Complete Pathological Response in Advanced Hepatocellular Carcinoma: Be Brave

Authors

  • Ingrid Karmane Sumou Department of Oncology, Centro Hospitalar Conde de São Januário, Macao
  • Cheng Vai Hui Department of Oncology, Centro Hospitalar Conde de São Januário, Macao https://orcid.org/0000-0003-3041-1794
  • Lai Fong Kok Department of Pathology, Centro Hospitalar Conde de São Januário, Macao
  • José Costa-Maia Department of General Surgery, Centro Hospitalar Conde de São Januário, Macao https://orcid.org/0000-0002-6363-3628

Keywords:

Advanced hepatocellular carcinoma, multidisciplinary, complete pathological response

Abstract

Hepatocellular carcinoma (HCC) is the fourth most common malignancy and the third leading cause of cancer-related deaths among males in Macao population. Despite active preventative and screening measures, a majority of HCC patients present with advanced, unresectable disease. The treatment landscape for advanced HCC (aHCC) is rapidly evolving with the availability of novel agents. However, real-world evidence on the management of aHCC remains sparse, especially across different geographic areas, and there is currently no consensus guideline on optimal treatment sequence. In this report, we present the case of a male patient with large, multifocal aHCC, developing a complete pathological response (pCR) after a multidisciplinary onco-surgical approach.

References

Annual report of Macao Cancer Registry 2021. Macao: Macao Cancer Registry; 2023.

Choi K, Wong C, Ieong K. Effectiveness of Macau hepatitis B vaccination programme for newborns from hepatitis B carrier mother. Hong Kong Journal of Paediatrics 2019;24:76–9.

Chan SL, Ryu M-H, Waked I, Shao YY, Tai WMD, Breder V, et al. Real-world registry of patients with unresectable hepatocellular carcinoma: The OREIOS study. Journal of Clinical Oncology 2023;41:TPS618–TPS618. https://doi.org/10.1200/jco.2023.41.4_suppl.tps618.

Kudo M. A novel treatment strategy for patients with intermediate-stage HCC who are not suitable for Tace: upfront systemic therapy followed by curative conversion. Liver Cancer 2021;10:539–44. https://doi.org/10.1159/000519749.

Vilarinho S, Calvisi DF. New advances in precision medicine for hepatocellular carcinoma recurrence prediction and treatment. Hepatology 2014;60:1812–4. https://doi.org/10.1002/hep.27311.

Kang W, Hwang S, Song G, Lee Y, Kim K, Ahn C, et al. Prognostic effect of transarterial chemoembolization–induced complete pathological response in patients undergoing liver resection and transplantation for hepatocellular carcinoma. Liver Transplantation 2017;23:781–90. https://doi.org/10.1002/lt.24752.

Di Costanzo GG, Casadei Gardini A, Marisi G, Foschi FG, Scartozzi M, Granata R, et al. Validation of a simple scoring system to predict sorafenib effectiveness in patients with hepatocellular carcinoma. Targeted Oncology 2017;12:795–803. https://doi.org/10.1007/s11523-017-0522-5.

Mahn R, Vogt A, Kupczyk P, Sadeghlar F, van Beekum K, Hüneburg R, et al. Programmed cell death protein 1 (PD-1)-inhibition in hepatocellular carcinoma (HCC): a single center experience. Scandinavian Journal of Gastroenterology 2020;55:1057–62. https://doi.org/10.1080/00365521.2020.1794539.

Zhong K, Xu Y, Cheng Y, Wen Y, Cai L, He G, et al. Case report: Primary hepatocellular carcinoma with portal vein tumor thrombus characterized by active tumor immune microenvironment achieving a complete response following treatment of combined immunotherapy. Frontiers in Immunology 2022;13:999763–999763. https://doi.org/10.3389/fimmu.2022.999763.

Zhang W, Hu B, Han J, Wang Z, Ma G, Ye H, et al. Surgery after conversion therapy with PD-1 inhibitors plus tyrosine kinase inhibitors are effective and safe for advanced hepatocellular carcinoma: a pilot study of ten patients. Frontiers in Oncology 2021;11:747950–747950. https://doi.org/10.3389/fonc.2021.747950.

Cheng A-L, Qin S, Ikeda M, Galle PR, Ducreux M, Kim T-Y, et al. Updated efficacy and safety data from IMbrave150: Atezolizumab plus bevacizumab vs. sorafenib for unresectable hepatocellular carcinoma. Journal of Hepatology 2022;76:862–73. https://doi.org/10.1016/j.jhep.2021.11.030.

Xie D, Sun Q, Wang X, Zhou J, Fan J, Ren Z, et al. Immune checkpoint inhibitor plus tyrosine kinase inhibitor for unresectable hepatocellular carcinoma in the real world. Annals of Translational Medicine 2021;9:652–652. https://doi.org/10.21037/atm-20-7037.

Allard M-A, Sebagh M, Ruiz A, Guettier C, Paule B, Vibert E, et al. Does pathological response after transarterial chemoembolization for hepatocellular carcinoma in cirrhotic patients with cirrhosis predict outcome after liver resection or transplantation? Journal of Hepatology 2015;63:83–92. https://doi.org/10.1016/j.jhep.2015.01.023.

Habibollahi P, Shamchi SP, Choi JM, Gade TP, Stavropoulos SW, Hunt SJ, et al. Association of complete radiologic and pathologic response following locoregional therapy before liver transplantation with long-term outcomes of hepatocellular carcinoma: a retrospective study. Journal of Vascular and Interventional Radiology 2019;30:323–9. https://doi.org/10.1016/j.jvir.2018.11.037.

Reig M, Forner A, Rimola J, Ferrer-Fàbrega J, Burrel M, Garcia-Criado Á, et al. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update. Journal of Hepatology 2022;76:681–93. https://doi.org/10.1016/j.jhep.2021.11.018.

Downloads

Published

2024-05-09

Issue

Section

Case Reports

How to Cite

Complete Pathological Response in Advanced Hepatocellular Carcinoma: Be Brave. (2024). HPB Cancer International, 2(1), 1–4. https://rasayely-journals.com/index.php/hpbci/article/view/107