Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Mar 27, 2021; 13(3): 384-392
Published online Mar 27, 2021. doi: 10.4254/wjh.v13.i3.384
Conversion hepatectomy for hepatocellular carcinoma with main portal vein tumour thrombus after lenvatinib treatment: A case report
Kazuhiro Takahashi, Jaejeong Kim, Amane Takahashi, Shinji Hashimoto, Manami Doi, Kinji Furuya, Ryosuke Hashimoto, Yohei Owada, Koichi Ogawa, Yusuke Ohara, Yoshimasa Akashi, Katsuji Hisakura, Tsuyoshi Enomoto, Osamu Shimomura, Masayuki Noguchi, Tatsuya Oda
Kazuhiro Takahashi, Jaejeong Kim, Shinji Hashimoto, Manami Doi, Kinji Furuya, Yohei Owada, Koichi Ogawa, Yusuke Ohara, Yoshimasa Akashi, Katsuji Hisakura, Tsuyoshi Enomoto, Osamu Shimomura, Tatsuya Oda, Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
Amane Takahashi, Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama 3620806, Saitama, Japan
Ryosuke Hashimoto, Masayuki Noguchi, Department of Diagnostic Pathology, University of Tsukuba, Tsukuba 3058575, Ibaraki, Japan
Author contributions: Takahashi K, Kim J, Takahashi A, Hashimoto S, Doi M, Furuya K, Hashimoto R, Owada Y, Ogawa K, Ohara Y, Akashi Y, Hisakura K, Enomoto T, Shimomura O, Noguchi M and Oda T contributed equally to this work; Takahashi K and Kim J wrote the paper; all authors issued final approval for the version that was submitted.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE checklist (2016), and the manuscript was prepared and revised according to the CARE checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kazuhiro Takahashi, MD, PhD, Surgeon, Department of Gastrointestinal and Hepatobiliary Pancreatic Surgery, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba 3058575, Ibaraki, Japan. kazu1123@md.tsukuba.ac.jp
Received: January 6, 2021
Peer-review started: January 6, 2021
First decision: January 25, 2021
Revised: January 31, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: March 27, 2021
Processing time: 72 Days and 23.5 Hours
Core Tip

Core Tip: Patients with hepatocellular carcinoma (HCC) with portal vein tumour thrombus demonstrate an aggressive disease course, decreased liver function reserve, and higher recurrence rates after treatment. Clinical practice guidelines recommend systemic therapy as the first-line option for HCC with portal invasion. However, to achieve longer survival in these patients, the treatment strategy should be concluded with removal of the tumour. We report the first case of HCC with main portal vein tumour thrombus, in which radical conversion hepatectomy was successfully performed after lenvatinib treatment. Lenvatinib has several strengths that validate its use for targeting conversion hepatectomy for unresectable HCC.