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[Significance of typing of tumor thrombi in determination of treatment and assessment of prognosis of hepatocellular carcinoma with tumor thrombi in the portal vein].

OBJECTIVE
To evaluate the benefit of typing of tumor thrombi in determining treatment plan and assessing prognosis of hepatocellular carcinoma (HCC) with tumor thrombi in the portal vein.


METHODS
The clinical data of 84 patients of HCC with portal vein tumor thrombi admitted from Jan. 2000 to Jan. 2003 were analyzed retrospectively. The patients, 75 males and 9 females, aged 47 (28 - 70), were divided into 4 groups, groups I - IV, according to imaging examination of the tumor thrombi. The median survival periods and effectiveness of treatment, including surgical resection and non-surgical treatment, were observed.


RESULTS
The surgical resection rates were 64.7%, 83.8%, 31.4%, and 0 in the groups I - IV respectively (P = 0.912). The general median survival period of the patients undergoing surgery was 8.0 months, significantly longer than that of the patients receiving non-surgical treatment (4.0 months, P = 0.000 6). In different group of tumor thrombi type, the general median survival period of the patients undergoing surgery was significantly longer than that of the patients receiving non-surgical treatment. The median survival periods were 10.1, 7.2, 5.7 and 3.0 months for groups I (n = 17), II (n = 26), III (n = 35) and groups IV (n = 6) respectively, with significant difference between any 2 groups (all P = 0.000 1).


CONCLUSION
Typing of tumor thrombi helps determine the treatment plan and assess the prognosis of hepatocellular carcinoma patients with tumor thrombi in the portal vein.