title: Surgical treatment after hepatic arterial infusion chemotherapy for hepatocellular carcinoma extending into the right atrium.
abstract: A resected case of hepatocellular carcinoma which extended into the right atrium after treatment with hepatic arterial infusion chemotherapy (HAIC) is described. An 81-year-old man presented with right hypochondralgia. CT demonstrated a hypervascular tumor 11.5 cm in diameter extending into the right atrium through the right hepatic vein. The patient underwent HAIC with 100 mg of cisplatin (CDDP IA-call®) particles three times every month. The tumor showed a marked shrinkage and an involution of the venous thrombus around the orifice of the right hepatic vein. Right hemihepatectomy with tumor thrombectomy was performed as a salvage surgery using a total hepatic vascular exclusion technique. Histologically, the tumor turned into diffuse necrosis and fibrosis, so viable tumor cells were encountered neither in the main tumor nor venous thrombus. The therapeutic effect of HAIC was pathological complete remission. The patient has been doing well for 6 years after the surgery without evidence of tumor recurrence. The salvage operation was safely achievable for the initially unresectable advanced hepatocellular carcinoma extending into the right atrium.
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Kurahashi
authors.affiliation: Department of Gastroenterological Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sano
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Natsume
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.affiliation: Department of Interventional Radiology, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Yamaura
authors.affiliation: Department of Interventional Radiology, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Inaba
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
keywords: Hepatectomy; Hepatocellular carcinoma; Inferior vena cava; Right atrium; Tumor thrombus