Radioembolization for Hepatocellular Carcinoma With Portal Vein Tumoral Thrombosis

Trans-arterial Radioembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumoral Thrombosis

In patients with hgepatocellular carcinoma (HCC) and portal vein tumoral thrombosis (PVTT), Sorafenib represents the treatment of choice but more recently, trans-arterial radioembolization (TARE) with yttrium-90 has been also proposed. A considerable percentage of such patients are not only able to achieve stability of the disease, but also to obtain a complete radiological response (CR). The possibility of achieving a CR might allow these patients to be listed for liver transplantation (LT), in order to cure not only the cancer but also the underlying cirrhosis that generated it.

Inclusion Criteria:

1. diagnosis of HCC;
2. age ≥ 18 years;
3. performance status according to Eastern Cooperative Oncology Group 0-1;
4. preserved liver function (Child-Pugh score ≤B7);
5. PVTT limited to the first order portal branch.

Exclusion Criteria:

1. any contraindication to TARE treatment;
2. macrovascular invasion extended to the main portal trunk and/or to the contralateral portal branch;
3. presence of extra-hepatic disease