Abstract

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.

• Keywords: Hepatocellular carcinoma;Intraarterial infusion;Combination chemotherapy