A Multidisciplinary Treatment Strategy With Conversion Surgery for Hepatocellular Carcinoma

Area of Science:

• Hepatobiliary surgery
• Medical oncology
• Gastroenterology

Background:

• Sorafenib was the sole targeted therapy for hepatocellular carcinoma (HCC).
• Recent advancements have introduced new pharmaceutical options for HCC treatment.
• Unresectable advanced HCC cases can now achieve improved prognoses through surgical intervention following pharmaceutical therapy.

Purpose of the Study:

• To report cases of unresectable advanced HCC responding to pharmaceutical therapy.
• To evaluate the efficacy of lenvatinib followed by surgical intervention in improving HCC prognosis.

Main Methods:

• Retrospective review of five patients with intermediate and advanced HCC.
• Patients received lenvatinib followed by hepatectomy between October 2019 and September 2022.
• Comparison of patient, tumor, and treatment characteristics.

Main Results:

• Median patient age was 66 years; all patients were male.
• Lenvatinib treatment (median >2 months) resulted in partial responses (3 patients) or stable disease (2 patients).
• Three patients achieved partial pathological response; four underwent R0 resection with three experiencing no recurrence.

Conclusions:

• Lenvatinib demonstrates potential utility in treating intermediate and advanced HCC.
• Combining lenvatinib therapy with surgery may facilitate long-term survival in HCC patients.