Portal vein tumor thrombus should not be considered as a contraindication for liver resection

Hepatocellular carcinoma (HCC) is one of most frequently occurring cancers, approximately 12.5–39.7% of HCC patients associate with portal vein tumor thrombus (PVTT) at the time of diagnosis (1). These patients were belonging to the Barcelona clinic liver cancer stage C and usually associated with poor liver function, treatment difficultly and poor prognosis, the median survival time (MST) was 2.7 months for patients without any treatment (2). According to official guidelines, these patients are only recommended oral sorafenib for treatment, but the patient’s MST is only 5.5 months, and always accompany with many side effects, the quality of life of patients is poor (3). In recent years, many clinical studies have suggested that liver resection (LR) could prolong the survival time of PVTT patients. It means that the treatment of HCC patients with PVTT is not limited to sorafenib, breaking the conventional treatment to choose LR for PVTT patients may be able to benefit many selected patients. LR for the treatment of PVTT has been attempted in many Asian countries. However, due to the lack of large-sample, multi-center and prospective study, this treatment is still not widely recognized.