To date, there are limited data and little consensus on treatment strategies for huge hepatocellular carcinoma (HCC). Surgical resection provides significantly better survival than other modalities for single large HCC regardless of tumor stage. Recently, with technological advances in radiation therapy, stereotactic body radiation therapy (SBRT) is considered an alternative treatment option for HCC. Herein, we present a case of huge HCC that was successfully managed by SBRT. Transarterial embolization, previously performed in Russia, was incomplete. It was also not suitable for resection and transarterial chemoembolization. Although the rationale for radiotherapy in huge HCC was insufficient, SBRT was performed because no other treatment options were available. Additional radiofrequency ablation was performed for small HCC in a different segment, and radiological complete response (CR) was achieved. The CR was maintained over 4 years. Therefore, SBRT may be an alternative treatment option for large HCC that is not suitable for curative treatment.
Radiofrequency ablation (RFA) is a minimally invasive local therapy for hepatocellular carcinoma (HCC). Even though RFA is considered to be a safe treatment modality, a variety of complications have been reported. Recently, we encountered a case of refractory fistula between a liver abscess and the gallbladder after RFA. A 64-year-old woman diagnosed with HCC associated with chronic hepatitis B was treated by RFA. After RFA, she experienced abdominal pain, and abdominal computed tomography (CT) revealed a liver abscess complicated by a previous treatment of HCC, she was treated with intravenous antibiotics and percutaneous abscess drainage. Follow-up abdominal CT revealed a fistula between the liver abscess and gallbladder, which was successfully treated with percutaneous transcatheter n-butyl-2-cyanoacrylate (NBCA) embolization. We herein report the rare case of a refractory fistula between a liver abscess and the gallbladder after RFA in a patient treated with NBCA embolization.
External beam radiotherapy, transarterial chemoembolization and sorafenib are currently
standard treatments for advanced hepatocellular carcinoma (HCC) with portal vein
thrombosis. However, hepatic arterial infusion chemotherapy has been applied to advanced
stage HCC with a view to improving the therapeutic effect. We experienced a case of
advanced HCC with clinical complete response after hepatic artery infusion chemotherapy
and radiation therapy and report that.
Citations
Citations to this article as recorded by
A Case of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Treated by Hepatic Arterial Infusion Chemotherapy and Radiotherapy Jin Yong Lee, Jeong-Ju Yoo, Seong Joon Chun, Sun Hyun Bae, Jae Myeong Lee, Sang Gyune Kim, Young Seok Kim Journal of Liver Cancer.2020; 20(1): 78. CrossRef
Hepatocellular carcinoma (HCC) have relatively well known causative factors such as chronic
hepatitis B, chronic hepatitis C, alcoholic liver disease, Non-alcoholic fatty liver disease (NAFLD),
liver cirrhosis and so on. Recently, interesting reports that HCC in the absence of cirrhosis
or other chronic liver disease and HCC associated with NAFLD and metabolic syndrome are
increasing in USA. So far, there is no report about these issues in Korea. We present a 65 yearold
obesity male who had no preceding chronic liver disease history. He was diagnosed as
primary HCC and the mass was removed completely. However, HCC recurred shortly after
operation. Multiple recurred HCC were treated with transcatheter arterial chemoembolization.
(J Liver Cancer 2015;15:112-117)
Background/Aims Given the high incidence and mortality rate of hepatocellular carcinoma
(HCC), ensuring high quality of registry data is important for the improvement of health
service. Registries by voluntary reporting often lack case completeness and may cause
selection bias. A statutory Korean Central Cancer Registry (KCCR) has case completeness and
provides accurate information on HCC incidence, but provides limited information about HCC
characteristics. Methods The Korean Liver Cancer Study Group (KLCSG) and the KCCR jointly built a
nationwide cohort of patients who were diagnosed with HCC between 2003 and 2005. Out
of 31,521 new HCC cases that were registered at the KCCR between 2003 and 2005, 4,630 case s (14.7% of total HCC cases) were randomly selected and abstracted from 32 hospitals
nationwide, and followed up until December 2011. After excluding 110 patients who met the
exclusion criteria, a total of 4,520 HCC patients were analyzed. Results Mean age at the diagnosis of HCC was 57.1±10.8 years, and males comprised 81.0%.
Hepatitis B was the predominant etiology (72%), and hepatitis C comprised 12%. Stage
at diagnosis was 10%, 43%, 28%, 11% and 8% for modified International Union Against
Cancer (mUICC) stages I, II, III, IV-A and IV-B, respectively. Initial treatment modalities
were transarterial therapy in 53%, surgical resection in 10%, local ablation in 7%, and liver
transplantation in 1%. The median survival was 1.4 years, and the 1-, 3-, and 5-year survival rates were 56%, 35% and 27%, respectively. Age, gender, Child-Pugh class, etiology, tumor
stage at diagnosis, and treatment modality were factors independently related to survival. Conclusions About half of HCC patients are diagnosed at advanced stages in Korea. Curativeintent
treatments are rarely applied to patients. This data provides unbiased information
about the characteristics and outcome of HCC patients in Korea. (J Liver Cancer 2014;14:97-
107)
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Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry Young Eun Chon, Han Ah Lee, Jun Sik Yoon, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee Journal of Liver Cancer.2020; 20(2): 135. CrossRef
Subclassification of Barcelona Clinic Liver Cancer B and C hepatocellular carcinoma: A cohort study of the multicenter registry database Sangheun Lee, Beom Kyung Kim, Kijun Song, Jun Yong Park, Sang Hoon Ahn, Seung Up Kim, Kwang‐Hyub Han, Do Young Kim Journal of Gastroenterology and Hepatology.2016; 31(4): 842. CrossRef
Chang Wook Park, Young Lan Kown, Yong Jin Kim, Yoon Jung Kim, Hye Jin Seo, Kyung In Lee, Eun Soo Kim, Byung Kook Jang, Woo Jin Jeong, Kyung Sik Park, Kwang Bum Jo, Jae Seok Hwang, Young Hwan Kim, Jung Hyuk Kwon
Journal of the Korean Liver Cancer Study Group. 2010;10(1):40-43. Published online June 30, 2010
Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. Especially potal vein invasion is a grave
prognostic indicator in the setting of HCC. There is currently no effective method for treatment of HCC with portal vein
invasion. A 61-year-old female patient was diagnosed a massive HCCs in both hepatic lobe with portal vein thrombosis,
based on computed tomography (CT) and increased tumor marker, α-fetoprotein. She was treated with intrahepatic arterial
CDDP (10 mg on 1~5 day), 5-FU (250mg on 1~5 day) and leukovorin (12mg on 1~5 day) infusion via percutaneously
implantable port system (PIPS) every 3 weeks, totally seven times. The patient was still living 6 months after first hepatic
arterial infusion chemotherapy (HAIC) and follow-up CT showed partial response with necrosis of HCCs. We report here
a case of advanced HCC with portal vein thrombosis that was effectively treated with HAIC via PIPS.
Kyung In Lee, Young Lan Kwon, Yoon Jung Kim, Hye Jin Seo, Yong Jin Kim, Chang Wook Park, Eun Soo Kim, Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Jung Hyeok Kwon
Journal of the Korean Liver Cancer Study Group. 2010;10(1):64-68. Published online June 30, 2010
Bone metastasis is not uncommon and shows poor survival in patients with hepatocellular carcinoma (HCC). We describe
a case of HCC presenting with rib metastasis in a 54-year-old man. In spite of radiotherapy for rib metastasis, pain was
sustained and size of lesions were increased. So we performd CT-guided percutaneous ethanol injection therapy (PEIT).
Whenever new metastatic bone lesions were detected, we have done PEIT. However, abdominal CT scan at 25th month after
diagnosis shows residual viable tumors in pelvic bone and multiple metastatic nodules in both lung. He is alive by taking
conservative management for 27 months after diagnosis.
Improved imaging techniques have led to increasing detection of hepatic nodules incidentally. In many cases, a
lesion that has been detected by imaging studies is not sufficiently characteristic, or there are other clinical
concern, so that an imaging guided percutaneous needle biopsy is performed for definitive diagnosis. But
sometimes, there are diagnostic difficulty due to limited diagnostic samples. We report a case of diagnosis to
benign nodule, but not confirmed specific disease, by repeated CT guided fine needle biopsy.
Woo Jin Chung, Sang Hun Jeon, Dong Choon Kim, Ju Yup Lee, Kyung In Lee, Hye Jin Seo, Byung Kuk Jang, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Sung Hoon Ahn, Ku Jeong Kang, Young Hoon Kim, Jung Hyeok Kweon, Young Hwan Kim, Yu Na Kang
Journal of the Korean Liver Cancer Study Group. 2007;7(1):59-61. Published online June 30, 2007
A 51 years-old man who had postnecrotic liver cirrhosis due to chronic hepatitis B had elevated serum alpha
fetoprotein level. According to computed tomographic findings, about 2.4cm sized mass was noted at segment 7
and he underwent segmentectomy. After 9 months later, multicentric recurrence was detected at segment 5-6, So,
he underwent transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection therapy. After
22 months later, marginal recurrence was noted again at segment 6. So, he underwent 2nd TACE and he was
following up over 30 months until now.
Prognosis of advanced hepatocellular carcinoma (HCC) treated by conventional therapies has been considered
to be poor. Hepatic arterial infusion therapy (HAIT) has been tried for advanced hepatocellular carcinoma with
portal vein tumor thrombosis or ineffective response to other treatment. We report two cases of advanced HCC
showing good respense to transarterial chemoembolization and CT guided percutaneous ethanol injection therapy.
Extrahepatic metastases of hepatocellular carcinoma (HCC) are now increasing due to prolonged survival.
Extrahepatic metastases of HCC frequently develop in patients with more advanced stage and sometimes occur
without intrahepatic recurrence. We report two cases bone metastasis of HCC without intrahepatic recurrence
after treatment.