Journal of Liver Cancer

Case Reports

A Case of Curative Resection of Advanced Hepatocellular Carcinoma After Localized Concurrent Chemo-Radiation Therapy: Jee Suk Kwon, Jeong Eun Lee, Woo Young Park, Kyung In Lee, Eun Soo Kim, Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Bum Cho, Jaeseok Hwang; Journal of the Korean Liver Cancer Study Group. 2009;9(1):67-70. Published online June 30, 2009

Abstract PDF: Advanced hepatocellular carcinoma (HCC) with portal vein thrombosis is not suitable candidates for surgical treatment at the most 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) in patients having locally advanced HCC with left and main portal vein thrombosis. We report a case of locally advanced HCC patient who became surgically resectable by downstaging after localized CCRT. Localized CCRT was performed with a total radiation dose of 5,040 cGy (180 cGy×28 times) and hepatic arterial infusion of 5-fluorouracil (5-FU, 250 mg/day) and cisplatin (10 mg/day) for 5 days via implantable port system during the second and the fifth weeks of the radiotherapy. Marked contraction of HCC was noted on follow up computerized tomography (CT) after localized CCRT, and subsequently surgical resection with curative aim was performed. He was gave a additional transcatheter arterial chemoembolization (TACE) because follow up CT revealed intrahepatic metastasis at subcapsular portion of right hepatic lobe after 3 months of operation. The patient is in complete remission status without recurrence to date.

A Case of Curative Resection of Advanced Hepatocellular Carcinoma After Localized Concurrent Chemo-Radiation Therapy: 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; Journal of the Korean Liver Cancer Study Group. 2008;8(1):98-101. Published online June 30, 2008

Abstract PDF: 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: Ki Tae Yoon, Do Young Kim, Jin Sil Seong, Jun Yong Park, Jong Won Choi, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon; Journal of the Korean Liver Cancer Study Group. 2008;8(1):102-105. Published online June 30, 2008

Abstract PDF: 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.

Curative Resection of Advanced Hepatocellular Carcinoma (TNM stage IVa) after Concurrent Chemo-Radiation Therapy: A Case Report: DY Kim, KH Han, SH Ahn, CM Moon, KK Kim, CY Chon, YM Moon, KS Kim, JS Sung, YN Park; Journal of the Korean Liver Cancer Study Group. 2005;5(1):22-26. Published online June 30, 2005

Abstract PDF: Hepatocellular carcinoma (HCC) with portal vein thrombosis is a difficult form of HCC to treat. Therefore, no specific treatment mordality has been absent. Here, we present a patient diagnosed as hepatocellular carcinoma with right portal vein thrombosis (stage IVa). The patient had been treated with concurrent chemo-radiation therapy (CCRT) for five weeks. After CCRR, tumor size was markedly decreased. Two courses of additional transcatheter arterial chemoembolization (TACE) and five courses of intraarterial 5-fluorouracil (5-FU)/cisplatin infusion were performed. Follow-up computerized tomography (CT) scan showed about 2cm-sized nodular lesion at lateral margin of right hepatic lobe. On angiography, it was shown that both the mass and intestine were commonly supplied by omental artery. For the treatment of the mass, right hepatic lobectomy was undertaken.

Search