[A Case of a Long-Term Survivor Who Underwent Surgical Intervention for Hepatocellular Carcinoma Combined with Tumor Thrombus in the Main Trunkof the Portal Vein].

We reported a patient survived more than 7years after undergoing hepatectomy accompanied by tumor thrombectomy in the main trunk of the portal vein after preoperative hepatic arterial chemotherapy for hepatocellular carcinoma combined with tumor thrombus in the main portal vein. A 58-year-old man underwent hepatic arterial infusion therapy with 5-fluorouracil( 5-FU)plus cisplatin(CDDP)for 6 weeks for a solitary 7cm nodule of hepatocellular carcinoma on the liver(S6) with tumor thrombus in the main portal vein. Although hepatic arterial infusion therapy was effective and the tumor shrank markedly, the tumor thrombus of the main portal vein still existed and the existence of portal hypertension was predicted from lower platelet values. Therefore, we performed hepatectomy accompanied by tumor thrombectomy in the main portal vein. Four months after surgery, staining of a single tumor was observed in the residual liver by contrast computed tomography (CT)and Lipiodol-TAI was performed. There was no recurrence of cancer for about 4 years, when a single recurrent lesion was found in the liver caudate lobe and a single lung metastatic lesion was also found in the left lower lobe section. We performed hepatectomy of the caudate lobe, and furthermore, we performed the left basilar segmentectomy. After these operations, the patient remained cancer free and died suddenly of another disease 7years after the first treatment for the hepatoma.