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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Five-year complete remission of super-giant hepatocellular carcinoma with hepatectomy followed by sorafenib plus camrelizumab: A case report
Xiao-Qin Zheng, Li-Bo Sun, Wen-Jie Jin, Hui Liu, Wen-Yan Song, Hui Xu, Ju-Shan Wu, Xiao-Jun Wang, Chun-Yan Gou, Hui-Guo Ding
Xiao-Qin Zheng, Hui Xu, Xiao-Jun Wang, Chun-Yan Gou, Integrated Traditional Chinese and Western Medicine Center, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Li-Bo Sun, Ju-Shan Wu, Department of Surgery, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Wen-Jie Jin, Institute for Research in Biomedicine, Università della Svizzera italiana, Bellinzona 6500, Ticino, Switzerland
Hui Liu, Department of Pathology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Wen-Yan Song, Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Hui-Guo Ding, Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China
Co-corresponding authors: Chun-Yan Gou and Hui-Guo Ding.
Author contributions: Zheng XQ prepared and wrote the manuscript; Jin WJ and Sun LB drafted and corrected the figures; Xu H collected the data; Wu JS, Liu H, Song WY, and Wang XJ contributed to the design of the report; Ding HG and Gou CY critically revised and edited the manuscript. All authors have read and agreed to the published version of the manuscript. Both Gou CY and Ding HG contributed equally as co-corresponding authors, collaboratively overseeing the study design, data analysis, and interpretation of results. Both authors were equally involved in drafting and revising the manuscript, approving the final version, and are accountable for all aspects of the work, ensuring accuracy and integrity.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hui-Guo Ding, Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, No. 8 Xitoutiao, Youanmenwai, Fengtai District, Beijing 100069, China.
dinghuiguo@ccmu.edu.cn
Received: July 29, 2024
Revised: September 23, 2024
Accepted: October 28, 2024
Published online: January 27, 2025
Processing time: 151 Days and 0.7 Hours
BACKGROUND
Cirrhotic patients with super-giant hepatocellular carcinoma (HCC) and portal vein invasion generally have a poor prognosis. This paper presents a patient with super-giant HCC and portal vein invasion, who underwent hepatectomy followed by a combination of sorafenib and camrelizumab, resulting in complete remission (CR) for 5 years.
CASE SUMMARY
A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC, Barcelona Clinic Liver Cancer stage C. Enhanced computed tomography imaging revealed a 152 mm × 171 mm tumor in the right liver, invading the portal vein and hepatic vein. Liver function was normal. The patient successfully underwent hepatectomy on July 18, 2019. However, by December 2019, HCC recurrence with lung metastases and portal vein invasion were detected. He started treatment with sorafenib (200 mg twice daily) and camrelizumab (200 mg every 3 weeks). By May 12, 2020, the patient was confirmed to have CR. Camrelizumab was adjusted to 200 mg every 12 weeks from June 16, 2021, with the last infusion on March 29, 2024. Although no further tumor recurrence was observed, he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices, which were managed with endoscopic therapy. To date, the patient has remained in CR for 5 years.
CONCLUSION
The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with super-giant HCC and portal vein invasion. Further research is necessary to address these challenges and improve patient outcomes.
Core Tip: Cirrhotic patients with super-giant hepatocellular carcinoma (HCC), accompanied by portal vein invasion, generally have a poor prognosis. We report a patient with super-giant HCC and portal vein invasion, who underwent hepatectomy followed by sorafenib plus camrelizumab, resulting in complete remission for 5 years. However, two critical issues are raised: One is how to screen and manage portal hypertension in HCC, and the other is related to the optimal treatment duration of tyrosine kinase inhibitors and immune checkpoint inhibitors in HCC patients who achieve complete remission. Further research is needed to address these challenges.
