Portal venous tumor thrombus (PVTT) is a crucial factor that can worsen the prognosis of patients with hepatocellular carcinoma (HCC). It often leads to extensive spreading of the tumor throughout the liver, and can increase portal venous blood pressure, resulting in the fatal rupture of esophageal varices, and can decrease portal flow which causes ascites, jaundice, hepatic encephalopathy, and liver failure. However, there is no effective useful therapy for HCC combined with PVTT. Therefore, there is an urgent need for new and active drugs and combination chemotherapy of advanced HCC.
A total of 10 consecutive patients with Stage IVA HCC accompanied by PVTT were studied prospectively to examine the efficacy of treatment by intra-arterial infusion of a chemotherapeutic agents consisting of etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil by Ishikawa, et al.
The median survival time after the therapy was 457.2 days; the 1-year survival rate was 70 %. Adverse reactions were tolerable.
Although the prognosis of most patients with HCC by PVTT is poor, our combination chemotherapy may induce long-term survival and is an effective treatment and produced anti-tumor activity with tolerable adverse effects in patients for advanced HCC accompanied by PVTT.
Intra-arterial combination chemotherapy is useful and inducing long-term survival for advanced HCC accompanied by PVTT. Further prospective randomized clinical trials of chemotherapy for HCC with PVTT are needed.
Reference: Ishikawa T, Imai M, Kamimura H, Tsuchiya A, Togashi T, Watanabe K, Seki Ki, Ohta H, Yoshida T, Kamimura T. Improved survival for hepatocellular carcinoma with portal vein tumor thrombosis treated by intra-arterial chemotherapy combining etoposide, carboplatin, epirubicin and pharmacokinetic modulating chemotherapy by 5-FU and enteric-coated tegafur/uracil: A pilot study. World J Gastroenterol 2007; 13(41): 5465-5470
http://www.wjgnet.com/1007-9327/13/5465.asp
Correspondence: Toru Ishikawa, MD, Department of Gastroenterology and Hepatology, Saiseikai Niigata Second Hospital, Teraji 280-7, Niigata 950-1104, Japan. toruishi@ngt.saiseikai.or.jp
Telephone: +81-25-2336161 Fax: +81-25-2338880
About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by The WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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