Fonseca GM, Varella AD, Coelho FF, Abe ES, Dumarco RB, Herman P. Downstaging and resection after neoadjuvant therapy for fibrolamellar hepatocellular carcinoma. World J Gastrointest Surg 2014; 6(6): 107-111 [PMID: 24976904 DOI: 10.4240/wjgs.v6.i6.107]
Corresponding Author of This Article
Gilton Marques Fonseca, MD, Digestive Surgery Division, Department of Gastroenterology, University of São Paulo School of Medicine, Avenida Doutor Enéas de Carvalho Aguiar, 255, Instituto Central, 9° Andar, Sala 9074, 05403-900, São Paulo, Brazil. medgilton@yahoo.com.br
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Gastrointest Surg. Jun 27, 2014; 6(6): 107-111 Published online Jun 27, 2014. doi: 10.4240/wjgs.v6.i6.107
Downstaging and resection after neoadjuvant therapy for fibrolamellar hepatocellular carcinoma
Gilton Marques Fonseca, Antonio Drauzio Varella, Fabricio Ferreira Coelho, Emerson Shigueaki Abe, Rodrigo Blanco Dumarco, Paulo Herman
Gilton Marques Fonseca, Fabricio Ferreira Coelho, Emerson Shigueaki Abe, Rodrigo Blanco Dumarco, Paulo Herman, Digestive Surgery Division, Department of Gastroenterology, University of São Paulo School of Medicine, Avenida Doutor Enéas de Carvalho Aguiar 255, Instituto Central, 05403-900, São Paulo, Brazil
Antonio Drauzio Varella, Clinical Oncologist, Hospital Sírio-Libanês, 01308-050, São Paulo, Brazil
Author contributions: Fonseca GM and Herman P designed the study and wrote the manuscript; Fonseca GM, Coelho FF, Abe ES and Dumarco RB performed revision research; Coelho FF, Abe ES, Dumarco RB and Varella AD reviewed the manuscript.
Correspondence to: Gilton Marques Fonseca, MD, Digestive Surgery Division, Department of Gastroenterology, University of São Paulo School of Medicine, Avenida Doutor Enéas de Carvalho Aguiar, 255, Instituto Central, 9° Andar, Sala 9074, 05403-900, São Paulo, Brazil. medgilton@yahoo.com.br
Telephone: +55-11-26617560 Fax: +55-11-26617560
Received: February 20, 2014 Revised: June 4, 2014 Accepted: June 10, 2014 Published online: June 27, 2014 Processing time: 150 Days and 13.8 Hours
Core Tip
Core tip: Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare malignant liver neoplasm. The best treatment option is a surgical resection with liver hilum lymph node dissection. Currently there is no established systemic drug treatment for patients with locally advanced or metastatic disease. In this report, a patient with advanced FLHCC, initially considered unresectable due to vascular invasion, exhibited a significant tumor reduction following systemic chemotherapy with gemcitabine-oxaliplatin, allowing resection. This was an unusual case where gemcitabine-oxaliplatin treatment led to a significant tumor downstaging enabling curative resection. Additional studies are needed to confirm the efficacy of the systemic drug treatment for FLHCC.
