Clin Mol Hepatol.  2017 Dec;23(4):340-346. 10.3350/cmh.2016.0070.

Complete response of advanced hepatocellular carcinoma to sorafenib: another case and a comprehensive review

Affiliations
  • 1Department of Internal Medicine, Kangwon National University School of Medicine, Gangwon, Korea. kjhhepar@naver.com
  • 2Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Korea University College of Medicine, Seoul, Korea.

Abstract

Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCV-related HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.

Keyword

Hepatocellular carcinoma; Sorafenib; Response evaluation criteria in solid tumors; Hepatitis C

MeSH Terms

Biomarkers, Tumor
Carcinoma, Hepatocellular*
Follow-Up Studies
Hepacivirus
Hepatitis C
Humans
Liver
Liver Cirrhosis
Middle Aged
Portal Vein
Recurrence
Response Evaluation Criteria in Solid Tumors
Tomography, X-Ray Computed
Venous Thrombosis
Biomarkers, Tumor
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