Hepatic resection followed by IFN-α and 5-FU for advanced hepatocellular carcinoma with tumor thrombus in the major portal branch

Hiroaki Nagano, Masato Sakon, Hidetoshi Eguchi, Motoi Kondo, Tameyoshi Yamamoto, Hideo Ota, Masato Nakamura, Hiroshi Wada, Bazarragcha Damdinsuren, Shigeru Marubashi, Atsushi Miyamoto, Yutaka Takeda, Keizo Dono, Koji Umeshita, Shoji Nakamori, Morito Monden

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42 Citations (Scopus)

Abstract

Background/Aims: The prognosis of hepatocellular carcinoma (HCC) invading the major branches of the portal vein (Vp3) is extremely poor. Recently, we reported the efficacy of combination therapy with subcutaneous interferon (IFN)-alpha and intra-arterial 5-FU for intractable HCC with Vp3. In this study, this therapy was applied for resectable advanced HCC (Vp3) as a postoperative adjuvant. Methodology: Patients with HCC and tumor thrombi either in the major or first branch of portal vein were included (n = 30). Fifteen consecutive patients with HCC and Vp3 were treated with at least 3 cycles of a combination therapy consisting of continuous arterial infusion of 5-FU (300mg/mm 3/ day, 5 days/week, for the initial 2 weeks) and subcutaneous injection of IFN (5 MIU, 3 times/week, 4 weeks) as a postoperative adjuvant therapy following hepatic resection. Another 15 patients who underwent hepatic resection with no IFN/5-FU chemotherapy acted as controls. Results: The results were as follows in the IFN/5-FU adjuvant treatment group; disease-free survival (n = 11,5-55 months), survival with recurrence (n = 2, 9, 48 months), cancer death (n = 1, 18 months), death from other causes but no recurrence (n = 1, 22 months). The 1-year survival rate was 100% in patients treated with IFN/5-FU, and 41% in those without IFN/5-FU historical controls (n = 15). There was a significant difference in disease-free and overall survival rates between the two groups (p = 0.0033 and 0.0031). Conclusions: Combination therapy with subcutaneous IFN and intra-arterial perfusion of 5-FU seems to be a promising postoperative adjuvant treatment modality for resectable HCC with Vp3.

Original languageEnglish
Pages (from-to)172-179
Number of pages8
JournalHepato-gastroenterology
Volume54
Issue number73
Publication statusPublished - Jan 2007

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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