Clinical Training Center, Nara Medical University, Kashihara, Nara, 634-8522, Japan.
Department of Gastroenterology and Metabolism, Nara Medical University, Kashihara, Nara, 634-8522, Japan.
Clin J Gastroenterol. 2022 Oct;15(5):953-959. doi: 10.1007/s12328-022-01667-9. Epub 2022 Jun 30.
The prognosis of highly advanced unresectable hepatocellular carcinoma (HCC) with a portal vein tumor thrombus (PVTT) is poor. There are currently no reports of long-term survival for up to 5 years in patients with advanced HCC who were treated with sorafenib. We describe a patient with Vp4 HCC who was treated with a sorafenib-based multidisciplinary treatment and experienced long-term survival, which may be the longest survival to date. A man in his late 60 s presented with general fatigue. Eight years previously, he received interferon monotherapy for chronic hepatitis C for 48 weeks and achieved a sustained virological response. He was diagnosed with a PVTT (Vp4) with diffuse-type HCC in the S6 lobe of the liver. He received hepatic arterial infusion of chemotherapy using 5-fluorouracil and cisplatin. Because of the occurrence of adverse effects, he was placed on sorafenib treatment. The treatment was effective and the HCC reduced. However, after 3 years of treatment, a 2-cm HCC was observed in the S5 lobe, and the patient underwent laparoscopic partial hepatectomy. After the operation, he continued to receive sorafenib, with no obvious recurrence, and survived for over 108 months after the first treatment. There are currently no reported cases of long-term progression-free survival by sorafenib for five years in patients of Vp4 HCC. In conclusion, we report a case of longest survival of a patient with Vp4 HCC treated with sorafenib-based multidisciplinary treatment.
无法切除的晚期肝癌（HCC）伴门静脉癌栓（PVTT）的预后较差。目前尚无报告称，晚期 HCC 患者接受索拉非尼治疗可长达 5 年的长期生存。我们描述了一例 Vp4 HCC 患者，他接受了索拉非尼为基础的多学科治疗，并获得了长期生存，这可能是迄今为止最长的生存时间。一位 60 多岁的男性出现全身乏力。8 年前，他因慢性丙型肝炎接受干扰素单药治疗 48 周，实现了持续病毒学应答。他被诊断为 Vp4 型 HCC，伴有弥漫型 HCC，位于 S6 肝叶。他接受了氟尿嘧啶和顺铂肝动脉灌注化疗。由于出现不良反应，他开始接受索拉非尼治疗。治疗有效， HCC 缩小。然而，治疗 3 年后，S5 肝叶出现 2cm HCC，患者接受了腹腔镜部分肝切除术。手术后，他继续接受索拉非尼治疗，未见明显复发，自首次治疗后已存活超过 108 个月。目前尚无报告称 Vp4 HCC 患者接受索拉非尼治疗 5 年可获得长期无进展生存。总之，我们报告了一例 Vp4 HCC 患者接受索拉非尼为基础的多学科治疗后最长生存时间的病例。
