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.

• Keywords: Hepatocellular carcinoma;Portal vein thrombosis;Multimodal treatments