Gatti Pietro, Giorgio Antonio, Ciracì Emanuela, Roberto Italia, Anglani Alessandro, Sergio Spano, Rizzello Fernando, Giorgio Valentina, Semeraro Stefano
Internal Medicine Division, Ostuni Hospital, Ostuni, BR, Italy.
Interventional Ultrasound Unit, Tortorella Clinical Hospital, Salerno, Italy.
J Ultrasound. 2019 Sep;22(3):363-370. doi: 10.1007/s40477-019-00361-w. Epub 2019 Mar 12.
Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In advanced cancer stages (metastatic disease and/or vascular invasion), the generally accepted standard of care is systemic therapy using sorafenib as first-line treatment and, recently, regorafenib and nivolumab as second-line treatment, but the quality of life and the prognosis of patients remain very poor. Our paper reports a case of US-guided radiofrequency ablation (RFA) of both intraparenchymal HCC and inferior vena cava tumor thrombus.
We treated a patient with HCC associated with tumor thrombus extending into vena cava after failure of sorafenib therapy using US-guided radiofrequency ablation (RFA).
A good radiological and clinical response was observed in association with excellent tolerability. The patient has been followed up for 15 months from the ablation, is alive, and is in a good clinical condition without evidence of tumor recurrence.
This is the first case in which this minimally invasive percutaneous procedure has been successfully used to treat an HCC thrombus entering the vena cava.
肝细胞癌(HCC)是最常见的肝癌形式。在癌症晚期(转移性疾病和/或血管侵犯),普遍接受的治疗标准是使用索拉非尼作为一线治疗的全身治疗,最近,瑞戈非尼和纳武单抗作为二线治疗,但患者的生活质量和预后仍然很差。我们的论文报道了1例经超声引导对肝实质内肝癌和下腔静脉肿瘤血栓进行射频消融(RFA)的病例。
我们对1例索拉非尼治疗失败后出现肿瘤血栓延伸至腔静脉的HCC患者,采用超声引导下射频消融(RFA)进行治疗。
观察到良好的放射学和临床反应,且耐受性良好。自消融后该患者已随访15个月,仍然存活,临床状况良好,无肿瘤复发迹象。
这是首例成功使用这种微创经皮手术治疗进入腔静脉的HCC血栓的病例。