title: Orthotopic liver transplantation after the combined use of locoregional therapy and sorafenib for advanced hepatocellular carcinoma.
abstract: We herein report a patient with advanced hepatitis B virus-related hepatocellular carcinoma (HCC) beyond the Milan criteria. He underwent orthotopic liver transplantation after successful HCC downstaging that satisfied the University of California, San Francisco criteria, using concurrent chemoradiation therapy with a combination of repeated hepatic arterial infusion chemotherapy (HAIC) and sorafenib. A 52-year-old male was diagnosed with advanced hepatitis B virus-related HCC beyond the Milan criteria. He underwent concurrent chemoradiation therapy (50 Gy with 20 fractions over 5 weeks with HAIC using 5-fluorouracil at a dose of 500 mg/day, which was administered during the first and fifth weeks of radiation therapy) as an initial treatment modality. This was followed by the combined use of HAIC using 5-fluorouracil (500 mg/m(2) for 5 hours on days 1-3) and cisplatin (60 mg/m(2) for 2 hours on day 2) every 4 weeks (twelve cycles) and sorafenib (from the third to the twelfth cycle of HAIC) to treat the remaining HCC. Because a remarkable decrease in the tumor burden that satisfied the University of California, San Francisco criteria was observed after these combination treatments, the patient underwent orthotopic liver transplantation with curative aim and survived for 11 months without evidence of HCC recurrence.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Yoo
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Shin
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.forename: Dong Jin
authors.initials: DJ
authors.lastname: Joo
authors.forename: Jun Yong
authors.initials: JY
authors.lastname: Park
authors.forename: Gi Hong
authors.initials: GH
authors.lastname: Choi
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
authors.forename: Myung Joo
authors.initials: MJ
authors.lastname: Koh
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Chae Yoon
authors.initials: CY
authors.lastname: Chon
keywords: concurrent chemoradiation; downstaging; hepatic arterial infusion chemotherapy; hepatocellular carcinoma; liver transplantation; sorafenib