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Complete remission of hepatocellular carcinoma with portal vein tumor thrombus and lymph node metastases by arterial infusion of 5-fluorouracil and interferon-α combination therapy following hepatic resection

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Abstract

We report two cases of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) and lymph node (LN) metastases successfully treated by hepatic arterial infusion of 5-fluorouracil (5-FU) combined with systemic injection of interferon (IFN)-α following hepatic resection for the liver tumor. Complete remission was obtained. Case 1 was a 51-year-old man who had HCC in the right lobe of the liver with PVTT and multiple intrahepatic metastases. He also had abdominal and mediastinal LN metastases. Case 2 was a 53-year-old man who had diffuse-type HCC in the right lobe of the liver with PVTT and intrahepatic metastases. A chest computed tomography scan revealed lymph nodes enlarged to 1.0 cm from the mediastinum to the left supraclavicular space. Both patients underwent the hepatectomy to reduce the tumor volumes and remove the PVTT to relieve portal vein obstruction. Following the surgery, the patients underwent IFN-α/5-FU combination therapy. Three months after this combined therapy, tumor markers (both α-fetoprotein and protein induced by vitamin K absence or antagonist II) returned to the normal range and residual tumors in the liver disappeared. The patients are alive without any recurrence more than 1 year after initial treatment. IFN-α/5-FU combined therapy following hepatic resection is a promising modality for the treatment of advanced HCC with LN metastasis.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka E-2, Suita, Osaka, 565-0871, Japan

    Hiroshi Wada, Hiroaki Nagano, Takehiro Noda, Bazarragchaa Damdinsuren, Shigeru Marubashi, Atsushi Miyamoto, Yutaka Takeda, Koji Umeshita, Keizo Dono, Masato Sakon & Morito Monden

  2. Department of Pathology, Osaka City University Hospital, Osaka, Japan

    Kenichi Wakasa

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  1. Hiroshi Wada
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  2. Hiroaki Nagano
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  3. Takehiro Noda
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  4. Bazarragchaa Damdinsuren
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  5. Shigeru Marubashi
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  6. Atsushi Miyamoto
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  7. Yutaka Takeda
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  8. Koji Umeshita
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  9. Keizo Dono
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  10. Masato Sakon
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  11. Kenichi Wakasa
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  12. Morito Monden
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Wada, H., Nagano, H., Noda, T. et al. Complete remission of hepatocellular carcinoma with portal vein tumor thrombus and lymph node metastases by arterial infusion of 5-fluorouracil and interferon-α combination therapy following hepatic resection. J Gastroenterol 42, 501–506 (2007). https://doi.org/10.1007/s00535-007-2028-x

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  • DOI: https://doi.org/10.1007/s00535-007-2028-x

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