A case of multiple hepatocellular carcinoma with inferior vena cava thrombosis which was resectable after multimodality therapy

Abstract

A 56-year old man with chronic hepatitis B was diagnosed as multiple hepatocellular carcinoma (HCC) with inferior vena cava invasion. Liver function was Child-Pugh class A. Sorafenib was administered after irradiation of HCC invasion into inferior vena cava CT scaa one month after the start of sorafenib revealed a stable disease by modified RECIST criteria but new leisions appeared. Therefore, treatment was switched to a combination chemotherapy of intra-arterial 5-fluorouracil (5FU) and systemic interferon-a (IFN-a). After four cycles of chemotherapy, HCC reduced in size considerably, the number of viable HCC was reduced to two, and there was no viable HCC in inferior vena cava. At this time, residual HCC was successfully resected by radical surgery. The present case suggest the possibility that, in case with preserved liver function, multimodality therapy including radiation, sorafenib and intra-arterial chemotherapy may prolong survival of selected patients with advanced HCC. © 2013 The Japan Society of Hepatology.