Mechanisms and therapeutic methods of HCC with PVTT / 国际外科学杂志

ABSTRACT

Hepatocellular carcinoma (HCC) is one of the most common cancers in the worldwide.In recent years,the development of imaging techniques has facilitated the detection of HCC at early stages.However,HCC has a high frequency of portal vein invasion,which is reportedly observed in 11％ to 42％ of patients with HCC.Portal vein tumor thrombus(PVTT) is a crucial factor that can worsen the prognosis of HCC because it can be wide dissemination of tumor throughout the liver and cause a marked deterioration of hepatic function.It was considered that is not appropriate with surgical treatment in the past,which is treatment conservative or even give up,most of the patients died within a few months.Even if the patients have a chance to surgical resection,and the most of patients combined with TACE,portal vein stent implantation or chemotherapy postoperative,some patients can be more prolonged survival,however,due to the small tumor thrombus and micro metastases have exist before the surgery and can not be checked out.it's difficult to clean up in the surgery,easily lead to HCC recurrence postoperative.However,with the constant awareness the PVTT formation mechanism and scientific technology progress,more and more new treatment techniques is applied to clinical.This view focuses on the portal vein tumor thrombus formation mechanisms and Classic Transcatheter Arterial Chemoembolization and new treatment methods such asHelical tomotherapy,CIK cell therapy (cytokine-induced killer cell therapy),Chemoembolization and stent combined with iodine-125 seed.