Preoperative Radiation Therapy and Surgery in Three Patients with Hepatocellular Carcinoma with a Tumor Thrombus in the Portal Trunk

Tsuyoshi Shimamura, Yasuaki Nakajima, Naoki Sato, Shinichi Matsuoka, Kazuhito Misawa, Toshiya Kamiyama, Eisuke Nagabuchi, Hirofumi Kon, Hideki Kawamura, Ichirou Tsuda, Yoshie Une, Junichi Uchino

First Department of Surgery, Hokkaido University School of Medicine

Recently, we performed hepatectomies on three patients with hepatocellular carcinoma with a tumor thrombus in the portal trunk (Vp₃ HCC patient) after radiation therapy (30.0∼34.5 Gy) which was aimed to minimize the portal tumor thrombus. Another aim of this therapy was to decrease postoperative recurrence in the residual liver due to dissemination via the portal vein. Pathological findings in the resected specimens revealed degenerative changes in the portal tumor thrombus including complete necrosis. The mean survival period and the mean disease-free interval were, respectively 13.3 and 5.3 months in patients with preoperative radiation and 7.5 and 1.7 months in those without radiation. These differences were statistically significant, and hepatic resection following radiation therapy was proved to be effective in Vp₃ HCC patients.

Key words
hepatocellular carcinoma, portal tumor thrombus, hepatectomy after radiation therapy

Reprint requests
Tsuyoshi Shimamura First Department of Surgery, Hokkaido University School of Medicine
Kita 15 Nishi 7, Kita-ku Sapporo, 060 JAPAN

Accepted
June 17, 1992

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