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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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References

  1. DM Parkin F Bray J Ferlay P Pisani (2001) ArticleTitleEstimating the world cancer burden: Globocan 2000 Int J Cancer 94 153–6 Occurrence Handle11668491 Occurrence Handle10.1002/ijc.1440 Occurrence Handle1:CAS:528:DC%2BD3MXntVGlu78%3D

    Article  PubMed  CAS  Google Scholar 

  2. S Arii Y Yamaoka S Futagawa K Inoue K Kobayashi M Kojiro et al. (2000) ArticleTitleResults of surgical and nonsurgical treatment for small-sized hepatocellular carcinomas: a retrospective and nationwide survey in Japan. The Liver Cancer Study Group of Japan Hepatology 32 1224–9 Occurrence Handle11093728 Occurrence Handle10.1053/jhep.2000.20456 Occurrence Handle1:STN:280:DC%2BD3M%2FntFegsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  3. RT Poon ST Fan FH Tsang J Wong (2002) ArticleTitleLocoregional therapies for hepatocellular carcinoma: a critical review from the surgeon's perspective Ann Surg 235 466–86 Occurrence Handle11923602 Occurrence Handle10.1097/00000658-200204000-00004

    Article  PubMed  Google Scholar 

  4. J Bruix JM Llovet (2002) ArticleTitlePrognostic prediction and treatment strategy in hepatocellular carcinoma Hepatology 35 519–24 Occurrence Handle11870363 Occurrence Handle10.1053/jhep.2002.32089

    Article  PubMed  Google Scholar 

  5. T Uenishi K Hirohashi T Shuto S Kubo H Tanaka C Sakata et al. (2000) ArticleTitleThe clinical significance of lymph node metastases in patients undergoing surgery for hepatocellular carcinoma Surg Today 30 892–5 Occurrence Handle11059728 Occurrence Handle10.1007/s005950070040 Occurrence Handle1:STN:280:DC%2BD3crgslyqtA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. K Okuda T Ohtsuki H Obata M Tomimatsu N Okazaki H Hasegawa et al. (1985) ArticleTitleNatural history of hepatocellular carcinoma and prognosis in relation to treatment. Study of 850 patients Cancer 56 918–28 Occurrence Handle2990661 Occurrence Handle10.1002/1097-0142(19850815)56:4<918::AID-CNCR2820560437>3.0.CO;2-E Occurrence Handle1:STN:280:BiqB2MvivFE%3D

    Article  PubMed  CAS  Google Scholar 

  7. S Okada N Okazaki H Nose M Yoshimori K Aoki (1992) ArticleTitlePrognostic factors in patients with hepatocellular carcinoma receiving systemic chemotherapy Hepatology 16 112–7 Occurrence Handle1377657 Occurrence Handle10.1002/hep.1840160119 Occurrence Handle1:STN:280:By2A3MnksFw%3D

    Article  PubMed  CAS  Google Scholar 

  8. M Sakon H Nagano K Dono S Nakamori K Umeshita A Yamada et al. (2002) ArticleTitleCombined intraarterial 5-fluorouracil and subcutaneous interferon-alpha therapy for advanced hepatocellular carcinoma with tumor thrombi in the major portal branches Cancer 94 435–42 Occurrence Handle11900229 Occurrence Handle10.1002/cncr.10246 Occurrence Handle1:CAS:528:DC%2BD38XhtV2qs70%3D

    Article  PubMed  CAS  Google Scholar 

  9. H Ota H Nagano M Sakon H Eguchi M Kondo T Yamamoto et al. (2005) ArticleTitleTreatment of hepatocellular carcinoma with major portal vein thrombosis by combined therapy with subcutaneous interferon-alpha and intra-arterial 5-fluorouracil; role of type 1 interferon receptor expression Br J Cancer 93 557–64 Occurrence Handle16106266 Occurrence Handle10.1038/sj.bjc.6602742 Occurrence Handle1:CAS:528:DC%2BD2MXpsFalurg%3D

    Article  PubMed  CAS  Google Scholar 

  10. M Kondo H Nagano M Sakon H Yamamoto O Morimoto I Arai et al. (2000) ArticleTitleExpression of interferon alpha/beta receptor in human hepatocellular carcinoma Int J Oncol 17 83–8 Occurrence Handle10853022 Occurrence Handle1:CAS:528:DC%2BD3cXksV2ru78%3D

    PubMed  CAS  Google Scholar 

  11. H Ota H Nagano Y Doki M Sekimoto M Kondo H Wada et al. (2006) ArticleTitleExpression of type I interferon receptor as a predictor of clinical response to interferon-alpha therapy of gastrointestinal cancers Oncol Rep 16 249–55 Occurrence Handle16820899 Occurrence Handle1:CAS:528:DC%2BD28XptFWgtbg%3D

    PubMed  CAS  Google Scholar 

  12. J Kaczynski G Hansson S Wallerstedt (1995) ArticleTitleMetastases in cases with hepatocellular carcinoma in relation to clinicopathologic features of the tumor. An autopsy study from a low endemic area Acta Oncol 34 43–8 Occurrence Handle7865235 Occurrence Handle1:STN:280:ByqC28bktFY%3D

    PubMed  CAS  Google Scholar 

  13. T Nakashima K Okuda M Kojiro A Jimi R Yamaguchi K Sakamoto et al. (1983) ArticleTitlePathology of hepatocellular carcinoma in Japan. 232 consecutive cases autopsied in ten years Cancer 51 863–77 Occurrence Handle6295617 Occurrence Handle10.1002/1097-0142(19830301)51:5<863::AID-CNCR2820510520>3.0.CO;2-D Occurrence Handle1:STN:280:BiyC3c3otVQ%3D

    Article  PubMed  CAS  Google Scholar 

  14. J Watanabe O Nakashima M Kojiro (1994) ArticleTitleClinicopathologic study on lymph node metastasis of hepatocellular carcinoma: a retrospective study of 660 consecutive autopsy cases Jpn J Clin Oncol 24 37–41 Occurrence Handle8126919 Occurrence Handle1:STN:280:ByuC2s3otlE%3D

    PubMed  CAS  Google Scholar 

  15. K Uehara H Hasegawa S Ogiso E Sakamoto S Ohira T Igami et al. (2003) ArticleTitleSkip lymph node metastases from a small hepatocellular carcinoma with difficulty in preoperative diagnosis J Gastroenterol Hepatol 18 345–9 Occurrence Handle12603540 Occurrence Handle10.1046/j.1440-1746.2003.02795.x

    Article  PubMed  Google Scholar 

  16. JM Llovet J Bustamante A Castells R Vilana C Ayuso Mdel M Sala et al. (1999) ArticleTitleNatural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials Hepatology 29 62–7 Occurrence Handle9862851 Occurrence Handle10.1002/hep.510290145 Occurrence Handle1:STN:280:DyaK1M%2FotFKrsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  17. T Okusaka S Okada H Ishii H Nose H Nagahama H Nakasuka et al. (1997) ArticleTitlePrognosis of hepatocellular carcinoma patients with extrahepatic metastases Hepatogastroenterology 44 251–7 Occurrence Handle9058154 Occurrence Handle1:STN:280:ByiB3M7hsFI%3D

    PubMed  CAS  Google Scholar 

  18. S Obi H Yoshida R Toune T Unuma M Kanda S Sato et al. (2006) ArticleTitleCombination therapy of intraarterial 5-fluorouracil and systemic interferon-alpha for advanced hepatocellular carcinoma with portal venous invasion Cancer 106 1990–7 Occurrence Handle16565970 Occurrence Handle10.1002/cncr.21832 Occurrence Handle1:CAS:528:DC%2BD28XkvFGhs7s%3D

    Article  PubMed  CAS  Google Scholar 

  19. Nagano H, Sakon M, Eguchi H, Kondo M, Yamamoto T, Ota H, et al. Hepatic resection followed by IFN-alpha and 5-FU for advanced hepatocellular carcinoma with tumor thrombus in the major portal branch. Hepatogastroenterology (in press)

  20. H Yatsuhashi T Fujino T Matsumoto O Inoue M Koga M Yano (1999) ArticleTitleImmunohistochemical analysis of hepatic interferon alpha-beta receptor level: relationship between receptor expression and response to interferon therapy in patients with chronic hepatitis C J Hepatol 30 995–1003 Occurrence Handle10406176 Occurrence Handle10.1016/S0168-8278(99)80252-9 Occurrence Handle1:CAS:528:DyaK1MXktFemsrY%3D

    Article  PubMed  CAS  Google Scholar 

  21. TC Wagner S Velichko SK Chesney S Biroc D Harde D Vogel et al. (2004) ArticleTitleInterferon receptor expression regulates the antiproliferative effects of interferons on cancer cells and solid tumors Int J Cancer 111 32–42 Occurrence Handle15185340 Occurrence Handle10.1002/ijc.20236 Occurrence Handle1:CAS:528:DC%2BD2cXlsFWrtL8%3D

    Article  PubMed  CAS  Google Scholar 

  22. V Mazzaferro E Regalia R Doci S Andreola A Pulvirenti F Bozzetti et al. (1996) ArticleTitleLiver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis N Engl J Med 334 693–9 Occurrence Handle8594428 Occurrence Handle10.1056/NEJM199603143341104 Occurrence Handle1:STN:280:BymC2srhs1E%3D

    Article  PubMed  CAS  Google Scholar 

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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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