title: [A case of hepatocellular carcinoma with Vp4 tumor thrombus treated by radiation therapy before hepatectomy].
abstract: A 61-year-old man who complained of right hypochondralgia was diagnosed as hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection. The tumor was located in the right lobe and S3, and the tumor thrombus extended into the main portal and left portal veins. Preoperatively, real-time tumor-tracking radiation therapy was performed on the tumor thrombus (20 Gy/4 Fr),after vessel coils were placed at the anterior hepatic artery as a marker for the radiation. Ten days after radiation therapy, extended right hepatectomy with thrombectomy and S3 partial hepatectomy were performed. There were no postsurgical complications, and intrahepatic artery infusion chemotherapy was performed. The patient was alive with no recurrences 20 months after surgery. Radiation therapy before hepatectomy is an effective treatment for portal venous tumor thrombus in HCC.
authors.affiliation: Dept. of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine.
authors.forename: Takao
authors.initials: T
authors.lastname: Tamesa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Taichi
authors.initials: T
authors.lastname: Kuwahara
authors.forename: Noriaki
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Tokumitsu
authors.forename: Yoshitaro
authors.initials: Y
authors.lastname: Shindo
authors.forename: Michihisa
authors.initials: M
authors.lastname: Iida
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tokuhisa
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Maeda
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Suzuki
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Tomio
authors.initials: T
authors.lastname: Ueno
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Shoichi
authors.initials: S
authors.lastname: Hazama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000098:blood supply / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D013927:Thrombosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome