MDT discussion of comprehensive downstaging treatment for 2 cases of liver cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LUO De ^1,2 , ZHU Gang ^1,2 , LUO Bin ^1,2 , XIE Yunchuan ³ , HAN Yunwei ⁴ , PENG Fangyi ^1,2 , FANG Cheng ^1,2 , GAN Yu ^1,2 , YANG Xiaoli ^1,2 , SU Song ^1,2 ,  LI Bo ^1,2

1. Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
2. Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan 646000, P. R. China;
3. Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
4. Department of Oncology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding?author：

LI Bo, Email: liboer2002@126.com

Keywords：

liver cancer; comprehensive treatment; downstaging treatment; multidisciplinary team

DOI：

10.7507/1007-9424.201912064

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore value of multidisciplinary team (MDT) discussion in comprehensive downstaging treatment of liver cancer.Method The clinical data of 2 patients with liver cancer who could not undergo the radical surgery admitted to the Affiliated Hospital of Southwest Medical University were analyzed retrospectively.Results Case 1 was diagnosed as the liver cancer with extensive double lung metastasis at admission. The clinical stage was stage Ⅲb; After MDT discussion, the patient was treated with chemotherapy and embolization via hepatic artery and bronchial artery; At the same time, the patient was treated with apatinib; At present, the metastasis of both lungs disappeared completely; The clinical stage was stage ⅡB, and the radical resection was proposed. Case 2 was diagnosed as the right liver cancer at admission. The clinical stage was stage Ⅰ b. The preoperative examination showed that the hepatic reserve function was poor and the patient could not tolerate the half hepatectomy; After MDT discussion, the patient was treated with the combination of chemotherapy and embolization via the hepatic artery and apatinib in the same period; At the same time, the patient was treated with liver protection. The clinical stage was reduced to stage Ⅰ a. The hepatic reserve function improved and the laparoscopic right hemihepatectomy was performed, no recurrence or metastasis was found after 3 months follow-up.Conclusion Comprehensive downstaging treatment based on MDT model could bring better clinical outcomes for patients with liver cancer who are unable to undergo one-stage radical surgery.

Citation： LUO De, ZHU Gang, LUO Bin, XIE Yunchuan, HAN Yunwei, PENG Fangyi, FANG Cheng, GAN Yu, YANG Xiaoli, SU Song, LI Bo. MDT discussion of comprehensive downstaging treatment for 2 cases of liver cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(5): 600-605. doi: 10.7507/1007-9424.201912064 Copy

1.	李川江, 周杰. 肝細胞肝癌經肝動脈化療栓塞聯合索拉非尼降期后二期切除的初步報告. 腹部外科, 2017, 30(4): 295-298, 301.
2.	金鑫, 史憲杰, 王茂強, 等. 大肝癌 58 例患者經肝動脈插管化療栓塞降期治療體會. 中華醫學雜志, 2011, 91(14): 950-955.
3.	賴俊雄, 劉曉欣, 劉允怡. 原發性肝癌降期手術新進展. 臨床外科雜志, 2015, 23(1): 5-7.
4.	王浩, 陳光, 高海軍, 等. 載藥微球介入栓塞治療在肝癌肝移植術前降期治療中的應用. 中華普通外科雜志, 2019, 34(5): 410-412.
5.	中華人民共和國衛生和計劃生育委員會醫政醫管局. 原發性肝癌診療規范(2017 年版). 中華消化外科雜志, 2017, 16(7): 635-647.
6.	蔡秀軍, 鄭強, 蔣廣宜. 肝癌外科治療的現狀和展望. 中華外科雜志, 2019, 57(7): 494-499.
7.	Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant, 2009, 9(8): 1920-1928.
8.	尹偉利, 連佳, 肖時湘, 等. 載藥微球與傳統碘化油經肝動脈化療栓塞術治療不可切除肝癌效果比較的 Meta 分析. 臨床肝膽病雜志, 2019, 35(6): 1270-1275.
9.	邱力戈, 梁若斯, 李勇, 等. HepaSphere 載藥微球與碘油化療栓塞大肝癌的不良反應比較. 中華介入放射學電子雜志, 2018, 6(2): 99-103.
10.	林繼平, 肖亦明, 唐承富. 載藥微球與碘化油在肝癌栓塞治療中的療效及并發癥對比研究. 中國實用醫藥, 2019, 14(22): 40-41.
11.	曹國洪, 王凱, 李佳琪, 等. CalliSphere?載藥微球經動脈導管化療栓塞治療肝癌患者的有效性及安全性分析. 中國介入影像與治療學, 2018, 15(1): 42-46.
12.	張錫武, 陳瑩, 黃娟, 等. CalliSpheres?載藥微球化學栓塞治療中早期肝細胞癌患者的療效、安全性及預后因素分析. 第二軍醫大學學報, 2019, 40(4): 399-407.
13.	中國醫師協會介入醫師分會. 中國肝細胞癌經動脈化療栓塞治療(TACE)臨床實踐指南. 中華肝臟病雜志, 2019, 27(3): 172-181.
14.	王浩, 陳光, 高海軍, 等. 載藥微球化療栓塞在肝癌患者肝移植等待期間應用的療效分析. 中華肝膽外科雜志, 2019, 25(4): 246-248.
15.	黎瑩, 楊冬陽, 賴曉嶸, 等. 阿帕替尼聯合 TACE 對肝癌患者 AFP、VEGF 和 CEA 的影響. 肝臟, 2018, 23(5): 426-430.
16.	楊慶, 潘松松, 施昌盛, 等. 甲磺酸阿帕替尼聯合 TACE 治療中晚期肝癌的效果及對患者血清 VEGF 和 MMP-9 的影響. 中華介入放射學電子雜志, 2019, 7(2): 111-116.
17.	吳發宗, 呂秀玲, 宋晶晶, 等. 阿帕替尼聯合肝動脈化療栓塞術的抗肝癌療效及對腫瘤血管再生的影響. 溫州醫科大學學報, 2019, 49(6): 423-426, 431.
18.	謝佳杭, 王久惠. 索拉菲尼聯合 TACE 治療進展期原發性肝癌療效及并發癥分析. 腫瘤預防與治療, 2015, 28(3): 152-154.
19.	吳金道, 韓國勇, 陸森, 等. 肝動脈栓塞化療術聯合索拉菲尼對比單純介入術治療原發性肝癌的臨床觀察. 南京醫科大學學報(自然科學版), 2015, 35(12): 1739-1742.
20.	Liu GM, Huang XY, Shen SL, et al. Adjuvant antiviral therapy for hepatitis B virus-related hepatocellular carcinoma after curative treatment: A systematic review and meta-analysis. Hepatol Res, 2016, 46(1): 100-110.
21.	Chen XX, Cheng JW, Huang A, et al. The effect of antiviral therapy on patients with hepatitis B virus-related hepatocellular carcinoma after curative resection: a systematic review and meta-analysis. Onco Targets Ther, 2017, 10: 5363-5375.
22.	徐建波, 張建淮, 宋研, 等. 經導管肝動脈栓塞化療聯合抗病毒治療對乙肝相關肝癌患者復發的影響. 中華肝膽外科雜志, 2018, 24(9): 590-593.
23.	Sinn DH, Choi GS, Park HC, et al. Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients. PLoS One, 2019, 14(1): e0210730.

1. 李川江, 周杰. 肝細胞肝癌經肝動脈化療栓塞聯合索拉非尼降期后二期切除的初步報告. 腹部外科, 2017, 30(4): 295-298, 301.
2. 金鑫, 史憲杰, 王茂強, 等. 大肝癌 58 例患者經肝動脈插管化療栓塞降期治療體會. 中華醫學雜志, 2011, 91(14): 950-955.
3. 賴俊雄, 劉曉欣, 劉允怡. 原發性肝癌降期手術新進展. 臨床外科雜志, 2015, 23(1): 5-7.
4. 王浩, 陳光, 高海軍, 等. 載藥微球介入栓塞治療在肝癌肝移植術前降期治療中的應用. 中華普通外科雜志, 2019, 34(5): 410-412.
5. 中華人民共和國衛生和計劃生育委員會醫政醫管局. 原發性肝癌診療規范(2017 年版). 中華消化外科雜志, 2017, 16(7): 635-647.
6. 蔡秀軍, 鄭強, 蔣廣宜. 肝癌外科治療的現狀和展望. 中華外科雜志, 2019, 57(7): 494-499.
7. Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant, 2009, 9(8): 1920-1928.
8. 尹偉利, 連佳, 肖時湘, 等. 載藥微球與傳統碘化油經肝動脈化療栓塞術治療不可切除肝癌效果比較的 Meta 分析. 臨床肝膽病雜志, 2019, 35(6): 1270-1275.
9. 邱力戈, 梁若斯, 李勇, 等. HepaSphere 載藥微球與碘油化療栓塞大肝癌的不良反應比較. 中華介入放射學電子雜志, 2018, 6(2): 99-103.
10. 林繼平, 肖亦明, 唐承富. 載藥微球與碘化油在肝癌栓塞治療中的療效及并發癥對比研究. 中國實用醫藥, 2019, 14(22): 40-41.
11. 曹國洪, 王凱, 李佳琪, 等. CalliSphere?載藥微球經動脈導管化療栓塞治療肝癌患者的有效性及安全性分析. 中國介入影像與治療學, 2018, 15(1): 42-46.
12. 張錫武, 陳瑩, 黃娟, 等. CalliSpheres?載藥微球化學栓塞治療中早期肝細胞癌患者的療效、安全性及預后因素分析. 第二軍醫大學學報, 2019, 40(4): 399-407.
13. 中國醫師協會介入醫師分會. 中國肝細胞癌經動脈化療栓塞治療(TACE)臨床實踐指南. 中華肝臟病雜志, 2019, 27(3): 172-181.
14. 王浩, 陳光, 高海軍, 等. 載藥微球化療栓塞在肝癌患者肝移植等待期間應用的療效分析. 中華肝膽外科雜志, 2019, 25(4): 246-248.
15. 黎瑩, 楊冬陽, 賴曉嶸, 等. 阿帕替尼聯合 TACE 對肝癌患者 AFP、VEGF 和 CEA 的影響. 肝臟, 2018, 23(5): 426-430.
16. 楊慶, 潘松松, 施昌盛, 等. 甲磺酸阿帕替尼聯合 TACE 治療中晚期肝癌的效果及對患者血清 VEGF 和 MMP-9 的影響. 中華介入放射學電子雜志, 2019, 7(2): 111-116.
17. 吳發宗, 呂秀玲, 宋晶晶, 等. 阿帕替尼聯合肝動脈化療栓塞術的抗肝癌療效及對腫瘤血管再生的影響. 溫州醫科大學學報, 2019, 49(6): 423-426, 431.
18. 謝佳杭, 王久惠. 索拉菲尼聯合 TACE 治療進展期原發性肝癌療效及并發癥分析. 腫瘤預防與治療, 2015, 28(3): 152-154.
19. 吳金道, 韓國勇, 陸森, 等. 肝動脈栓塞化療術聯合索拉菲尼對比單純介入術治療原發性肝癌的臨床觀察. 南京醫科大學學報(自然科學版), 2015, 35(12): 1739-1742.
20. Liu GM, Huang XY, Shen SL, et al. Adjuvant antiviral therapy for hepatitis B virus-related hepatocellular carcinoma after curative treatment: A systematic review and meta-analysis. Hepatol Res, 2016, 46(1): 100-110.
21. Chen XX, Cheng JW, Huang A, et al. The effect of antiviral therapy on patients with hepatitis B virus-related hepatocellular carcinoma after curative resection: a systematic review and meta-analysis. Onco Targets Ther, 2017, 10: 5363-5375.
22. 徐建波, 張建淮, 宋研, 等. 經導管肝動脈栓塞化療聯合抗病毒治療對乙肝相關肝癌患者復發的影響. 中華肝膽外科雜志, 2018, 24(9): 590-593.
23. Sinn DH, Choi GS, Park HC, et al. Multidisciplinary approach is associated with improved survival of hepatocellular carcinoma patients. PLoS One, 2019, 14(1): e0210730.

Previous Article
主動脈-股動脈分流用于合并心力衰竭的主動脈縮窄矯正術一例
Next Article
主動脈-股動脈分流用于合并心力衰竭的主動脈縮窄矯正術一例

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

MDT discussion of comprehensive downstaging treatment for 2 cases of liver cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content