[A case of HCC with portal vein thrombosis treated with multidisciplinary treatment combined with preoperative SBRT and radical resection].
A 70s man with advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) (Vp-HCC) in the main trunk (Vp4) was referred to our hospital. He was negative for hepatitis C virus (HCV) and hepatitis B virus (HBV), and his liver function was well preserved. The main tumor was in the right lobe and exceeded 10 cm in diameter. There were no intrahepatic metastases to the left lobe. The patient underwent stereotactic body radiation therapy (SBRT) (48 Gy/4 fractions) to the area of the PVTT. Six days after SBRT, the patient underwent right lobectomy for removal of PVTT. The postoperative course was uneventful, and low-dose 5-fluorouracil and cisplatin(FP)intra-arterial chemotherapy was administered for 3 months. Histopathological findings for the tumor indicated a poorly differentiated HCC, vp4, with moderate to severe tumor necrosis or degeneration in the area that received SBRT. Tumor markers (alpha-fetoprotein [AFP], proteins induced by vitamin K absence [PIVKA-II]) decreased within the normal range, and there was no apparent HCC recurrence 6 months after the hepatectomy. Multidisciplinary treatment combined with preoperative SBRT and radical resection for Vp-HCC was feasible and effective in this case.
Dept. of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Shigeru
S
Marubashi
Kunihito
K
Gotoh
Hirofumi
H
Akita
Hidenori
H
Takahashi
Keijiro
K
Sugimura
Norikatsu
N
Miyoshi
Masaaki
M
Motoori
Kentaro
K
Kishi
Shingo
S
Noura
Masayuki
M
Ohue
Yoshiyuki
Y
Fujiwara
Masahiko
M
Yano
Osamu
O
Ishikawa
Masato
M
Sakon
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D011169:Portal Vein / Q000473:pathology*; D020246:Venous Thrombosis / Q000473:pathology / Q000628:therapy*