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.	吳孟超, 湯釗猷, 劉允怡, 等. 原發性肝癌診療規范 (2017 年版). 臨床肝膽病雜志, 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.	高揚, 邵雨辰, 蘇明珠, 等. 癌癥患者的多學科團隊協作診療模式研究進展. 中國醫院管理, 2019, 39(3): 34-37.
9.	陳孝平, 張志偉. 肝癌多學科綜合治療團隊建立與運作. 中國實用外科雜志, 2014, 34(8): 685-687.
10.	楊斌, 李財勝, 萬鈞, 等. 探討綜合治療巨大肝癌的臨床療效. 當代醫學, 2018, 24(35): 85-86.
11.	苗春木, 丁雄, 鄧開, 等. MDT 主導的 BCLC B 期肝右葉原發性巨塊型肝癌 TACE 術后外科根治性切除的時機探討. 中國普外基礎與臨床雜志, 2018, 25(6): 735-743.
12.	劉付寶, 耿小平. 巨大肝癌外科手術治療的抉擇. 肝膽外科雜志, 2017, 25(1): 1-4.
13.	葛寧靈. 肝細胞癌多學科團隊 (MDT) 協作診療模式的重要性. 胃腸病學和肝病學雜志, 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.	劉淦, 孫杰, 張婷, 等. 原發性肝癌免疫治療的現狀及未來. 傳染病信息, 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, 劉釗, 梁錫天, 等. 肝癌靶向治療靶點的研究進展. 現代腫瘤醫學, 2018, 26(5): 776-779.
20.	廣東省抗癌協會肝癌專業委員會. 肝癌 MDT 團隊建立和多學科聯合治療的專家共識. 肝癌電子雜志, 2014, 1(3): 4-20.
21.	李屈進, 劉作金, 涂兵, 等. MDT 在聯合肝臟離斷和門靜脈結扎的二步肝切除術中的運用. 中國普外基礎與臨床雜志, 2018, 25(7): 852-858.
22.	胡澤明, 陳彪, 鐘佳寧, 等. 原發性肝癌治療方法的應用進展. 山東醫藥, 2019, 59(9): 106-110.
23.	黃海于, 黎克全. 原發性肝癌的局部消融治療進展. 現代醫藥衛生, 2016, 32(11): 1661-1664.
24.	劉澤龍, 王陽, 張國志, 等. 肝動脈栓塞化療聯合肝葉切除術治療原發性肝癌患者臨床療效觀察. 實用肝臟病雜志, 2017, 20(3): 368-369.
25.	王天浩, 任正剛, 葉青海, 等. 術前輔助性肝動脈化療栓塞對可切除巨塊型肝癌術后生存的影響. 中華腫瘤防治雜志, 2010, 17(15): 1210-1213.
26.	張世超. 術前輔助性 TACE 對米蘭標準內乙肝相關肝癌切除術后遠期生存影響的回顧性研究. 上海: 中國人民解放軍海軍軍醫大學, 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. 吳孟超, 湯釗猷, 劉允怡, 等. 原發性肝癌診療規范 (2017 年版). 臨床肝膽病雜志, 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. 高揚, 邵雨辰, 蘇明珠, 等. 癌癥患者的多學科團隊協作診療模式研究進展. 中國醫院管理, 2019, 39(3): 34-37.
9. 陳孝平, 張志偉. 肝癌多學科綜合治療團隊建立與運作. 中國實用外科雜志, 2014, 34(8): 685-687.
10. 楊斌, 李財勝, 萬鈞, 等. 探討綜合治療巨大肝癌的臨床療效. 當代醫學, 2018, 24(35): 85-86.
11. 苗春木, 丁雄, 鄧開, 等. MDT 主導的 BCLC B 期肝右葉原發性巨塊型肝癌 TACE 術后外科根治性切除的時機探討. 中國普外基礎與臨床雜志, 2018, 25(6): 735-743.
12. 劉付寶, 耿小平. 巨大肝癌外科手術治療的抉擇. 肝膽外科雜志, 2017, 25(1): 1-4.
13. 葛寧靈. 肝細胞癌多學科團隊 (MDT) 協作診療模式的重要性. 胃腸病學和肝病學雜志, 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. 劉淦, 孫杰, 張婷, 等. 原發性肝癌免疫治療的現狀及未來. 傳染病信息, 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, 劉釗, 梁錫天, 等. 肝癌靶向治療靶點的研究進展. 現代腫瘤醫學, 2018, 26(5): 776-779.
20. 廣東省抗癌協會肝癌專業委員會. 肝癌 MDT 團隊建立和多學科聯合治療的專家共識. 肝癌電子雜志, 2014, 1(3): 4-20.
21. 李屈進, 劉作金, 涂兵, 等. MDT 在聯合肝臟離斷和門靜脈結扎的二步肝切除術中的運用. 中國普外基礎與臨床雜志, 2018, 25(7): 852-858.
22. 胡澤明, 陳彪, 鐘佳寧, 等. 原發性肝癌治療方法的應用進展. 山東醫藥, 2019, 59(9): 106-110.
23. 黃海于, 黎克全. 原發性肝癌的局部消融治療進展. 現代醫藥衛生, 2016, 32(11): 1661-1664.
24. 劉澤龍, 王陽, 張國志, 等. 肝動脈栓塞化療聯合肝葉切除術治療原發性肝癌患者臨床療效觀察. 實用肝臟病雜志, 2017, 20(3): 368-369.
25. 王天浩, 任正剛, 葉青海, 等. 術前輔助性肝動脈化療栓塞對可切除巨塊型肝癌術后生存的影響. 中華腫瘤防治雜志, 2010, 17(15): 1210-1213.
26. 張世超. 術前輔助性 TACE 對米蘭標準內乙肝相關肝癌切除術后遠期生存影響的回顧性研究. 上海: 中國人民解放軍海軍軍醫大學, 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