Pathological complete response by advanced hepatocellular carcinoma with massive macrovascular invasion to hepatic arterial infusion chemotherapy: a case report.

Abstract

BACKGROUND:

Advanced hepatocellular carcinoma (HCC) with macrovascular invasion has an extremely dismal prognosis. We report a rare case of multiple HCC with tumor thrombosis in the portal vein and inferior vena cava that was initially treated with hepatic arterial infusion chemotherapy (HAIC); later resection revealed pathological complete response.

CASE PRESENTATION:

A 75-year-old man presented with HCC in his right liver, with tumor thrombosis growing to the right portal vein and the inferior vena cava, and bilateral intrahepatic liver metastases. He underwent HAIC (5-fluorouracil [170 mg/m2] + cisplatin [7 mg/m2]) via an indwelling port. Although the tumor shrank and tumor marker levels decreased rapidly, we abandoned HAIC after one cycle because of cytopenia. We resumed HAIC 18 months later because of tumor progression, using biweekly 5-fluorouracil only [1000 mg] due to renal dysfunction. However, after 54 months, the HAIC indwelling port was occluded. The patient therefore underwent a right hepatectomy to resect the residual lesion. Histopathological findings showed complete necrosis with no viable tumor cells. The patient has been doing well without postoperative adjuvant therapy for more than 10 years after initially introducing HAIC and 6 years after the resection, without evidence of tumor recurrence.

CONCLUSIONS:

HAIC can be an effective alternative treatment for advanced HCC with macrovascular invasion.

• Authors: Shusei Sano, Shinji Nakata, Shuichi Wada, Masatsugu Kuroiwa, Hiroki Sakai, Kei Kusama, Taiichi Machida, Akihito Nishio, Ichiro Ito, Harutsugu Sodeyama
• Journal: World journal of surgical oncology (World J Surg Oncol) Vol. 17 Issue 1 Pg. 229 (Dec 26 2019) ISSN: 1477-7819 [Electronic] England
• PMID: 31878937 (Publication Type: Case Reports, Journal Article)

Chemical References

• Cisplatin
• Fluorouracil

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Carcinoma, Hepatocellular (blood supply, drug therapy, pathology, surgery)
• Cisplatin (administration & dosage)
• Combined Modality Therapy
• Fluorouracil (administration & dosage)
• Hepatic Artery (pathology)
• Humans
• Infusions, Intra-Arterial
• Liver Neoplasms (blood supply, drug therapy, pathology, surgery)
• Male
• Treatment Outcome
• Venous Thrombosis (pathology)