Journal of Liver Cancer

Case Reports

Long-term survival after CCRT and HAIC followed by ALPPS for hepatocellular carcinoma with portal vein invasion: a case report: In-Jung Kim, Sung Hwan Yoo, Jung Il Lee, Kwan Sik Lee, Hyun Woong Lee, Jin Hong Lim; J Liver Cancer. 2022;22(1):84-90. Published online March 22, 2022; DOI: https://doi.org/10.17998/jlc.2022.03.07

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There are various methods for treating advanced hepatocellular carcinoma with portal vein invasion, such as systemic chemotherapy, transarterial chemoembolization, transarterial radioembolization, and concurrent chemoradiotherapy. These methods have similar clinical efficacy but are designed with a palliative aim. Herein, we report a case that experienced complete remission through “associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)” after concurrent chemoradiotherapy and hepatic artery infusion chemotherapy. In this patient, concurrent chemoradiotherapy and hepatic artery infusion chemotherapy induced substantial tumor shrinkage, and hypertrophy of the nontumor liver was sufficiently induced by portal vein ligation (stage 1 surgery) followed by curative resection (stage 2 surgery). Using this approach, long-term survival with no evidence of recurrence was achieved at 16 months. Therefore, the optimal use of ALPPS requires sufficient consideration in cases of significant hepatocellular carcinoma shrinkage for curative purposes.

Citations

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Higher objective responses by hepatic arterial infusion chemotherapy following atezolizumab and bevacizumab failure than when used as initial therapy in hepatocellular carcinoma: a retrospective study
Jae-Sung Yoo, Ji Hoon Kim, Hee Sun Cho, Ji Won Han, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Suho Kim, Jung Suk Oh, Ho Jong Chun, Pil Soo Sung
Abdominal Radiology.2024; 49(9): 3127. CrossRef
Is multidisciplinary treatment effective for hepatocellular carcinoma with portal vein tumor thrombus?
Won Hyeok Choe
Journal of Liver Cancer.2022; 22(1): 1. CrossRef

Advanced Stage Hepatocellular Carcinoma Successfully Treated with Liver-directed Concurrent Chemoradiotherapy and Sequential Transarterial Radio-embolization: Minho Noh, Beom Kyung Kim, Seung Up Kim; J Liver Cancer. 2021;21(1):97-103. Published online March 31, 2021; DOI: https://doi.org/10.17998/jlc.21.1.97

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Abstract PDF: Optimal treatment strategies for patients with advanced hepatocellular carcinoma (HCC) is yet to be determined. Herein, we present a case of advanced HCC with tumor invasion into the right anterior portal vein and right hepatic vein where complete response (CR) was achieved via a multidisciplinary approach. This patient had a 10.5 cm-sized HCC invading segment VI, without extrahepatic spread. Liver function was classified as Child-Pugh class A, and the performance status was good. Transarterial radio-embolization (TARE) was performed 6 weeks after the completion of liver-directed concurrent chemoradiotherapy, and CR was confirmed 3 months post-TARE. Adoptive cell therapies were performed as adjuvant therapy and CR was maintained for over 15 months, until the local recurrence of a 2 cm-sized HCC was found. Therefore, in selected cases with preserved liver function, combination therapies, including LRTs and systemic therapy, can be a useful therapeutic option for advanced HCC.

A Case of Concurrent Chemoradiation Therapy for Locally Advanced Hepatocellular Carcinoma with Portal Vein Thrombosis: Tae Young Yang, Suk Pyo Shin, Joo Ho Lee, Yun Bin Lee, Hana Park, Seong Gyu Hwang, Kyu Sung Rim; J Liver Cancer. 2015;15(1):52-56. Published online March 31, 2015; DOI: https://doi.org/10.17998/jlc.15.1.52

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Abstract PDF: Patients with advanced hepatocellular carcinoma (HCC) with portal vein thrombosis (PVT) have an extremely poor prognosis. Although the Barcelona Clinic Liver Cancer guideline recommends sorafenib in advanced HCC with PVT, which has provided survival benefits of 2 or 3 months compared to the placebo group, many liver cancer centers in Asia still select multimodality approaches including transarterial chemoembolization, radiofrequency ablation, radiation therapy (RT) as well as systemic/intra-arterial chemotherapy. Recently advanced RT technologies have shown potential to improve survival without severe radiationrelated toxicity. For locally advanced HCC patients with PVT, concurrent chemoradiotherapy (CCRT) has been applied as a loco-regional treatment and provides potential cures. We herein report our recent experience of a patient accompanying large HCC with PVT who successfully undergone CCRT followed by hepatic arterial infusion chemotherapy.

Two Cases of Acute Hepatic Decompensation after Concurrent Chemoradiotherapy in Patients with Advanced Hepatocellular Carcinoma: Myoung Hwan Kim, Sang Hoon Ahn, Yong Han Paik, Kwan Sik Lee, Chae Yoon Chon, Young Myoung Moon, Jinsil Seong, Kwang Hyub Han; Journal of the Korean Liver Cancer Study Group. 2005;5(1):52-56. Published online June 30, 2005

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Abstract PDF: Advanced hepatocellular carcinoma with portal vein thrombosis has a poor prognosis. Concurrent chemoradiation (CCRT) therapy achieved favorable results in advanced hepatocellular carcinoma with portal vein thrombosis and can be considered as a treatment option for the management of advanced hepatocellular carcinoma.2 But, exacerbation of liver function during concurrent chemoradiotherapy is a critical complication in patients with hepatitis B virus (HBV) related HCC. Reactivation of HBV replication is a well-known complication in cancer patients receiving chemotherapy. We report two cases with acute exacerbation of liver function. The one
result
ed in hepatic decompensation after CCRT probably due to HCC progression and/or chemoradiotherapy and the other is due to reactivation of HBV replication after CCRT, who recovered after lamivudine and corticosteroid therapy.

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