Treatment of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is very poor although sorafenib is recommended as the first-line treatment. Therefore, an effective treatment regime is needed for treating HCC with PVTT. This review summarized seven potential treatment regimes which including transarterial chemoembolization (TACE), TACE combined with sorafenib, TACE combined with radiotherapy (RT), hepatectomy, hepatic arterial infusion chemotherapy (HAIC), HAIC combined with sorafenib and HAIC combined with RT in the treatment of HCC with PVTT. In conclusion, hepatectomy or the combination of HAIC and sorafenib may be a more effective modality in the treatment of HCC patients with type I - II PVTT. HAIC combined with or without sorafenib/RT or the combination of RT and TACE is an alternative treatment choice for HCC patients with type III - IV PVTT. Further randomized controlled studies are warranted.