title: [A successful case of systemic chemotherapy followed by liver resection for advanced hepatocellular carcinoma with highly vascular invasion and multiple pulmonary metastases].
abstract: The prognosis for hepatocellular carcinoma with extrahepatic metastasis or vascular invasion is very poor. We treated a case successfully by combining chemotherapy and liver resection for hepatocellular carcinoma with multiple pulmonary metastases and vascular invasion. A 56-year-old man who complained of abdominal pain in his right side was transported to the hospital by ambulance. Because CT scan revealed the rupture of hepatocellular carcinoma, he underwent emergency transcatheter arterial embolization (TAE). A close examination revealed tumor thrombus in the inferior vena cava and posterior segment of the portal vein branch, with multiple pulmonary metastases. We conducted right hepatic lobectomy and removal of the inferior vena cava tumor thrombus. After the operation, pulmonary metastatic lesions gradually grew larger, so the oral administration of S-1 at 120 mg per day was started. At the end of the first course, the CT scan revealed that multiple pulmonary metastases were significantly reduced, and treatment was maintained until the end of 4 courses. A prolongation of survival could be expected by combining systemic chemotherapy and liver resection for advanced hepatocellular carcinoma such as the present case.
authors.affiliation: Dept. of General Surgery, Hokkaido University Graduate School of Medicine.
authors.forename: Tatsuzo
authors.initials: T
authors.lastname: Mizukami
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kamiyama
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Taniguchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Yokoo
authors.forename: Munenori
authors.initials: M
authors.lastname: Tahara
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kakisaka
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kamachi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Matsushita
authors.forename: Satoru
authors.initials: S
authors.lastname: Todo
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003131:Combined Modality Therapy; D004338:Drug Combinations; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D010094:Oxonic Acid / Q000627:therapeutic use*; D011379:Prognosis; D005641:Tegafur / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid