Successful treatment of multiple hepatocellular carcinoma with tumor thrombi in the major portal branches by intraarterial 5-fluorouracil perfusion chemotherapy combined with subcutaneous interferon-alpha and hepatectomy.
We experienced a patient who received successful treatment for multiple hepatocellular carcinoma (HCC) nodules, with tumor thrombi in the major portal branches, with intraarterial 5-fluorouracil perfusion chemotherapy combined with subcutaneous interferon-alpha administration. The patient was a 50-year-old man with hepatitis C virus and HCC. The tumors consisted of a 5-cm main nodule in the right lobe (segment 8) and multiple intrahepatic metastases. The tumor also involved portal vein thrombosis throughout the right portal branch. After two cycles of interferon-alpha/5-fluorouracil combination chemotherapy, tumor markers demonstrated a decreasing tendency. Nine months after the initiation of this therapy, the tumors were limited to the right lobe and were surgically removed by S8 subsegmentectomy, S5 partial hepatectomy, and portal thrombectomy. The serum levels of both alpha-fetoprotein and protein induced by vitamin K absence II fell to normal levels after hepatic resection. Fifty-eight months after the first treatment, he is alive with several recurrent nodules in the liver. In conclusion, the interferon-alpha/5-fluorouracil combination therapy is a useful treatment for HCC in patients who have multiple intrahepatic metastases and portal vein thrombosis. In addition to this therapy, combined modality therapy including, for example, surgical resection, can sometimes have a dramatic therapeutic effect, shown by tumor markers reverting to normal levels.
Yamamoto
Tameyoshi
T
Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Nagano
Hiroaki
H
Imai
Yasuharu
Y
Fukuda
Kazuto
K
Matsumoto
Hitoshi
H
Kondo
Motoi
M
Ota
Hideo
H
Nakamura
Masato
M
Wada
Hiroshi
H
Noda
Takehiro
T
Damdinsuren
Bazarragchaa
B
Dono
Keizo
K
Umeshita
Koji
K
Nakamori
Shoji
S
Sakon
Masato
M
Wakasa
Kenichi
K
Monden
Morito
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D005472:Fluorouracil / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D007279:Injections, Subcutaneous; D016898:Interferon-alpha / Q000008:administration & dosage; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009360:Neoplastic Cells, Circulating / Q000187:drug effects*; D010477:Perfusion; D011169:Portal Vein / Q000473:pathology*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy*
D016898:Interferon-alpha; D005472:Fluorouracil