Detailed Abstract
[Poster - Transplantation]
[P060] Management of peritoneal recurrence of hepatocellular carcinoma after 10 years of transplantation
Su-Min HA, Shin HWANG, Sang-Hyeon KANG, Yong-Kyu JUNG, Tae-Yong HA, Gi-Won SONG, Dong-Hwan JUNG, Gil-Chun PARK, Chul-Soo AHN, Deog-Bog MOON, Ki-Hun KIM, Sung-Gyu LEE
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea, Korea
Introduction : Hepatocellular carcinoma (HCC) can recur at any time even after 10 years following liver transplantation (LT).
Methods : We herein report 2 cases of very late peritoneal recurrence of HCC and discuss therapeutic strategy.
Results : A 78 year-old male patient who had undergone whole LT 10 years before showed slow elevation of PIVKA-II over 6 months. Close observation with frequent imaging studies and monthly tumor marker studies revealed solitary peritoneal seeding mass. Complete imaging studies revealed that the mass was highly suspicious of metastatic lesion. The mass was excised and all tumor markers returned to be within the normal range. The patient is receiving everolimus monotherapy and preemptive half-dose sorafenib, showing no evidence of recurrence for 8 months. Another 66-year-old male patient who had undergone living donor LT showed insidious elevation of AFP 12 years after transplantation. After observation for 3 months, follow-up studies revealed peritoneal seeding mass. Complete imaging studies revealed that the mass was highly suspicious of metastatic lesion. Two mass were excised. The patient underwent low-dose calcineruin inhibitor, sirolimus and full-dose sorafenib. Tumor marker elevated and growth of peritoneal seeding nodules was visualized, thus sorafenib was stopped after 2-year administration. He administers only everolimus for recent 2 years. The patient has shown slowly growing tumors, but is doing well without significant deterioration of quality of life for 6 years.
Conclusions : For very late peritoneal recurrence of HCC, therapeutic modalities include surgical resection if possible, everolimus, preemptive sorafenib and meticulous tumor marker monitoring.
Methods : We herein report 2 cases of very late peritoneal recurrence of HCC and discuss therapeutic strategy.
Results : A 78 year-old male patient who had undergone whole LT 10 years before showed slow elevation of PIVKA-II over 6 months. Close observation with frequent imaging studies and monthly tumor marker studies revealed solitary peritoneal seeding mass. Complete imaging studies revealed that the mass was highly suspicious of metastatic lesion. The mass was excised and all tumor markers returned to be within the normal range. The patient is receiving everolimus monotherapy and preemptive half-dose sorafenib, showing no evidence of recurrence for 8 months. Another 66-year-old male patient who had undergone living donor LT showed insidious elevation of AFP 12 years after transplantation. After observation for 3 months, follow-up studies revealed peritoneal seeding mass. Complete imaging studies revealed that the mass was highly suspicious of metastatic lesion. Two mass were excised. The patient underwent low-dose calcineruin inhibitor, sirolimus and full-dose sorafenib. Tumor marker elevated and growth of peritoneal seeding nodules was visualized, thus sorafenib was stopped after 2-year administration. He administers only everolimus for recent 2 years. The patient has shown slowly growing tumors, but is doing well without significant deterioration of quality of life for 6 years.
Conclusions : For very late peritoneal recurrence of HCC, therapeutic modalities include surgical resection if possible, everolimus, preemptive sorafenib and meticulous tumor marker monitoring.
SESSION
Poster
Poster / Exhibition Hall and Lobby(2F) 1/1/1970 9:00 AM - 9:00 AM