Prognostic value of preoperative circulating tumor cells for hepatocellular carcinoma with portal vein tumor thrombosis: A propensity score analysis

Abstract

Abstract Purpose The role of circulating tumor cell (CTC) has not been fully understood in Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods In this retrospective analysis, 316 HCC patients who underwent hepatectomy and preoperative CTC detection were included. Forty-one pairs of matched HCC patients with/without PVTT were selected by a propensity score matching (PSM) analysis. The preoperative CTC counts were compared in patients of full cohort and PSM model respectively. While their associations with disease-free survival (DFS) and overall survival (OS) were further analyzed. Results Before and after PSM analysis, the preoperative CTC counts in HCC with PVTT group were substantially higher than in HCC without PVTT group. In full cohort of patients and in PSM model, patients with CTC ≥ 2 showed significantly shorter OS and DFS than patients with CTC < 2. The outcome of HCC patients with PVTT could be well differentiated by preoperative CTC levels, HCC patients with CTC ≥ 2 had noticeably shorter OS (9.9 months vs. 24.6 months, P = 0.0003) and DFS (6.0 months vs. 12.3 months, P = 0.0041) than those with CTC < 2. Moreover, preoperative CTC ≥ 2 remained independent in all groups’ multivariate analysis. Conclusion We discovered a link between preoperative CTC counts and the occurrence of PVTT, and confirmed the prognostic significance of preoperative CTC in HCC patients with PVTT. These findings suggested that preoperative CTC counts have the potential to assist in identifying patients with HCC and PVTT who may benefit from surgery.