Pathologically successful conversion hepatectomy for advanced giant hepatocellular carcinoma after multidisciplinary therapy:A case report and review of literature  

作　　者：Ju-Hang Chu Lu-Yao Huang Ya-Ru Wang Jun Li Shi-Long Han Hao Xi Wen-Xue Gao Ying-Yu Cui Ming-Ping Qian 

机构地区：[1]Department of General Surgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China [2]Department of Interventional and Vascular Surgery,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China [3]Department of Pathology,Shanghai Tenth People's Hospital,School of Medicine,Tongji University,Shanghai 200072,China [4]Clinical Research Management Office,Shanghai Tenth People’s Hospital,Shanghai 200072,China [5]Department of Cell Biology,Institute of Medical Genetics,State Key Laboratory of Cardiology,Tongji University School of Medicine,Shanghai 200331,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第4期1647-1659,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by Shanghai Hospital Development Center Foundation,No.SHDC2022CRS033.

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of death due to its complexity,heterogeneity,rapid metastasis and easy recurrence after surgical resection.We demonstrated that combination therapy with transcatheter arterial chemoembolization(TACE),hepatic arterial infusion chemotherapy(HAIC),Epclusa,Lenvatinib and Sintilimab is useful for patients with advanced HCC.CASE SUMMARY A 69-year-old man who was infected with hepatitis C virus(HCV)30 years previously was admitted to the hospital with abdominal pain.Enhanced computed tomography(CT)revealed a low-density mass in the right lobe of the liver,with a volume of 12.9 cm×9.4 cm×15 cm,and the mass exhibited a“fast-in/fast-out”pattern,with extensive filling defect areas in the right branch of the portal vein and an alpha-fetoprotein level as high as 657 ng/mL.Therefore,he was judged to have advanced HCC.During treatment,the patient received three months of Epclusa,three TACE treatments,two HAIC treatments,three courses of sintilimab,and twenty-one months of lenvatinib.In the third month of treatment,the patient developed severe side effects and had to stop immunotherapy,and the Lenvatinib dose had to be halved.Postoperative pathological diagnosis indicated a complete response.The patient recovered well after the operation,and no tumor recurrence was found.CONCLUSION Multidisciplinary conversion therapy for advanced enormous HCC caused by HCV infection has a significant effect.Individualized drug adjustments should be made during any treatment according to the patient's tolerance to treatment.

关 键 词：Hepatocellular therapy Conversion hepatectomy Interventional therapy Epclusa Lenvatinib Sintilimab Case report 

分 类 号：R735.9[医药卫生—肿瘤]