Introduction : Treatment of Liver metastasis of colorectal cancer (CLM) is now evolving rapidly with regards to oncological and technical resectability. Little is known about multiple CLM with tumor thrombus in the portal vein (PVTT). On the literatures, Authors suggested at least that macroscopic PVTT is not a contraindication to liver surgery. Herein, we report the clinical outcomes of two patients with progressive PVTT and multiple CLM underwent hepatectomy.

Methods : none

Results : Case 1 A 73-year-old man presented with a metastatic liver tumor accompanied by a macroscopic tumor thrombus in the right portal branch and multiple CLM on both lobes. Extended right hemi-hepatectomy with and removal of the tumor thrombus were performed, and the liver metastasis and tumor thrombus were successfully resected. The patient had the multiple CLM on remnant lobe with left main PVTT at 8 months after the liver surgery. Case 2 A 64-year-old woman who had previously undergone palliative chemotherapy for ascending colon cancer presented with CLM accompanied by a macroscopic tumor thrombus in the left portal branch. Tumor and PVTT were progressed regardless of various chemoagents. Left hemihepatectomy with radiofrequency ablation on right lobe and right hemicolectomy were performed. But, CLM occurred just at 3 months after the liver surgery.

Conclusions : The prognosis of patients with liver metastasis accompanied by a PVTT remains unknown. Considering previous our cases, a poor prognosis may be expected even though the tumor is successfully removed by liver resection. We introspected whether surgery is the treatment option for such pattern of liver metastasis in this era.