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ID 116240
Author
Tanaka, Hironori Tokushima University
Keywords
ablation
conversion therapy
hepatic functional reserve
hepatocellular carcinoma
lenvatinib
resection
Content Type
Journal Article
Description
Introduction: Lenvatinib (LEN) is a novel potent multi-tyrosine kinase inhibitor, approved as first-line treatment for unresectable hepatocellular carcinoma (HCC). Considering its high objective response rate, LEN therapy could be expected to achieve downstaging of tumors and lead to conversion therapy with hepatectomy or ablation. However, the feasibility of conversion therapy after LEN treatment in unresectable HCC remains largely unknown.
Patient concerns: Here, we reported 3 cases of unresectable HCC: case 1, a 69-year-old man diagnosed with ruptured HCC; case 2, a 72-year-old woman with nonalcoholic steatohepatitis-based HCC; and case 3, a 73-year-old man with a history of alcoholic cirrhosis-based HCC.
Diagnosis: In all cases, cirrhosis was classified as Child-Pugh 5 and modified albumin-bilirubin grade 1 or 2a. HCC was diagnosed as Barcelona Clinic Liver Cancer (BCLC) stage B.
Interventions: In all cases, LEN was initiated after conventional-transcatheter arterial embolization enforcement, while maintaining liver function.
Outcomes: In all cases, the main tumor size decreased after 6 months of LEN treatment and no satellite nodes were detected, indicating downstaging of HCC to BCLC stage A. Subsequently, conversion hepatectomy or ablation was performed. After successful conversion therapy, the general condition of the patients was good, without tumor recurrence during the observation period (median 10 months).
Lessons: This study demonstrated that LEN enables downstaging of HCC and thus represents a bridge to successful surgery or ablation therapy. In particular, LEN treatment may facilitate the possibility for conversion therapy of initially unresectable HCC, while maintaining the hepatic functional reserve.
Journal Title
Medicine
ISSN
00257974
15365964
NCID
AA00728867
Publisher
Wolters Kluwer Health
Volume
99
Issue
42
Start Page
e22782
Published Date
2020-10-16
Rights
This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY)(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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language
eng
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departments
University Hospital
Medical Sciences