- A Case of Long Term Survival in Patient with Early Intrahepatic Recurrence and Extrahepatic Metastasis after Curative Resection of Hepatocellular Carcinoma
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Dong Il Jeong, Young Mi Hong, Mong Cho, Ki Tae Yoon
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J Liver Cancer. 2015;15(2):132-135. Published online September 30, 2015
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DOI: https://doi.org/10.17998/jlc.15.2.132
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Abstract
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- The most effective therapy in patients with hepatocellular carcinoma (HCC) is curative
resection of liver cancer. However, the long-term prognosis is not good in high intrahepatic
recurrence. The recurrence rate after curative resection of HCC is 70-100% and the average
survival time was about 15.8 months in early relapse after curative resection. Extra hepatic
metastases in HCC is associated not uncommon, in general, lungs are the most common
organ, lymph nodes, bone, and adrenal gland is relatively often observed. Extrahepatic
recurrence after curative resection of HCC has been reported in 14-26% of the total recurrent
cancer. Most of the recurrent cancer is multiple and the median survival time of patients
after the extrahepatic recurrence is about 4-5 months it found that the prognosis is very
poor. Therefore, the authors report a case showed long term survival in patients with early
intrahepatic recur and extrahepatic metastasis after curative resection of HCC.
- A Case of Curative Resection of Advanced Hepatocellular Carcinoma After Localized Concurrent Chemo-Radiation Therapy
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Wonseok Kang, Ki Tae Yoon, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Chae Yoon Chon, Kyung Sik Kim, Young Nyun Park, Jin Sil Seong, Kwang Hyub Han
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Journal of the Korean Liver Cancer Study Group. 2008;8(1):98-101. Published online June 30, 2008
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Abstract
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- Most patients with advanced hepatocellular carcinoma (HCC) are not suitable candidates for surgical treatment
at the time of diagnosis because of poor liver function, extensive tumor involvement of the liver, vascular
involvement, and/or intra/extrahepatic metastasis. We attempted localized concurrent chemo-radiation therapy
(CCRT) followed by hepatic arterial infusion chemotherapy (HAIC) in patients having locally advanced HCC with
vascular involvement and preserved hepatic function. We report a case of locally advanced HCC patient who
became surgically resectable by downstaging after localized CCRT followed by HAIC. Localized CCRT was
performed with a total radiation dose of 4,500 cGy (180 cGy × 25 times) and hepatic arterial infusion of
5-fluorouracil (5-FU, 500 mg/day) via implantable port system during the first and the last weeks of the
radiotherapy. Following localized CCRT, the patient was scheduled to receive HAIC with 5-FU (500 mg/m2 for
5 hours, days 1~3) and cisplatin (60 mg/m2 for 2 hours, day 2) every 4 weeks. Marked contraction of HCC was
noted on follow up computerized tomography (CT) and positron emission tomography (PET) after localized CCRT
and HAIC, and subsequently surgical resection with curative aim was performed. The patient is in complete
remission status without recurrence to date.
- A Case of Localized Concurrent Chemo-radiation Therapy Using with Tomotherapy for Hilar Hepatocellular Carcinoma with Invasion of Bilateral Bile Duct
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Ki Tae Yoon, Do Young Kim, Jin Sil Seong, Jun Yong Park, Jong Won Choi, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon
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Journal of the Korean Liver Cancer Study Group. 2008;8(1):102-105. Published online June 30, 2008
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Abstract
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- Hepatocellular carcinoma (HCC) usually takes an intrahepatic spread via portal vein branches, and the incidence
of portal vein invasion is reported to be 34~40% in surgical resected series. On the other hand, the rate of
intrabiliary growth of HCC is rare, ranging from 2.3~13% in surgical and autopsy cases. Here, we report a case
of the patient treated with localized concurrent chemo-radiation therapy (CCRT) for hilar HCC with invasion of
bilateral bile duct. The tomotherapy was performed with a total radiation dose of 4,240 cGy (20 times, 212
cGy/time) on tumor bed and hepatic arterial infusion of 5-fluorouracil (1,000 mg/day, day 1~5 and day 16~20)
and cisplatin (60 mg/m2, day 3 and day 18) was done via implantable port system during the radiotherapy. After
that, tumor size and tumor marker was decreased and treatment response was achieved as partial response. CCRT
is expected as one of the appropriated treatment options for inoperable HCC with bile duct invasion.
- Excellent Response to Hepatic Arterial Infusional Chemotherapy in Advanced Hepatocellular Carcinoma with Portal Vein Thrombosis
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Keun-Ho Lee, Ja Kyung Kim, Kwang-Hyub Han, Jong Tae Lee, Do Youn Lee, Jong Yoon Won, Hyun Woong Lee, Hwa Sook Kim, Ki Tae Yoon, Sang Hoon Ahn, Chae Yoon Chon, Young Myoung Moon
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Journal of the Korean Liver Cancer Study Group. 2006;6(1):42-46. Published online June 30, 2006
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Abstract
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- There is no treatment of curative aim in advanced hepatocellular carcinoma (HCC) with portal vein thrombosis
(PVT), which is associated with poor prognosis. Albeit one of the treatment options is intra-arterial infusional
chemotherapy, its therapeutic efficacy was minimal. In this report, we present an unusual case of a patient with
favorable result after intra-arterial infusional chemotherapy. This patient was HBV carrier and diagnosed having
HCC of stage IVb (T4N0M1) with right PVT on February 1999. Direct right adrenal gland and right kidney
invasion and numerous intrahepatic metastases were also noted. The serum AFP level showed more than 60,000
ng/mL, and the Child-Pugh score was 5 (class A). The patient received three sessions of intra-arterial
5-fluorouracil (5-FU) and cisplatin combination chemotherapy and two additional sessions of systemic (5-FU)
chemotherapy combined with intra-arterial cisplatin infusion. After total 5 sessions of combination chemotherapy,
follow-up CT scan revealed grossly total necrosis of main HCC and numerous intrahepatic metastases, without
evidence of viable portion in July 1999. The AFP level decreased to 79.4 ng/mL. The latest CT scan taken in
November 2005 also showed no evidence of recurrence. It is noteworthy that the patient with advanced HCC with
PVT showed complete remission only after 5 sessions of intra-arterial chemotherapy and the status of complete
remission is maintained for more than 76 months.
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