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Journal of the Korean Liver Cancer Study 2007;7(1):66-70.
Published online June 30, 2007.
A long-term survival case of advanced hepatocellular carcinoma with portal vein thrombosis successfully treated with multimodal treatments
Ju Hyun Choi1, Han Eul Song1, Chang Il Kwon1, Kwang Hyun Ko1, Sung Pyo Hong1, Seong Gyu Hwang1, Pil Won Park1, Kyu Sung Rim1, Man Deuk Kim2, Sung Won Kwon3
1Departments of Internal Medicine, College of Medicine, Pochon CHA University, Seongnam, Korea
2Departments of Radiology, College of Medicine, Pochon CHA University, Seongnam, Korea
3Departments of Surgery, College of Medicine, Pochon CHA University, Seongnam, Korea
Correspondence:  Seong Gyu Hwang,
Email: sghwang@cha.ac.kr
Copyright ©2007 by The Korean Liver Cancer Association
Abstract
We reported a 52-year-old women with hepatocellular carcinoma (HCC) of 10 cm in diameter involving entire right lobe with advanced tumor thrombosis in the both branches and main trunk of portal vein. She was treated with multimodal treatments resulting in a long-term survival of more than 5 years. At first, she was treated with hepatic arterial chemotherapy (HAC) using cisplatin and 5-FU for 5 cycles and radiation therapy in September 2002. The tumor size decreased and the main and left portal vein thrombosis was disappeared. Although, she had been treated with the 3th radiofrequency ablation (RFA) and the 3th transarterial chemoembolization (TACE) three times for the treatment of main tumor, follow-up CT scan still showed marginal viable tumor at the segment 5. Therefore, she was underwent right lobectomy of the liver and splenectomy. Further TACE was performed once for the small remnant tumor around inferior vena cava at the postoperative 4 months. Finally, she has been survived for over 5 years from the initial treatment and 23 months after operation without evidence of recurrence. We suggest that the long-term survival was achieved in this patient through appropriate treatment selections at the right time, such as HAC, RFA, TACE, hepatic resection and external radiotherapy based on changes in diagnostic imaging and tumor markers.
Key Words: Hepatocellular carcinoma; Portal vein thrombosis; Multimodal treatments
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