Affiliation:
1. Department of General Surgery, Nanjing Drum Tower Hospital Chinese Academy of Medical Sciences & Peking Union Medical College, Graduate School of Peking Union Medical College Nanjing China
2. Department of Hepatobiliary Surgery The Affiliated Drum Tower Hospital of Nanjing University Medical School Nanjing China
3. Department of General Surgery The First Affiliated Hospital of Anhui Medical University Hefei China
4. Department of General Surgery Xishan People's Hospital of Wuxi City Wuxi China
Abstract
Key Clinical MessageFor potentially resectable HCC, a more aggressive conversion therapy strategy (high‐intensity combined with multiple treatment modalities) can be used.AbstractHepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide. The best treatment for HCC is radical surgical resection, but 70%–80% of patients are ineligible for surgery. Although conversion therapy is an established treatment strategy for various solid tumors, there is no uniform protocol for treating HCC. In this case, we present a 69‐year‐old male patient diagnosed with massive HCC with Barcelona clinical liver cancer (BCLC) stage B. Because of the insufficient volume of the future liver remnant, we believed radical surgical resection was temporarily impossible. Therefore, the patient received conversion therapy, including four cycles of transcatheter arterial embolization (TAE) and hepatic arterial infusion chemotherapy (HAIC‐Folfox), lenvatinib (8 mg orally once a day), and tislelizumab (an anti‐PD‐1 antibody, 200 mg intravenously once every 3 weeks). Fortunately, the patient achieved a good treatment response (smaller lesions and improved liver function) and underwent radical surgery finally. There was no clinical evidence of recurrence at 6 months of follow‐up. For potentially resectable HCC, this case reveals that a more aggressive conversion therapy strategy (high‐intensity combined with multiple treatment modalities) can be used.
Funder
Anhui Provincial Key Research and Development Plan
National Natural Science Foundation of China
Natural Science Foundation of Jiangsu Province