open access

Vol 15, No 2 (2019)
Case report
Published online: 2019-05-17
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Complete pathological remission after palliative therapy with sorafenib in hepatocellular carcinoma — case report

Aneta Lebiedzińska, Dawid Sigorski, Maciej Michalak, Zygmunt Kozielec, Anna Doboszyńska, Dariusz Zadrożny, Paweł Różanowski
DOI: 10.5603/OCP.2019.0010
·
Oncol Clin Pract 2019;15(2):127-131.

open access

Vol 15, No 2 (2019)
CASE REPORT
Published online: 2019-05-17

Abstract

Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver cancer. The five-year overall survival (OS) in men diagnosed with HCC does not exceed 9%. Patients (pts) with advanced disease are treated with sorafenib (multikinase inhibitor). In randomised trials the OS advantage was within the range of three months for sorafenib. Stabilisation of disease was achieved in 71% of patients, and no case of CR was reported. We present a case of 60-year-old patient with locally advanced cT3aN0M0 (stage IIIA according to seventh TNM) bifocal HCC (12 × 10 cm and 10 × 8 cm). The diagnosis was confirmed by pathologic examination. Due to the clinical stage, palliative treatment with sorafenib was administered from January 2016 to February 2017. A clinical partial response (cPR) enabled surgery. In May 2017, left-sided liver bisegmentomy and resection of residual lesion in segment 6 were performed. The pathological report revealed ypCR. Subsequently, pathology verification changed the primary diagnosis to PR. In September 2017 thermoablation of lesion in segment 5 of the liver was performed. The increased AFP (alpha-fetoprotein) level at baseline was normalised during treatment. The sorafenib therapy was completed after one year. The patient remains in follow-up with no evidence of relapse. Treatment with sorafenib in the presented case enabled radical therapy, so the palliative treatment turned out to be an induction treatment. Clinical CR (especially pCR) in advanced non-operable solid tumours after systemic treatment is quite rare (3–15%), and even less common in HCC. So far, only a few cases of achievement of CR during sorafenib therapy in HCC have been described.

Abstract

Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver cancer. The five-year overall survival (OS) in men diagnosed with HCC does not exceed 9%. Patients (pts) with advanced disease are treated with sorafenib (multikinase inhibitor). In randomised trials the OS advantage was within the range of three months for sorafenib. Stabilisation of disease was achieved in 71% of patients, and no case of CR was reported. We present a case of 60-year-old patient with locally advanced cT3aN0M0 (stage IIIA according to seventh TNM) bifocal HCC (12 × 10 cm and 10 × 8 cm). The diagnosis was confirmed by pathologic examination. Due to the clinical stage, palliative treatment with sorafenib was administered from January 2016 to February 2017. A clinical partial response (cPR) enabled surgery. In May 2017, left-sided liver bisegmentomy and resection of residual lesion in segment 6 were performed. The pathological report revealed ypCR. Subsequently, pathology verification changed the primary diagnosis to PR. In September 2017 thermoablation of lesion in segment 5 of the liver was performed. The increased AFP (alpha-fetoprotein) level at baseline was normalised during treatment. The sorafenib therapy was completed after one year. The patient remains in follow-up with no evidence of relapse. Treatment with sorafenib in the presented case enabled radical therapy, so the palliative treatment turned out to be an induction treatment. Clinical CR (especially pCR) in advanced non-operable solid tumours after systemic treatment is quite rare (3–15%), and even less common in HCC. So far, only a few cases of achievement of CR during sorafenib therapy in HCC have been described.
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Keywords

hepatocellular carcinoma; sorafenib; complete response

About this article
Title

Complete pathological remission after palliative therapy with sorafenib in hepatocellular carcinoma — case report

Journal

Oncology in Clinical Practice

Issue

Vol 15, No 2 (2019)

Article type

Case report

Pages

127-131

Published online

2019-05-17

DOI

10.5603/OCP.2019.0010

Bibliographic record

Oncol Clin Pract 2019;15(2):127-131.

Keywords

hepatocellular carcinoma
sorafenib
complete response

Authors

Aneta Lebiedzińska
Dawid Sigorski
Maciej Michalak
Zygmunt Kozielec
Anna Doboszyńska
Dariusz Zadrożny
Paweł Różanowski

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