[Long-term survival in a case of advanced hepatocellular carcinoma with tumor thrombus in the portal vein and the right atrium (vp4,vv3 ) treated successfully with multidisciplinary therapies].
The prognosis for hepatocellular carcinoma (HCC) with severe vascular invasion is dismal. Surgery alone is not enough to control recurrence. Here, we report long-term survival in a case of HCC with tumor thrombus in the portal vein and right atrium, which was successfully treated through multidisciplinary therapies including surgery. The patient, a 74-year-old man, had undergone several rounds of local ablation and transarterial chemoembolization for HCC recurrence, in another hospital. He was referred to us for recurrent HCC with vascular invasion in July 2011. An abdominal computed tomography (CT) revealed a mass lesion(4 cm in diameter)in the left hepatic lobe. It also detected a tumor thrombus in the main trunk of the portal vein (Vp4), and in the right atrium (Vv3). Consequently, the patient underwent an extended left lobectomy and removal of the tumor thrombus in the portal vein and right atrium. Subsequently, fluorouracil (FU) arterial infusion and interferon therapy (FAIT) was initiated, and followed with sorafenib administration. However, multiple recurrent lesions were found in the liver, lungs, and lymph nodes. The dose of sorafenib was increased and maintained for 10 months. So far, the patient has been alive for 35 months after the operation.
Dept. of Gastroenterological Surgery, Graduate School of Medicine, Osaka University.
Satoshi
S
Hyuga
Akira
A
Tomokuni
Yoshito
Y
Tomimaru
Hiroshi
H
Wada
Naoki
N
Hama
Koichi
K
Kawamoto
Shogo
S
Kobayashi
Shigeru
S
Marubashi
Hidetoshi
H
Eguchi
Yuichiro
Y
Doki
Masaki
M
Mori
Hiroaki
H
Nagano
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000628:therapy*; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D006325:Heart Atria / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D009360:Neoplastic Cells, Circulating; D011169:Portal Vein / Q000473:pathology*; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*