Long-term complete response of advanced hepatocellular carcinoma treated with multidisciplinary therapy including reduced dose of sorafenib: Case report and review of the literature

Masahiro Shinoda, Norihiro Kishida, Osamu Itano, Shigenori Ei, Akihisa Ueno, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Yohei Masugi, Minoru Tanabe, Koichi Aiura, Michiie Sakamaoto, Akihiro Tanimoto, Yuukou Kitagawa

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Abstract

An 83-year-old man underwent computed tomography during a routine check-up due to a history of surgical treatment for pancreatic cancer. Two tumors were detected in the anterior segment of the liver. A needle biopsy of the larger tumor was performed, and pathological examination showed that the tumor was a poorly differentiated hepatocellular carcinoma. Resection was not performed considering the patient's poor physical condition. Thus, transcatheter arterial chemoembolization and radiofrequency ablation of the tumors were performed. Three months later, residual tumor of the larger lesion and multiple pulmonary metastases were detected. This time, continuous hepatic arterial infusion chemotherapy was performed. Although the pulmonary metastases markedly reduced, tumor thrombi appeared in the right portal vein on computed tomography. Finally, sorafenib was administered, which led to disappearance of the tumor thrombi and no other signs of recurrence 8 months after initiation of sorafenib on computed tomography. Although sorafenib administration has continued at reduced doses of 200 mg per day or less due to hypertension, complete response has persisted for the past 34 months. It is noteworthy that sorafenib has been given at reduced doses, but a long-term complete response is maintained in a patient who had portal tumor thrombi and distant metastasis. Herein, we present this rare case of advanced hepatocellular carcinoma controlled with reduced doses of sorafenib following multidisciplinary therapy, describe our single center experience with sorafenib use in patients with hepatocellular carcinoma, and review previous reports that focused on dose reduction of sorafenib.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalWorld Journal of Surgical Oncology
DOIs
Publication statusAccepted/In press - 2015 Apr 9

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Hepatocellular Carcinoma
Neoplasms
Thrombosis
Tomography
Neoplasm Metastasis
Therapeutics
Lung
Liver
Residual Neoplasm
Needle Biopsy
Portal Vein
sorafenib
Pancreatic Neoplasms
Hypertension
Recurrence
Drug Therapy

Keywords

  • Hepatocellular carcinoma
  • Long-term complete response
  • Reduced dose
  • Sorafenib
  • Tumor thrombi

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

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title = "Long-term complete response of advanced hepatocellular carcinoma treated with multidisciplinary therapy including reduced dose of sorafenib: Case report and review of the literature",
abstract = "An 83-year-old man underwent computed tomography during a routine check-up due to a history of surgical treatment for pancreatic cancer. Two tumors were detected in the anterior segment of the liver. A needle biopsy of the larger tumor was performed, and pathological examination showed that the tumor was a poorly differentiated hepatocellular carcinoma. Resection was not performed considering the patient's poor physical condition. Thus, transcatheter arterial chemoembolization and radiofrequency ablation of the tumors were performed. Three months later, residual tumor of the larger lesion and multiple pulmonary metastases were detected. This time, continuous hepatic arterial infusion chemotherapy was performed. Although the pulmonary metastases markedly reduced, tumor thrombi appeared in the right portal vein on computed tomography. Finally, sorafenib was administered, which led to disappearance of the tumor thrombi and no other signs of recurrence 8 months after initiation of sorafenib on computed tomography. Although sorafenib administration has continued at reduced doses of 200 mg per day or less due to hypertension, complete response has persisted for the past 34 months. It is noteworthy that sorafenib has been given at reduced doses, but a long-term complete response is maintained in a patient who had portal tumor thrombi and distant metastasis. Herein, we present this rare case of advanced hepatocellular carcinoma controlled with reduced doses of sorafenib following multidisciplinary therapy, describe our single center experience with sorafenib use in patients with hepatocellular carcinoma, and review previous reports that focused on dose reduction of sorafenib.",
keywords = "Hepatocellular carcinoma, Long-term complete response, Reduced dose, Sorafenib, Tumor thrombi",
author = "Masahiro Shinoda and Norihiro Kishida and Osamu Itano and Shigenori Ei and Akihisa Ueno and Minoru Kitago and Yuta Abe and Taizo Hibi and Hiroshi Yagi and Yohei Masugi and Minoru Tanabe and Koichi Aiura and Michiie Sakamaoto and Akihiro Tanimoto and Yuukou Kitagawa",
year = "2015",
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doi = "10.1186/s12957-015-0559-9",
language = "English",
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journal = "World Journal of Surgical Oncology",
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T1 - Long-term complete response of advanced hepatocellular carcinoma treated with multidisciplinary therapy including reduced dose of sorafenib

T2 - Case report and review of the literature

AU - Shinoda, Masahiro

AU - Kishida, Norihiro

AU - Itano, Osamu

AU - Ei, Shigenori

AU - Ueno, Akihisa

AU - Kitago, Minoru

AU - Abe, Yuta

AU - Hibi, Taizo

AU - Yagi, Hiroshi

AU - Masugi, Yohei

AU - Tanabe, Minoru

AU - Aiura, Koichi

AU - Sakamaoto, Michiie

AU - Tanimoto, Akihiro

AU - Kitagawa, Yuukou

PY - 2015/4/9

Y1 - 2015/4/9

N2 - An 83-year-old man underwent computed tomography during a routine check-up due to a history of surgical treatment for pancreatic cancer. Two tumors were detected in the anterior segment of the liver. A needle biopsy of the larger tumor was performed, and pathological examination showed that the tumor was a poorly differentiated hepatocellular carcinoma. Resection was not performed considering the patient's poor physical condition. Thus, transcatheter arterial chemoembolization and radiofrequency ablation of the tumors were performed. Three months later, residual tumor of the larger lesion and multiple pulmonary metastases were detected. This time, continuous hepatic arterial infusion chemotherapy was performed. Although the pulmonary metastases markedly reduced, tumor thrombi appeared in the right portal vein on computed tomography. Finally, sorafenib was administered, which led to disappearance of the tumor thrombi and no other signs of recurrence 8 months after initiation of sorafenib on computed tomography. Although sorafenib administration has continued at reduced doses of 200 mg per day or less due to hypertension, complete response has persisted for the past 34 months. It is noteworthy that sorafenib has been given at reduced doses, but a long-term complete response is maintained in a patient who had portal tumor thrombi and distant metastasis. Herein, we present this rare case of advanced hepatocellular carcinoma controlled with reduced doses of sorafenib following multidisciplinary therapy, describe our single center experience with sorafenib use in patients with hepatocellular carcinoma, and review previous reports that focused on dose reduction of sorafenib.

AB - An 83-year-old man underwent computed tomography during a routine check-up due to a history of surgical treatment for pancreatic cancer. Two tumors were detected in the anterior segment of the liver. A needle biopsy of the larger tumor was performed, and pathological examination showed that the tumor was a poorly differentiated hepatocellular carcinoma. Resection was not performed considering the patient's poor physical condition. Thus, transcatheter arterial chemoembolization and radiofrequency ablation of the tumors were performed. Three months later, residual tumor of the larger lesion and multiple pulmonary metastases were detected. This time, continuous hepatic arterial infusion chemotherapy was performed. Although the pulmonary metastases markedly reduced, tumor thrombi appeared in the right portal vein on computed tomography. Finally, sorafenib was administered, which led to disappearance of the tumor thrombi and no other signs of recurrence 8 months after initiation of sorafenib on computed tomography. Although sorafenib administration has continued at reduced doses of 200 mg per day or less due to hypertension, complete response has persisted for the past 34 months. It is noteworthy that sorafenib has been given at reduced doses, but a long-term complete response is maintained in a patient who had portal tumor thrombi and distant metastasis. Herein, we present this rare case of advanced hepatocellular carcinoma controlled with reduced doses of sorafenib following multidisciplinary therapy, describe our single center experience with sorafenib use in patients with hepatocellular carcinoma, and review previous reports that focused on dose reduction of sorafenib.

KW - Hepatocellular carcinoma

KW - Long-term complete response

KW - Reduced dose

KW - Sorafenib

KW - Tumor thrombi

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JO - World Journal of Surgical Oncology

JF - World Journal of Surgical Oncology

SN - 1477-7819

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