Preoperative Chemotherapy Followed by Hepatectomy for Potentially Resectable UICC7 Stage IIIA, IIIB Hepatocellular Carcinoma; A Phase II Clinical Trial

DOI Web Site PubMed 参考文献21件
  • GOTO YUICHI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • NIIZEKI TAKASHI
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • FUKUTOMI SHOGO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • SHIRONO TOMOTAKE
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • SHIMOSE SHIGEO
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • IWAMOTO HIDEKI
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • KOJIMA SATOKI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • KANNO HIROKI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • UCHINO YOSHIHIRO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • SASAKI SHIN
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • SHIRAHAMA NOBUHISA
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • MUROYA DAISUKE
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • NOMURA YORIKO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • AKASHI MASANORI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • NAKAYAMA GOICHI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • HIRAKAWA YUSUKE
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • SATO TOSHIHIRO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • YOSHITOMI MUNEHIRO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • SAKAI HISAMUNE
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • HISAKA TORU
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • KAKUMA TATSUYUKI
    Biostatistics Center, Kurume University
  • KOGA HIRONORI
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • TORIMURA TAKUJI
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine
  • AKAGI YOSHITO
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine
  • OKUDA KOJI
    Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Kurume University School of Medicine

抄録

<p>Summary: Background: The Japanese guideline for therapeutic strategy in HCC does not recognize any benefit of preoperative chemotherapy for potentially resectable hepatocellular carcinoma (HCC), and only upfront resec tion is recommended even for an advanced HCC. Data on preoperative chemotherapy for advanced HCC is still limited. Poor prognostic factors of HCC after resection are tumor more than 5 cm in diameter, multiple lesions, and gross tumor thrombosis, which constitute UICC7 Stage IIIA and IIIB HCC. There are no prospective studies about preoperative chemotherapy in these patients. </p><p>Aim: To evaluate the benefit of preoperative chemotherapy for UICC7 Stage IIIA and IIIB potentially resectable HCC. </p><p>Discussion: Our recent study demonstrated that the 5-year overall survival rate (OS) of patients diagnosed as UICC7 Stage IIIA and IIIB who had received upfront resection was only 16.5%. In contrast, the 5-year OS of UICC7 Stage IIIA and IIIB initially unresectable patients who had achieved conversion from unresectable to resect able status under successful hepatic infusion chemotherapy prior to resection was as high as 61.3%. Additionally, recent studies reported transarterial chemoembolization achieved outcomes comparable with those of resection. Therefore, we believe that patients with UICC7 Stage IIIA and IIIB should be considered borderline resectable. To evaluate this hypothesis we registered the present phase II clinical trial to assess the benefit of preoperative chemo therapy followed by hepatectomy in potentially resectable UICC7 Stage IIIA and IIIB HCC patients. </p>

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