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仑伐替尼治疗下转化性肝切除术的结局:单中心经验。

The Outcome of Conversion Liver Resection Surgery by Lenvatinib Treatment: A Single Center Experience.

机构信息

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan;

Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

出版信息

Anticancer Res. 2022 Jun;42(6):3049-3054. doi: 10.21873/anticanres.15791.

Abstract

BACKGROUND

The efficacy of molecular-targeted agents (MTAs) has been demonstrated in recent years. However, the results of multidisciplinary treatment including hepatic resection are still unclear. The present study evaluated the outcomes of MTA treatment for advanced, unresectable hepatocellular carcinoma (HCC), with the goal of achieving liver resection, in our department.

PATIENTS AND METHODS

Nine patients in whom Lenvatinib had been administered to achieve conversion surgery for unresectable HCC were included in this study. The patient characteristics were as following: median tumor size of 10 cm, vascular invasion in 5 cases, multiple tumors in 2 cases, median treatment duration of 8 weeks, dose reduction due to side effects in 4 patients, and discontinuation of treatment in 1 patient due to tumor growth.

RESULTS

The efficacy by modified Response Evaluation Criteria in Solid Tumors (mRECIST) was partial response in 3, sustained disease in 5 and progressive disease in 1, while the liver resection rate was 88%. Four patients (50%) had recurrence after resection, and the median recurrence-free survival was 12.7 months; however, treatment for recurrence was successful and all patients are alive.

CONCLUSION

Lenvatinib may improve the prognosis of HCC with vascular invasion and multiple lesions by achieving radical resection at the appropriate time for patients with tumor shrinkage.

摘要

背景

近年来,分子靶向药物(MTAs)的疗效已经得到证实。然而,包括肝切除术在内的多学科治疗的结果仍不清楚。本研究评估了我们科室中使用 MTA 治疗不可切除的晚期肝细胞癌(HCC)以实现肝切除术的效果。

患者和方法

本研究纳入了 9 例接受仑伐替尼治疗以实现不可切除 HCC 转化手术的患者。患者特征如下:肿瘤大小中位数为 10cm,5 例存在血管侵犯,2 例为多发病灶,中位治疗时间为 8 周,4 例因副作用而减少剂量,1 例因肿瘤生长而停止治疗。

结果

根据改良实体瘤反应评价标准(mRECIST)评估疗效,3 例为部分缓解,5 例为疾病稳定,1 例为疾病进展,肝切除率为 88%。4 例(50%)患者在切除后复发,中位无复发生存期为 12.7 个月;然而,复发后的治疗是成功的,所有患者均存活。

结论

仑伐替尼可通过使肿瘤缩小,为适当时间的患者实现根治性切除,改善伴有血管侵犯和多发病灶的 HCC 的预后。

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