Medical Treatment of Advanced Hepatocellular Carcinoma Patients: The Issue Is Not the Right Drug, but the Right Patient

Hepatology ◽  
2019 ◽  
Vol 70 (1) ◽  
pp. 429-430
Author(s):  
Camillo Porta ◽  
Chiara Broglia ◽  
Francesca Negri
Keyword(s):  
Hepatocellular Carcinoma ◽  
Medical Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

scholarly journals Advanced Hepatocellular Carcinoma with Subtotal Occlusion of the Inferior Vena Cava and a Right Atrial Mass

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Steinberg ◽  
Suzanne Boudreau ◽  
Felix Leveille ◽  
Marc Lamothe ◽  
Patrick Chagnon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Vena Cava ◽  
Great Majority ◽  
Right Atrial ◽  
Advanced Hepatocellular Carcinoma ◽  
Regional Lymph Nodes ◽  
The Right

Hepatocellular carcinoma usually metastasizes to regional lymph nodes, lung, and bones but can rarely invade the inferior vena cava with intravascular extension to the right atrium. We present the case of a 75-year-old man who was admitted for generalized oedema and was found to have advanced HCC with invasion of the inferior vena cava and endovascular extension to the right atrium. In contrast to the great majority of hepatocellular carcinoma, which usually develops on the basis of liver cirrhosis due to identifiable risk factors, none of those factors were present in our patient.

scholarly journals Transarterial Radioembolization Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

2021 ◽  
pp. 1-4
Author(s):  
Kabalane Yammine ◽  
◽  
Sarah Khalife ◽  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Inferior Vena Cava ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Inferior Vena ◽  
Vena Cava ◽  
Treatment Strategies ◽  
Complete Response ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

Tumor thrombus infiltration of hepatocellular carcinoma (HCC) into the inferior vena cava and right atrium is rare and is associated with a poor prognosis due to the critical location of the tumor and the limited efficiency of the available treatment strategies. In this study, we report the case of a patient with advanced HCC and tumor thrombus in the inferior vena cava and right atrium who demonstrated complete response with mass retraction upon Yttrium-90 trans-arterial radioembolization (90Y- TARE) therapy. Throughout the 16 months follow-ups after the radioembolization, the patient was free of any complications, revealing no occurrence of radiation-induced pneumonitis or tumor recurrence.

scholarly journals Clinically Silent Intracardiac Metastasis with Extremely Poor Prognosis in a Patient with Hepatocellular Carcinoma

2017 ◽  
Vol 11 (2) ◽  
pp. 416-421 ◽  
Author(s):  
Mashal Salehi ◽  
The Yee ◽  
Eric Alatevi ◽  
Yamin Thein
Keyword(s):  
Hepatocellular Carcinoma ◽  
Poor Prognosis ◽  
Vena Cava ◽  
Signs And Symptoms ◽  
Cardiac Metastasis ◽  
Advanced Hepatocellular Carcinoma ◽  
Unusual Site ◽  
Cardiac Extension ◽  
Prognostic Importance ◽  
The Right

Intracavitary cardiac extension remains an unusual site of extrahepatic metastasis in patients with hepatocellular carcinoma. While patients can present with signs and symptoms suggestive of right-sided heart failure, it may be totally asymptomatic, which is very rare with only a few cases reported so far. Also, cardiac metastasis is of great prognostic importance as patients with intracardiac metastasis can have an extremely poor prognosis. Here, we present the case of a 52-year-old male patient with advanced hepatocellular carcinoma, with an incidentally found tumor thrombus extending from the inferior vena cava to the right atrium, protruding through the tricuspid valve into the right ventricle, on routine echocardiography. The patient did not have any signs or symptoms of heart involvement and unfortunately died on the 18th day of the hospital stay.

scholarly journals Angiogenesis inhibitors for advanced hepatocellular carcinoma: in search for the right partner

2020 ◽  
Vol 8 (22) ◽  
pp. 1532-1532
Author(s):  
Claudia Campani ◽  
Lorenza Rimassa ◽  
Nicola Personeni ◽  
Fabio Marra
Keyword(s):  
Hepatocellular Carcinoma ◽  
Angiogenesis Inhibitors ◽  
Advanced Hepatocellular Carcinoma ◽  
The Right

scholarly journals Transarterial Radioembolization for the Treatment of Advanced Hepatocellular Carcinoma Invading the Right Atrium

2020 ◽  
Vol 43 (11) ◽  
pp. 1712-1715
Author(s):  
Raphaël Girardet ◽  
Sarah Boughdad ◽  
Antonia Digklia ◽  
Catherine Beigelman ◽  
Marie Meyer ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Right Atrium ◽  
Venous System ◽  
Advanced Hepatocellular Carcinoma ◽  
Organizing Pneumonia ◽  
Transarterial Radioembolization ◽  
The Right

Abstract Hepatocellular carcinoma (HCC) has the tendency to invade the portal and/or hepatic venous system. The invasion of the right atrium is uncommonly observed and constitutes a treatment challenge. We report the case of a patient with HCC invading the right atrium treated with 90Yttrium-transarterial radioembolization (90Y-TARE). Following the treatment, organizing pneumonia secondary to nivolumab occurred, raising the question of an interaction between 90Y-TARE and nivolumab.

scholarly journals Hepatocellular Carcinoma with Distant Metastasis Cured by 20-Day Sorafenib Treatment

2021 ◽  
pp. 610-615
Author(s):  
Seok Bae Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Lymph Node ◽  
Advanced Hepatocellular Carcinoma ◽  
Sorafenib Treatment ◽  
Node Metastasis ◽  
Extended Right Hepatectomy ◽  
Subcarinal Lymph Node ◽  
The Right ◽  
Hands And Feet ◽  
Severe Fever

There are only 13 cases of complete remission after sorafenib use in advanced hepatocellular carcinoma (HCC) worldwide. We herein report a rarer case in which the patient was cured after only 20 days of sorafenib use. A 61-year-old male patient was diagnosed with a huge HCC. The mass occupied almost the whole of the right hepatic lobe and a portion of segment 4. We performed extended right hepatectomy for cure. However, 3.5-cm-sized subcarinal lymph node metastasis was detected at 15 months after operation. We prescribed sorafenib 400 mg bid for palliative treatment. The patient had severe fever, pain, and blisters on the hands and feet, so the patient stopped taking it after 20 days. Subcarinal lymph node disappeared on chest computed tomography after 3 months, and there was no evidence of recurrence for a year.

scholarly journals Conversion hepatectomy for advanced hepatocellular carcinoma after right portal vein transection and lenvatinib therapy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuki Ohya ◽  
Shintaro Hayashida ◽  
Akira Tsuji ◽  
Kunitaka Kuramoto ◽  
Hidekatsu Shibata ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Vein ◽  
Kinase Inhibitor ◽  
Sharp Decrease ◽  
Hepatic Function ◽  
Advanced Hepatocellular Carcinoma ◽  
Right Hepatectomy ◽  
Advanced Hcc ◽  
Extended Right Hepatectomy ◽  
The Right

Abstract Background Lenvatinib is a novel tyrosine kinase inhibitor that exhibits an antitumor effect on hepatocellular carcinoma (HCC). An established strategy that involves surgery and usage of lenvatinib for advanced HCC remains elusive. Case presentation A 58-year-old male patient with advanced HCC and untreated hepatitis B was referred to our hospital. The tumor at the right lobe was 10 cm in diameter with right portal vein thrombus. Because of the possible lung metastasis and concern about the remaining hepatic function after extended right hepatectomy, lenvatinib was initiated before surgery. After the confirmation of a sharp decrease of tumor markers during the 3-week lenvatinib therapy, only a right portal vein transection was done leaving the enlargement of the left lobe for improved post-hepatectomy liver function while lenvatinib therapy was continued. The laparotomy revealed that the tumor was invading the right diaphragm. After 7 weeks of lenvatinib administration after right portal vein transection, an extended right hepatectomy with resection of the tumor-invaded diaphragm was successfully done. The lung nodules that were suspected as metastases had disappeared. The patient has been doing well without any sign of recurrence for 1 year. Conclusion The strategy involving the induction of lenvatinib to conversion hepatectomy including the portal vein transection was effective for advanced HCC.

Treatment of right-sided hepatocellular carcinoma with uni-lobar y-90 radioembolisation and induction of hypertrophy in the the contralateral left lobe.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15102-e15102
Author(s):  
Pierce K. H. Chow ◽  
Jin Yao Teo ◽  
John Carson Allen ◽  
David Chee Eng Ng ◽  
Richard H. G. Lo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Left Lobe ◽  
Post Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Remnant Liver ◽  
Right Hepatic Artery ◽  
Pre Treatment ◽  
The Right

e15102 Background: Yttrium-90 microsphere (Y90) is currently used to treat locally advanced hepatocellular carcinoma (HCC) including those where resection is precluded because of inadequate future remnant liver. Hypertrophy of the contralateral lobe after Y90 treatment has been reported. This study aims to quantify this hypertrophy and identify factors predictive of this response. Methods: Radiological review of patients undergoing Y-90 with treatment delivered via right hepatic artery for advanced HCC between January 2008 – January 2012 was performed. Diagnosis of HCC was by AASLD criteria and patients must have at least one follow-up scan in our institution. Excluded were: tumour in the contralateral lobe, concomitant other treatment for HCC, patients enrolled in clinical trials. Pre- and post-treatment images were reviewed and volumes were measured using 3D software. Statistical analysis was conducted using SPSS version 16.0. Results: During this period 50 patients treated with Y90 for HCC had follow-up imaging at our institution. Of 37 patients with right-sided Y90 treatment, 11 had concomitant left-sided disease treated with TACE and RFA, 7 had follow-up scans of inadequate quality to perform accurate volumetric assessment, 2 had pre-treatment scans performed at another institution which were not accessible for study purposes. Seventeen (17) patients thus fulfilled criteria. Mean and median left-lobe hypertrophy were 34.2% (SD±35.9%) and 31.7% (range -19.0 – 106.5%) respectively at a median of 5 months post-treatment. Univariate analysis identified no specific pre-treatment factor predictive of the degree of left lobe hypertrophy. There were no cases of acute liver failure after administration of SIRT in this study and none of the patients developed disease in the contralateral lobe over the study period. Conclusions: In patients with HCC receiving SIRT to the right lobe via the right hepatic artery, a significant degree of left lobe hypertrophy results. This opens the possibility of the utilisation of SIRT as neoadjuvant therapy for borderline resectable HCC, thus increasing the pool of potentially operable and curable patients.

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