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首页> 外文期刊>癌と化学療法 >Sustained complete remission with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for bilobar multiple hepatocellular carcinoma with portal venous tumor thrombus--a case report
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Sustained complete remission with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for bilobar multiple hepatocellular carcinoma with portal venous tumor thrombus--a case report

机译：还原性手术加经皮离体肝灌注（PIHP）持续完全缓解用于多发性多发性肝细胞癌伴门静脉肿瘤血栓的一例报告

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摘要

For patients with multiple bilobar hepatocellular carcinoma (m-HCC) and/or advanced portal venous tumor thrombus (Vp3, 4), there has been no effective therapy, and the survival of more than 6 months was exceptional. Under these circumstances, we have developed a dual treatment (dual Tx) that combines reductive hepatectomy with percutaneous isolated hepatic perfusion (PIHP) for such patients. This dual Tx offers the high-rate of mid- and long-term survival in a subset of patients who had previously a dismal prognosis. Herein, we report a patient with Vp4 m-HCC who was successfully treated with dual Tx and survived for more than 2 years with a complete remission of hepatic tumors. A 53-year-old man had main tumors in the right lobe liver and multiple bilobar intrahepatic metastases (IM) with portal venous tumor thrombus reaching the portal trunk. He underwent an extended right hepatectomy with portal venous tumor thrombectomy, and subsequently PIHP twice in a 3-month period after reductive hepatectomy. After dual Tx, he had sustained complete remission for more than 2 years. He died because of obstruction of the superior vena cava by recurrent tumors in the mediastinum. His clinical course after treatment strongly indicates that the dual Tx should become a major treatment option for patients with Vp3, 4 m-HCC.
机译：对于患有多发性肝叶肝细胞癌（m-HCC）和/或晚期门静脉肿瘤血栓（Vp3，4）的患者，目前尚无有效的治疗方法，其6个月以上的生存期非常出色。在这种情况下，我们针对此类患者开发了双重治疗（双重Tx），将还原性肝切除术与经皮离体肝灌注（PIHP）结合在一起。这种双重Tx功能可在一部分患者预后不良的患者中提供较高的中长期生存率。本文中，我们报道了一名Vp4 m-HCC患者，该患者已成功接受双重Tx治疗，并生存了2年以上，肝肿瘤得以完全缓解。一名53岁的男性患者的主要肿瘤位于右叶肝，并伴有多发性双叶肝内转移（IM），门静脉肿瘤血栓到达门干。他进行了右肝扩大切除术，并进行了门静脉肿瘤血栓切除术，随后在还原性肝切除术后的3个月内两次进行了PIHP。在进行两次Tx之后，他已经完全缓解了2年以上。他死于纵隔肿瘤反复阻塞上腔静脉。他的治疗后临床历程强烈表明，双重Tx应该成为Vp3、4 m-HCC患者的主要治疗选择。

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