Curative surgery for multiple hepatocellular carcinomas after lenvatinib plus transarterial chemoembolization: a case...

Area of Science:

• Hepatobiliary surgery
• Interventional oncology
• Medical oncology

Background:

• Intermediate-stage hepatocellular carcinoma (HCC) presents complex treatment challenges.
• Lenvatinib (LEN) plus transarterial chemoembolization (TACE) is a recognized therapeutic strategy for advanced HCC.
• Surgical intervention following systemic and locoregional therapy is being explored for resectable HCC.

Observation:

• A 66-year-old male with hepatitis C presented with four intermediate-stage HCC lesions up to 14 cm.
• The patient received neoadjuvant lenvatinib (LEN) plus transarterial chemoembolization (TACE).
• Computed tomography revealed tumor shrinkage and no new lesions after 8 weeks of LEN, indicating a partial response.

Findings:

• The patient underwent successful radical resection, including caudate lobectomy and partial hepatectomy of segments 6/7, combined with microwave coagulation therapy.
• Postoperative follow-up at 12 months showed no evidence of recurrence.
• This case demonstrates a positive outcome for combining systemic therapy, locoregional treatment, and surgical resection.

Implications:

• Hepatic resection combined with local therapy may be an effective treatment option for patients with multiple HCC lesions.
• This multimodal approach could improve outcomes in intermediate-stage HCC.
• Further research is warranted to validate this therapeutic strategy in larger patient cohorts.