多学科治疗策略联合转化手术治疗肝细胞癌。

A Multidisciplinary Treatment Strategy With Conversion Surgery for Hepatocellular Carcinoma.

机构信息

Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan;

Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.

出版信息

Anticancer Res. 2023 Apr;43(4):1761-1766. doi: 10.21873/anticanres.16329.

DOI:10.21873/anticanres.16329

PMID:36974796

Abstract

BACKGROUND/AIM: Sorafenib was previously the only targeted therapy for hepatocellular carcinoma (HCC). However, pharmaceutical therapy for HCC has undergone remarkable advances in recent years. Herein, we report cases of unresectable advanced HCC responding to pharmaceutical therapy resulting in improved prognosis through surgical intervention.

PATIENTS AND METHODS

Five patients with intermediate and advanced stage HCC treated with lenvatinib followed by hepatectomy between October 2019 and September 2022 were retrospectively reviewed. Patient characteristics, tumor factors, and treatment factors were compared.

RESULTS

The median patient age was 66 (60-79) years, and all patients (100%) were male. The median follow-up period was 10.4 months. All five patients received lenvatinib treatment for more than 2 months before surgery. Three patients achieved partial responses and 2 patients had stable disease with modified RESIST in response to lenvatinib. Three patients had a partial pathological response (50% or more tumor necrosis). Four patients underwent R0 resection and 3 cases had no recurrence.

CONCLUSION

Lenvatinib might be useful for intermediate and advanced HCC and long-term survival may be obtained by combining lenvatinib therapy with surgery.

摘要

背景/目的：索拉非尼曾是肝细胞癌（HCC）唯一的靶向治疗药物。然而，近年来，HCC 的药物治疗取得了显著进展。在此，我们报告了通过手术干预改善预后的不可切除的晚期 HCC 对药物治疗有反应的病例。

患者和方法

回顾性分析了 2019 年 10 月至 2022 年 9 月期间接受仑伐替尼治疗后行肝切除术的 5 例中晚期 HCC 患者。比较了患者特征、肿瘤因素和治疗因素。

结果

中位患者年龄为 66（60-79）岁，均为男性（100%）。中位随访时间为 10.4 个月。所有 5 例患者均在手术前接受仑伐替尼治疗超过 2 个月。3 例患者对仑伐替尼有部分缓解，2 例患者对仑伐替尼有疾病稳定（改良 RESIST）。3 例患者有部分病理缓解（50%或更多肿瘤坏死）。4 例患者行 R0 切除术，3 例无复发。