A case of pathological complete response after combination chemotherapy by sorafenib and cisplatin hepatic arterial infusion for an advanced hepatocellular carcinoma

Sorafenib has emerged as an effective new drug for advanced hepatocellular carcinoma. Until now, however, only a few authors have reported reduction of an advanced hepatocellular carcinoma after treatment including sorafenib, with subsequent resection. We present a case of an advanced hepatocellular carcinoma resected following combination therapy by sorafenib and cisplatin transcatheter arterial infusion. A 56-year-old man with alcoholic liver disease underwent 6 courses of combination chemotherapy by sorafenib (400 mg orally, twice daily) and cisplatin transcatheter arterial infusion (65 mg/m², every 4-6 weeks) for a hepatocellular carcinoma in the right liver measuring 9 cm in diameter with tumor thrombi in the main portal vein and the inferior vena cava. The tumor showed stable disease according to RECIST criteria, but a partial response was achieved according to the modified RECIST criteria with marked shrinkage of the tumor thrombi. Therefore, right hepatectomy with tumor thrombectomy was performed 41 days after the final administration of sorafenib. Histologically, no viable tumor cells were found in the resected specimen and pathologic complete response was confirmed. The postoperative course was uneventful, and the patient is currently alive without recurrence 2 years after the surgery.