Inclusion Criteria:

- Male or female patients ≥18 years of age

- Initially diagnosed or recurrent hepatocellular carcinoma (HCC)

- Eastern Cooperative Oncology Group performance status 0 or 1

- HCC with major portal vein tumor thrombosis (tumor thrombosis in the main portal vein
or 1st branch of portal vein)

- Cirrhotic status of Child Pugh class A or B7

- Patients can have extra-hepatic disease; provided the hepatic disease is the highest
burden, the extra-hepatic disease is low burden and potentially treatable with
radiotherapy, chemotherapy and target agent etc; patient survival is expected to be
at least 6 months.

- Patient or guardian must be able to provide verbal and written informed consent

Exclusion Criteria:

- Prior trans-arterial chemo-embolization ≥4 after diagnosis of major portal vein tumor
thrombosis

- Severe complication caused by liver cirrhosis eg. variceal bleeding, poorly
controlled ascites, hepatic encephalopathy)

- Uncontrolled inter-current illness except liver cirrhosis