原发性肝癌合并门静脉癌栓的治疗进展

目的综述肝癌合并门静脉癌栓(PVTT)的治疗现状,以进一步提高其疗效。方法通过文献检索对近年来与肝癌合并PVTT有关的治疗方法和治疗效果进行总结。结果 PVTT是肝癌的常见合并症,其治疗方法有外科手术切除、肝动脉栓塞和化疗、经门静脉治疗、放射性治疗、各种消融治疗、分子靶向治疗等;肝癌合并PVTT患者的手术切除率低,治疗困难且预后差,疗效有待提高。结论肝癌合并PVTT的治疗应以手术为主,多学科、多手段联合治疗,并根据患者的病情及癌栓的情况进行个体化和序贯性的综合治疗,以提高肝癌合并PVTT患者的生存率。

The Progress of Treatment for Primary Liver Cancer with Portal Vein Tumor Thrombus

Objective To improve the prognosis of primary liver cancer with portal vein tumor thrombus(PVTT),the progress of treatment for primary liver cancer with PVTT was reviewed.Methods The therapeutic approach and its efficacy for primary liver cancer with PVTT were summarized by literature search within recent years.Results PVTT is a common complication of primary liver cancer,the therapeutic approach are surgical resection,transcatheter arterial chemoembolization(TACE),intraportal venous therapy,radiotherapy,ablation therapy,molecular targeted therapy,etc.The excision rate for primary liver cancer with PVTT is low,the treatment is difficult and the outcome is dismal.It remains a poor prognosis at present,and the therapeutic effect need to be promoted.Conclusions The main treatment for primary liver cancer with PVTT should be surgical excision combine with other multidisciplinary comprehensive treatment to improve the survival in patients with PVTT,moreover,the therapeutic approach should be individualized and sequentially according to the patient’s condition and the type of PVTT.