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Recurrence of hepatocellular carcinoma after radiofrequency ablation in a poor-risk patient with chronic renal failure and other complications successfully treated with stereotactic body radiotherapy

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Abstract

The patient was an 85-year-old man with hepatitis C-related liver cirrhosis and chronic renal failure caused by diabetes mellitus under maintenance hemodialysis (HD) who developed hepatocellular carcinoma (HCC) after achieving a sustained viral response with direct acting antiviral therapy 1 year and 3 months previously. HCC located near the right hepatic vein was treated by radiofrequency ablation (RFA) but recurrent disease accompanied by hepatic vein invasion was detected 3 months after RFA. The recurrent HCC was curatively treated with stereotactic body radiotherapy (SBRT). The patient had additional complications, including grade III AV block controlled by a pacemaker, colonic adenoma resected by endoscopic mucosal resection, and a small cerebral aneurysm, which was untreated. At 2 years after SBRT, there had been no recurrence of HCC. In this old HCC patient with various complications including HD with polypharmacy, multidisciplinary treatment, including SBRT, enabled the patient to achieve complete remission and maintain a good quality of life.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Kusunoki Hospital, 607-22 Fujioka, Fujioka, Gunma, 375-0024, Japan

    Toyokazu Saito, Satoshi Takakusagi, Hitoshi Takagi, Youzo Yokoyama, Kazuko Kizawa, Kyoko Marubashi & Takashi Kosone

  2. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan

    Toyokazu Saito & Toshio Uraoka

  3. Department of Radiation Oncology, Japanese Red Cross Maebashi Hospital, 389-1 Asakuramachi, Maebashi, Gunma, 371-0811, Japan

    Hiroki Kiyohara

  4. Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma, 371-8511, Japan

    Kei Shibuya

Authors
  1. Toyokazu Saito
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  2. Satoshi Takakusagi
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  3. Hitoshi Takagi
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  6. Kyoko Marubashi
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  7. Takashi Kosone
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  8. Hiroki Kiyohara
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  10. Toshio Uraoka
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Correspondence to Hitoshi Takagi.

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Saito, T., Takakusagi, S., Takagi, H. et al. Recurrence of hepatocellular carcinoma after radiofrequency ablation in a poor-risk patient with chronic renal failure and other complications successfully treated with stereotactic body radiotherapy. Clin J Gastroenterol 16, 216–223 (2023). https://doi.org/10.1007/s12328-022-01734-1

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  • DOI: https://doi.org/10.1007/s12328-022-01734-1

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