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.-World Journal of Gastroenterology