Portal vein tumor thrombosis in hepatocellular carcinoma: molecular mechanism and therapy

Clin Exp Metastasis. 2023 Feb;40(1):5-32. doi: 10.1007/s10585-022-10188-1. Epub 2022 Nov 1.

Abstract

Portal vein tumor thrombosis (PVTT), a common complication of advanced hepatocellular carcinoma (HCC), remains the bottleneck of the treatments. Liver cancer cells potentially experienced multi-steps during PVTT process, including cancer cells leave from cancer nest, migrate in extracellular matrix, invade the vascular barrier, and colonize in the portal vein. Accumulated evidences have revealed numerous of molecular mechanisms including genetic and epigenetic regulation, cancer stem cells, immunosuppressive microenvironment, hypoxia, et al. contributed to the PVTT formation. In this review, we discuss state-of-the-art PVTT research on the potential molecular mechanisms and experimental models. In addition, we summarize PVTT-associated clinical trials and current treatments for PVTT and suppose perspectives exploring the molecular mechanisms and improving PVTT-related treatment for the future.

Keywords: Hepatocellular carcinoma; Metastasis; Molecular mechanisms; Portal vein tumor thrombosis; Therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Hepatocellular* / drug therapy
  • Carcinoma, Hepatocellular* / therapy
  • Epigenesis, Genetic
  • Humans
  • Liver Neoplasms* / drug therapy
  • Liver Neoplasms* / therapy
  • Portal Vein / pathology
  • Retrospective Studies
  • Treatment Outcome
  • Tumor Microenvironment
  • Venous Thrombosis* / complications
  • Venous Thrombosis* / therapy