- A Case of Advanced Hepatocellular Carcinoma which was Supervening with Renal Cell Cancer Cured by Repeated Transarterial Chemoembolization and Sorafenib after Resection
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Bun Kim, Jae Hoon Min, Seung Up Kim, Jun Yong Park, Kwang Hoon Lee, Do Youn Lee, Jin Sub Choi, Young Deuk Choi, Nam Hoon Cho, Young Nyun Park, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Do Young Kim
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Journal of the Korean Liver Cancer Study Group. 2012;12(1):51-57. Published online February 28, 2012
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Abstract
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- Advanced hepatocellular carcinoma (HCC) is difficult to treat and the survival is poor. Here, we present a patient diagnosed as
advanced HCC (stage IIIa) which was supervening with early renal cell cancer (stage I). The patient was treated with
pre-operational transarterial chemoembolization (TACE) and surgical resection (right hepatectomy, right nephrectomy, and
cholecystectomy). Sorafenib were taken continually after surgery. Multiple recurred HCC nodules in remnant liver were detected
2 months later after surgery. Combined treatment modalities including 4 sessions of TACE, and 12 cycles of 5-flurouracil
(FU)/carboplatin based hepatic arterial infusional chemotherapy (HAIC) induced complete response. After the diagnosis of
advanced HCC, the patient survived 36 months and experienced disease-free status for 19 months.
- A Case of Hepatocellular Carcinoma showing Progressive Disease in Systemic Chemotherapy, but Partial Response in Hepatic Arterial Infusion Chemotherapy with the Same Regimen
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Soung Min Jeon, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Chae Yoon Chon, Jun Yong Park
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Journal of the Korean Liver Cancer Study Group. 2010;10(1):44-48. Published online June 30, 2010
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Abstract
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- Hepatocellular carcinoma (HCC) is the third most common malignancy in Korea. Despite recent advances in the area of
HCC, a considerable number of HCC patients require non-surgical treatments and systemic therapies because of poor liver
function or intermediate to advanced cancer stages at the time of diagnosis. Unfortunately, chemotherapy for advanced HCC
has limited response rates and provides a marginal survival benefit. Several studies have supported potential advantages of
hepatic arterial infusion chemotherapy (HAIC), designed to improve chemotherapy benefits by increasing the amount of
chemotherapy delivered to the site of the tumor and to minimizes the side-effects of the chemotherapy. However, there hasn’t
been any report showing different responses between systemic chemotherapy and HAIC for the same patient. Herein, we
report a case of HCC showing progressive disease in systemic chemotherapy, but partial response in HAIC with the same
regimen for the same patient with portal vein thrombosis. This case implies HAIC might be alternative option for HCC
patient showing ineffective response to systemic chemotherapy, even with the same regimen.
- 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 Advanced Hepatocellular Carcinoma with Inferior Vena Caval Invasion, Resected with a Curative Aim after Concurrent Chemo-Radiation Therapy
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Seung Up Kim, Kwang Hyub Han, Jin Sil Sung, Do Young Kim, Sang Hoon Ahn, Gyeong Sig Kim, Young Nyun Park, Chae Yoon Chon
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Journal of the Korean Liver Cancer Study Group. 2007;7(1):77-81. Published online June 30, 2007
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Abstract
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- Hepatocellular carcinoma (HCC) with tumor thrombus in inferior vena cava (IVC) is difficult to treat. Therefore,
there are no specific treatment modalities for such case. Here, we present a patient diagnosed as hepatocellular
carcinoma with tumor thrombus in inferior vena cava (stage IVa). The patient was treated with concurrent
chemo-radiation therapy (CCRT) for 5 weeks. After that, tumor size was markedly decreased, and 9th courses of
additional intra-arterial chemotherapy were performed. Follow-up positron emission tomography- computed
tomography (PET-CT) showed shrinked hepatocellular carcinoma and right lobe, disappearance of IVC tumor
thrombus, decreased size of right hepatic vein thrombus and a faint uptake at gallbladder. Residual malignancy
could not be excluded. So, right hepatic lobectomy with a curative aim was performed and its result was
successful.
- A Case of Hepatocellular Carcinoma with Bile Duct Invasion
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Seung Min Bang, Hye Won Chung, Jae Youn Cheong, Chung Ryul Lee, Kun Hoon Song, Kwang Hyub Han, Chae Yoon Cheon, Young Myoung Moon, Sung Il Park, Do Yun Lee, Jong Tae Lee
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Journal of the Korean Liver Cancer Study Group. 2001;1(1):85-88. Published online June 30, 2001
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Abstract
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- A 52 year-old female patient with liver cirrhosis admitted due to icteric skin color for 3 weeks. Four months ago, she had been diagnosed as hepatocellular carcinoma(HCC), and treated with transarterial chemoembolization(TACE) at another hospital. Physical findings revealed that she had icteric sclera without ascites or palpable hepatosplenomegaly. Total bilirubin was 6.0mg/dL, ALT/AST was 117/111 IU/L. Computed tomography showed 3cm sized nodular mass involving left lateral segment of the liver and left intrahepatic bile duct. Endoscopic retrograde cholangiopancreatography(ERCP) revealed filling defect of left intrahepaitc duct and common hepatic duct, suggesting left intrahepatic duct and common hepatic duct invasion of HCC. After endoscopic retrograde biliary drainage(ERBD) with stent insertion, total bilirubin was decreased and clinical symptoms were improved. She was treated with TACE using adriamycin after ERBD. Thereafter, she was prescribed oral 5-fluorouracil and treated with external radiotherapy(4,500cGy). Five months later after the treatment, CT scan showed decrease in tumor size, and jaundice was improved as well.
- A Case of Hepatocellular Carcinoma with Dramatic Therapeutic Response in Stage Ⅳa (T4N0M0)
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Hye Won Chung, Jae Youn Cheong, Kun Hoon Song, Kwang Hyub Han, Young Myoung Moon, Byoung Ro Kim, Jin Sil Seong, Myoung Jin Kim, Do Yun Lee, Young Nyun Park
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Journal of the Korean Liver Cancer Study Group. 2001;1(1):89-92. Published online June 30, 2001
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Abstract
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- A 52 year-old-female patient was admitted due to right upper quadrant abdominal pain and right shoulder pain for 1 month. She had no history of previous medical problem before admission. At admission, physical findings revealed that she had 2 FB palpable hepatomegaly and others were not remarkable. Laboratory findings revealed that HBsAg and HBeAG were positive enhanced at arterial phase involving entire right lobe and S4, and thrombus at main portal vein. Clinically she was diagnosed advanced hepatocellular carcinoma(HCC) and TNM stage was T4N0M0, stage Ⅳa. She was treated with transarterial chemoembolization(TACE) for 2 cycles and radiation therapy. After TACE and radiation therapy, the tumor size decreased and the main portal vein thrombus was disappeared. Then, she underwent extended right lobectomy of the liver. Pathology of operative specimen revealed well-encapsulated HCC at Edmonsons grade Ⅱ, near total necrosis. Normal liver tissue showed sinusoidal congestion, mild periportal fibrosis, and veno-occlusive disease. Two years after the operation, there had been no sign of recurrence and follow-up CT scan showed sign of recurrence at S2. He underwent percutaneous Holmium injection 3 times and TACE 4 times, and so far he survived for 6 years and 10 months. He is currently under observation at out patient department.
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