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Background: The presence of portal vein tumor thrombosis PVTT in patients ith hepatocellular carcinoma HCC is regarded as indicating an advanced stage, and liver resection LR is not recommended. The aim of this study as to evaluate the survival benefit of LR for HCC patients ith PVTT through the analysis of the data from a Japanese nationide survey. Methods: We analyzed data for 6,474 HCC patients ith PVTT registered beteen 2000 and 2007. Of these patients,2,093 patients ho underent LR and 4,381 patients ho received other treatments ere compared. The propensity scores ere calculated for 1,786 patients in the LR group and 3,758 patients in the non-LR group and e successfully matched 1,229 patients 68.8 percent of the LR group . Results: The median survival time MST in the LR group as 1.93 years longer than that in the non-LR group 2.74 years vs 0.81 years; Plt 0.001 and 1.03 years longer than that in the non-LR group 2.41 years vs 1.38 years; Plt 0.001 in a propensity score-matched cohort. A subgroup analysis revealed that LR provides a survival benefit regardless of the Child-Pugh grade, etiology of HCC, and tumor number. The survival benefit as not statistically significant only in patients ith PVTT invading the main trunk or contralateral branch. In the LR group, the postoperative mortality rate as 1.4 percent 29 patients and the multivariate analysis identified liver cirrhosis hazard ratio [HR] 1.31 , Child-Pugh class B HR 1.69 , and R2 resection HR 1.60 as significant risk factors for the overall survival other than tumor related factors. Conclusions: As long as the PVTT is limited to the first-order branch, LR leads to a longer survival outcome than non-surgical treatment, especially in the presence of good liver function.,J Clin Oncol 34, 2016 suppl; abstr 4067 00:00.0,Gastrointestinal Noncolorectal Cancer