J Liver Cancer.  2019 Mar;19(1):64-68. 10.17998/jlc.19.1.64.

Liver Transplantation after Successful Downstaging with Hepatic Arterial Infusion Chemotherapy in a Patient with Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Affiliations
  • 1Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yoonsk@catholic.ac.kr
  • 2The Catholic Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 3Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The majority of patients with HCC are diagnosed at advanced disease stages with vascular invasion, where curative approaches are often not feasible. Currently, sorafenib is the only available standard therapy for HCC with portal vein tumor thrombosis (PVTT). However, in many cases, sorafenib therapy fails to achieve satisfactory results in clinical practice. We present a case of advanced HCC with PVTT that was treated with hepatic arterial infusion chemotherapy (HAIC) followed by liver transplantation. Three cycles of HAIC treatment resulted in necrotic changes in most of the tumors, and PVTT was reduced to an extent at which liver transplantation was possible. Further studies are required to determine the treatment strategies for advanced HCC with PVTT that can improve prognosis.

Keyword

Hepatocellular carcinoma; Venous thrombosis
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