Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2020; 8(12): 2574-2584
Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2574
Lenvatinib for large hepatocellular carcinomas with portal trunk invasion: Two case reports
Satoshi Komiyama, Kazushi Numata, Satoshi Moriya, Hiroyuki Fukuda, Makoto Chuma, Shin Maeda
Satoshi Komiyama, Kazushi Numata, Satoshi Moriya, Hiroyuki Fukuda, Makoto Chuma, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Kanagawa 2320024, Japan
Shin Maeda, Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 2360004, Japan
Author contributions: Komiyama S, Numata K, Moriya S, Fukuda H and Chuma M reviewed the literature and drafted the manuscript; Maeda S were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be 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: Kazushi Numata, MD, PhD, Clinical Professor, Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune, Minami-ku, Yokohama, Kanagawa 2320024, Japan. kz-numa@urahp.yokohama-cu.ac.jp
Received: March 19, 2020
Peer-review started: March 19, 2020
First decision: April 7, 2020
Revised: April 24, 2020
Accepted: June 4, 2020
Article in press: June 4, 2020
Published online: June 26, 2020
Processing time: 97 Days and 2.3 Hours
Core Tip

Core tip: We present two cases of unresectable hepatocellular carcinoma with a tumor thrombus in the main portal vein and a high tumor burden accompanied by a tumor diameter > 100 mm. Despite the aforementioned poor prognostic factors, due to the well-preserved liver function, we elected to treat both patients with lenvatinib in the hope of obtaining tumor shrinkage, based on the REFLECT trial. Lenvatinib was demonstrated to be safe, and good therapeutic responses were obtained. Thus, even in the presence of poor prognostic factors, if the liver function is well-preserved, lenvatinib can be effective and safe in patients with unresectable hepatocellular carcinoma.