Treatment for hepatocellular carcinoma with portal vein tumor thrombosis: The emerging role for radioembolization using yttrium-90

Wan Yee Lau, Bruno Sangro, Pier Jer Chen, Shu Qun Cheng, Pierce Chow, Rheun Chuan Lee, Thomas Leung, Kwang Hyub Han, Ronnie T.P. Poon

Research output: Contribution to journalReview article

91 Citations (Scopus)

Abstract

Background/Purpose: Patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) have an extremely poor prognosis and relatively few treatment options. Method: During a consensus meeting, experts met to examine the published data for HCC treatment strategies in patients with PVTT. Results: Many treatment guidelines consider the presence of PVTT a contraindication to partial hepatectomy or liver transplantation. Transarterial chemoembolization (TACE) is associated with an increased risk of ischemic necrosis of liver and of treatment-related death in patients with PVTT, and is, therefore, limited to a select group of patients with good hepatic function and adequate collateral circulation around the occluded portal vein. Systemic sorafenib results in survival benefit in patients regardless of the presence of PVTT. However, side effects are common, and there are no effects on time-to-symptom progression or quality of life. Transarterial radioembolization (TARE) with yttrium-90 microspheres is emerging as a valuable strategy. A wider range of patients with PVTT are suitable for this procedure compared to TACE. TARE is as effective as TACE in HCC and has quality-of-life advantages. Conclusion: In patients with HCC with PVTT, medical evidence suggests that TARE is a good choice of treatment.

Original languageEnglish
Pages (from-to)311-318
Number of pages8
JournalOncology (Switzerland)
Volume84
Issue number5
DOIs
Publication statusPublished - 2013

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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