Debulking surgery followed by intraarterial 5-fluorouracil chemotherapy plus subcutaneous interferon alfa for massive hepatocellular carcinoma with multiple intrahepatic metastases: a pilot study.

Abstract

BACKGROUND:

The prognosis in advanced hepatocellular carcinoma (HCC) with multiple intrahepatic metastases is extremely poor. Combination therapy with subcutaneous interferon (IFN) alfa and intraarterial 5-fluorouracil was reported to be effective against such advanced HCC. We describe results of debulking surgery followed by combination therapy with IFN alfa and 5-FU for massive HCC with multiple intrahepatic metastases.

METHODS:

In 27 HCC patients with massive tumors and multiple intrahepatic metastases, we performed combination therapy with IFN alfa and 5-FU after maximal liver tumor resection.

RESULTS:

Mean patient age was 63.3 years. Including intrahepatic metastases, tumors numbered 5 or more in 17 patients (63%). Portal or hepatic vein branches were invaded in 22 (81%). The mean maximum tumor diameter was 102 mm. Among 24 patients whose results were analyzed, an objective response by residual intrahepatic metastases was observed in 13 (54%; complete response in 12, and partial response in 1). Overall 1-, 3-, and 5-year survival was 73.2%, 38.7%, and 38.7%, respectively; 1-, 3-, and 5-year progression-free rates were 38.2%, 22.3%, and 22.3%.

CONCLUSIONS:

Debulking surgery followed by IFN alfa and 5-FU combination chemotherapy offers possibility of long-term survival despite massive HCC with multiple intrahepatic metastases.

• Authors: K Tanaka, Y Yabushita, K Nakagawa, T Kumamoto, K Matsuo, M Taguri, I Endo
• Journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Eur J Surg Oncol) Vol. 39 Issue 12 Pg. 1364-70 (Dec 2013) ISSN: 1532-2157 [Electronic] England
• PMID: 24183169 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.

Chemical References

• Interferon-alpha
• Fluorouracil

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Carcinoma, Hepatocellular (pathology, secondary, therapy)
• Disease-Free Survival
• Female
• Fluorouracil (administration & dosage)
• Hepatectomy
• Humans
• Infusions, Intra-Arterial
• Injections, Subcutaneous
• Interferon-alpha (administration & dosage)
• Kaplan-Meier Estimate
• Liver Neoplasms (pathology, secondary, therapy)
• Male
• Middle Aged
• Neoplasm Invasiveness
• Pilot Projects
• Proportional Hazards Models
• Survival Rate
• Tumor Burden