Jan B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Graafen, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
dos Santos, Daniel PintoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Galle, Peter R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kloeckner, RomanUNSPECIFIEDorcid.org/0000-0001-5492-4792UNSPECIFIED
URN: urn:nbn:de:hbz:38-158288
DOI: 10.1111/liv.13988
Journal or Publication Title: Liver Int.
Volume: 39
Number: 2
Page Range: S. 324 - 332
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1478-3231
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HEPATIC RESECTION; TREATMENT STRATEGIES; SURVIVAL; PROGNOSIS; CHEMOEMBOLIZATION; RADIOEMBOLIZATION; SORAFENIB; DISEASE; CANCERMultiple languages
Gastroenterology & HepatologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15828

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