Abstract

A case of hepatocellular carcinoma (HCC) with portal vein tumor thrombi (PVTT) which was performed hepatectomy after down-staging by proton therapy is reviewed. Generally, the recommended therapeutic strategy for this kind of HCC is radiation therapy, systemic or infusion anticancer chemotherapy. However, the response of HCC and its PVTT of this 56 year-old male patient was relatively good after 22 times of proton therapy, and we performed right hemihepatectomy on the concept of clinical trial under the informed consent of patient and his families. He is still alive without recurrence 15 months after hepatectomy. We suggest that hemihepatectomy with removal of PVTT could be an alternative strategy in the PVTT accompanied HCC cases who show good responses after the above generally recommended therapies.

• Keywords: Hepatocellular carcinoma;Portal vein tumor thrombus;Down-staging;Hepatectomy