Downstaging and resection after neoadjuvant therapy for fibrolamellar hepatocellular carcinoma

作     者：Gilton Marques Fonseca Antonio Drauzio Varella Fabricio Ferreira Coelho Emerson Shigueaki Abe Rodrigo Blanco Dumarco Paulo Herman 

作者机构：Digestive Surgery Division Department of Gastroenterology University of So Paulo School of Medicine Avenida Doutor Enéas de Carvalho Aguiar 255 Instituto Central 05403-900 So Paulo Brazil Clinical Oncologist Hospital Sírio-Libanês 01308-050 So Paulo Brazil 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2014年第6卷第6期

页      面：107-111页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：化疗 Gemcitabine Oxaliplatin Hepatectomy 肝的静脉 Fibrolamellar hepatocellular 癌 

摘      要：Fibrolamellar hepatocellular carcinoma(FLHCC) is a rare malignant liver neoplasm, commonly observed in adolescents and young adults of both genders. The disease is more common in Caucasians and in patients without a prior history of liver disease. The best treat-ment option is a surgical resection associated with liver hilum lymph node dissection. However, there is no established systemic drug treatment for patients with locally advanced or metastatic disease. We report on a patient with advanced FLHCC, initially considered un-resectable due to invasion of the right and the middle hepatic veins and circumferential involvement of the left hepatic vein. Following the treatment with gem-citabine-oxaliplatin systemic chemotherapy, the patient exhibited a significant tumor reduction. As a result, a complete resection was performed with an extended right hepatectomy associated with a partial resection of the inferior vena cava, a wedge resection in segment 2, and lymphadenectomy of the hepatic hilum. The case was unusual due to the significant tumor downstaging with gemcitabine-oxaliplatin, potentially enabling cura-tive resection. More studies are needed to confirm the efficacy of the systemic drug treatment for FLHCC.