Multi-disciplinary team treatment for a case of primary giant liver cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Peizhi ¹ , MIAO Chunmu ¹ , GONG Jianping ¹ ,  WANG Fanghua ²

1. Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;
2. Department of Surgery, The Second People’s Hospital of Yubei District, Chongqing 401147, P. R. China;

Corresponding author：

WANG Fanghua, Email: 1561540223@qq.com

Keywords：

primary hepatocellular carcinoma; giant liver cancer; multi-disciplinary team

DOI：

10.7507/1007-9424.201904099

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective The present study was to investigate the value of multi-disciplinary team (MDT) model in patient with primary giant liver cancer.Methods The MDT model was carried out for a BCLC B stage patient who admitted in the Second Affiliated Hospital of Chongqing Medical University in July 2018. The associated references were reviewed and the treatment methods were discussed about primary giant liver cancer.Results An elder man who was diagnosed as primary hepatocellular carcinoma (minor cancer) in right lobe of the liver in three years ago and took Chinese medicine orally. When the patient subsequent visited this time, the liver cancer increased about 10 cm. After discussed by MDT, the treatment method was draw up to transarterial chemoembolization (TACE) plus surgery. After received twice TACE therapies in the later 14 weeks, the tumor in right lobe had significantly shrinked and left lobe enlarged. The patient underwent laparoscopic right liver hepatectomy after the second MDT discussion in 5 months later. The patient underwent operation successfully. The operation lasted for 270 minutes, and the intraoperative blood loss was about 500 mL. The suspended red blood cells (400 mL) was infused. The patient underwent transient liver failure and recovered through hepatoprotective and symptomatic supportive treatment, and discharged on 12 days after operation. A retrospective examination of abdominal CT at 4 months postoperatively revealed a significant hyperplasia of the left lobe of the liver, and there was no sign of recurrent tumor. The patient was continue to followed up.Conclusions Thepatient with primary giant hepatocellular carcinoma who cannot underwent surgery at the first time can received TACE, and a few patients could be underwent radical operation later. MDT should be applied flexibly in the treatment of patients with huge hepatocellular carcinoma from beginning to end, so the best treatment plan should be carried out for patients.

Citation： LI Peizhi, MIAO Chunmu, GONG Jianping, WANG Fanghua. Multi-disciplinary team treatment for a case of primary giant liver cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1222-1229. doi: 10.7507/1007-9424.201904099 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2.	Zheng R, Qu C, Zhang S, et al. Liver cancer incidence and mortality in China: temporal trends and projections to 2030. Chin J Cancer Res, 2018, 30(6): 571-579.
3.	Kim HS, El-Serag HB. The epidemiology of hepatocellular carcinoma in the USA. Curr Gastroenterol Rep, 2019, 21(4): 17.
4.	Kulik L, El-Serag HB. Epidemiology and management of hepatocellular carcinoma. Gastroenterology, 2019, 156(2): 477-491.
5.	Fang KC, Kao WY, Su CW, et al. The prognosis of single large hepatocellular carcinoma was distinct from barcelona clinic liver cancer stage A or B: the role of albumin-bilirubin grade. Liver Cancer, 2018, 7(4): 335-358.
6.	吴孟超, 汤钊猷, 刘允怡, 等. 原发性肝癌诊疗规范 (2017 年版). 临床肝胆病杂志, 2017, 33(8): 1419-1431.
7.	Fu J, Wang H. Precision diagnosis and treatment of liver cancer in China. Cancer Lett, 2018, 412: 283-288.
8.	高扬, 邵雨辰, 苏明珠, 等. 癌症患者的多学科团队协作诊疗模式研究进展. 中国医院管理, 2019, 39(3): 34-37.
9.	陈孝平, 张志伟. 肝癌多学科综合治疗团队建立与运作. 中国实用外科杂志, 2014, 34(8): 685-687.
10.	杨斌, 李财胜, 万钧, 等. 探讨综合治疗巨大肝癌的临床疗效. 当代医学, 2018, 24(35): 85-86.
11.	苗春木, 丁雄, 邓开, 等. MDT 主导的 BCLC B 期肝右叶原发性巨块型肝癌 TACE 术后外科根治性切除的时机探讨. 中国普外基础与临床杂志, 2018, 25(6): 735-743.
12.	刘付宝, 耿小平. 巨大肝癌外科手术治疗的抉择. 肝胆外科杂志, 2017, 25(1): 1-4.
13.	葛宁灵. 肝细胞癌多学科团队 (MDT) 协作诊疗模式的重要性. 胃肠病学和肝病学杂志, 2018, 27(6): 605-608.
14.	Liang L, Xing H, Zhang H, et al. Surgical resection versus transarterial chemoembolization for BCLC intermediate stage hepatocellular carcinoma: a systematic review and meta-analysis. HPB (Oxford), 2018, 20(2): 110-119.
15.	Minami Y, Nishida N, Kudo M. Radiofrequency ablation of liver metastasis: potential impact on immune checkpoint inhibitor therapy. Eur Radiol, 2019, [Epub ahead of print].
16.	刘淦, 孙杰, 张婷, 等. 原发性肝癌免疫治疗的现状及未来. 传染病信息, 2019, 32(1): 87-95.
17.	Obeid JM, Kunk PR, Zaydfudim VM, et al. Immunotherapy for hepatocellular carcinoma patients: is it ready for prime time? Cancer Immunol Immunother, 2018, 67(2): 161-174.
18.	Mocan T, Sparchez Z, Craciun R, et al. Programmed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) axis in hepatocellular carcinoma: prognostic and therapeutic perspectives. Clin Transl Oncol, 2019, 21(6): 702-712.
19.	田宇航, 刘钊, 梁锡天, 等. 肝癌靶向治疗靶点的研究进展. 现代肿瘤医学, 2018, 26(5): 776-779.
20.	广东省抗癌协会肝癌专业委员会. 肝癌 MDT 团队建立和多学科联合治疗的专家共识. 肝癌电子杂志, 2014, 1(3): 4-20.
21.	李屈进, 刘作金, 涂兵, 等. MDT 在联合肝脏离断和门静脉结扎的二步肝切除术中的运用. 中国普外基础与临床杂志, 2018, 25(7): 852-858.
22.	胡泽明, 陈彪, 钟佳宁, 等. 原发性肝癌治疗方法的应用进展. 山东医药, 2019, 59(9): 106-110.
23.	黄海于, 黎克全. 原发性肝癌的局部消融治疗进展. 现代医药卫生, 2016, 32(11): 1661-1664.
24.	刘泽龙, 王阳, 张国志, 等. 肝动脉栓塞化疗联合肝叶切除术治疗原发性肝癌患者临床疗效观察. 实用肝脏病杂志, 2017, 20(3): 368-369.
25.	王天浩, 任正刚, 叶青海, 等. 术前辅助性肝动脉化疗栓塞对可切除巨块型肝癌术后生存的影响. 中华肿瘤防治杂志, 2010, 17(15): 1210-1213.
26.	张世超. 术前辅助性 TACE 对米兰标准内乙肝相关肝癌切除术后远期生存影响的回顾性研究. 上海: 中国人民解放军海军军医大学, 2018.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin, 2019, 69(1): 7-34.
2. Zheng R, Qu C, Zhang S, et al. Liver cancer incidence and mortality in China: temporal trends and projections to 2030. Chin J Cancer Res, 2018, 30(6): 571-579.
3. Kim HS, El-Serag HB. The epidemiology of hepatocellular carcinoma in the USA. Curr Gastroenterol Rep, 2019, 21(4): 17.
4. Kulik L, El-Serag HB. Epidemiology and management of hepatocellular carcinoma. Gastroenterology, 2019, 156(2): 477-491.
5. Fang KC, Kao WY, Su CW, et al. The prognosis of single large hepatocellular carcinoma was distinct from barcelona clinic liver cancer stage A or B: the role of albumin-bilirubin grade. Liver Cancer, 2018, 7(4): 335-358.
6. 吴孟超, 汤钊猷, 刘允怡, 等. 原发性肝癌诊疗规范 (2017 年版). 临床肝胆病杂志, 2017, 33(8): 1419-1431.
7. Fu J, Wang H. Precision diagnosis and treatment of liver cancer in China. Cancer Lett, 2018, 412: 283-288.
8. 高扬, 邵雨辰, 苏明珠, 等. 癌症患者的多学科团队协作诊疗模式研究进展. 中国医院管理, 2019, 39(3): 34-37.
9. 陈孝平, 张志伟. 肝癌多学科综合治疗团队建立与运作. 中国实用外科杂志, 2014, 34(8): 685-687.
10. 杨斌, 李财胜, 万钧, 等. 探讨综合治疗巨大肝癌的临床疗效. 当代医学, 2018, 24(35): 85-86.
11. 苗春木, 丁雄, 邓开, 等. MDT 主导的 BCLC B 期肝右叶原发性巨块型肝癌 TACE 术后外科根治性切除的时机探讨. 中国普外基础与临床杂志, 2018, 25(6): 735-743.
12. 刘付宝, 耿小平. 巨大肝癌外科手术治疗的抉择. 肝胆外科杂志, 2017, 25(1): 1-4.
13. 葛宁灵. 肝细胞癌多学科团队 (MDT) 协作诊疗模式的重要性. 胃肠病学和肝病学杂志, 2018, 27(6): 605-608.
14. Liang L, Xing H, Zhang H, et al. Surgical resection versus transarterial chemoembolization for BCLC intermediate stage hepatocellular carcinoma: a systematic review and meta-analysis. HPB (Oxford), 2018, 20(2): 110-119.
15. Minami Y, Nishida N, Kudo M. Radiofrequency ablation of liver metastasis: potential impact on immune checkpoint inhibitor therapy. Eur Radiol, 2019, [Epub ahead of print].
16. 刘淦, 孙杰, 张婷, 等. 原发性肝癌免疫治疗的现状及未来. 传染病信息, 2019, 32(1): 87-95.
17. Obeid JM, Kunk PR, Zaydfudim VM, et al. Immunotherapy for hepatocellular carcinoma patients: is it ready for prime time? Cancer Immunol Immunother, 2018, 67(2): 161-174.
18. Mocan T, Sparchez Z, Craciun R, et al. Programmed cell death protein-1 (PD-1)/programmed death-ligand-1 (PD-L1) axis in hepatocellular carcinoma: prognostic and therapeutic perspectives. Clin Transl Oncol, 2019, 21(6): 702-712.
19. 田宇航, 刘钊, 梁锡天, 等. 肝癌靶向治疗靶点的研究进展. 现代肿瘤医学, 2018, 26(5): 776-779.
20. 广东省抗癌协会肝癌专业委员会. 肝癌 MDT 团队建立和多学科联合治疗的专家共识. 肝癌电子杂志, 2014, 1(3): 4-20.
21. 李屈进, 刘作金, 涂兵, 等. MDT 在联合肝脏离断和门静脉结扎的二步肝切除术中的运用. 中国普外基础与临床杂志, 2018, 25(7): 852-858.
22. 胡泽明, 陈彪, 钟佳宁, 等. 原发性肝癌治疗方法的应用进展. 山东医药, 2019, 59(9): 106-110.
23. 黄海于, 黎克全. 原发性肝癌的局部消融治疗进展. 现代医药卫生, 2016, 32(11): 1661-1664.
24. 刘泽龙, 王阳, 张国志, 等. 肝动脉栓塞化疗联合肝叶切除术治疗原发性肝癌患者临床疗效观察. 实用肝脏病杂志, 2017, 20(3): 368-369.
25. 王天浩, 任正刚, 叶青海, 等. 术前辅助性肝动脉化疗栓塞对可切除巨块型肝癌术后生存的影响. 中华肿瘤防治杂志, 2010, 17(15): 1210-1213.
26. 张世超. 术前辅助性 TACE 对米兰标准内乙肝相关肝癌切除术后远期生存影响的回顾性研究. 上海: 中国人民解放军海军军医大学, 2018.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Multi-disciplinary team treatment for a case of primary giant liver cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content