Prevalence of Portal Vein Thrombosis in Hepatocellular Carcinoma
Portal vein thrombosis (PVT) is present in 20-30% of hepatocellular carcinoma (HCC) cases at the time of diagnosis. 1
Evidence from Multiple Guidelines
The most consistent data across multiple high-quality guidelines establishes this prevalence range:
The NCCN guidelines (2024) report that portal vein thrombosis occurs in approximately 20-30% of patients with hepatocellular carcinoma at diagnosis 1
The NCCN guidelines (2011) similarly document that portal vein thrombosis has been reported in 20% to 30% of patients with hepatocellular carcinoma at diagnosis 1
The EASL Clinical Practice Guidelines (2018) describe that "a substantial proportion of patients with HCC present with tumour-related portal vein thrombosis (PVTT) either at onset of disease or as result of HCC recurrence or progression" 1
Broader Range in Research Literature
Research studies report a wider prevalence range:
Some studies report 10-40% prevalence at the time of HCC diagnosis, reflecting variations in patient populations, imaging techniques, and detection methods 2, 3
One study specifically noted 30-40% prevalence in their cohort of HCC patients with portal vein tumor thrombosis 4
Clinical Significance
The presence of PVT at HCC diagnosis carries major prognostic implications:
PVT is an independent predictor of decreased survival in patients with hepatocellular carcinoma 1
Median survival is significantly reduced in HCC patients with portal vein thrombosis (2.3-6 months) compared to those without (16-17.6 months) 1
The extension of PVTT directly affects patient prognosis regardless of treatment approach, with grading systems (PV1-PV4) used to classify the extent of involvement 1
Detection rates have increased over time due to technical improvements in imaging techniques, particularly for segmental and sub-segmental level thrombosis 1