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Table 1: Tumor size, imaging and treatment responses in chronological order
July 2011 October 2011 February 2012 September 2012
Tumor size 9.7 cm (CT scan) 5.9 cm (CT scan) 5 cm (CT scan) 6 cm (PET scan)
AFP (ng/mL) 8,195 50 430 5,653
Treatments Once dose of TACE + sorafenib Sorafenib Two more doses of TACE + sorafenib Resection of HCC + IVC
AFP: alpha-fetoprotein; CT: computed tomography; TACE: transarterial chemoembolization; PET: positron emission tomography; HCC: hepatocellular carcinoma;
IVC: inferior vena cava
surgeons will definitely lead to earlier surgical treatment if Burock K, Zou J, Voliotis D, Guan Z. Effi cacy and safety of sorafenib
it is possible. in patients in the Asia-Pacifi c region with advanced hepatocellular
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A high pre-operative AFP level has been found to be 3. Sergio A, Cristofori C, Cardin R, Pivetta G, Ragazzi R, Baldan A,
associated with a higher rate of HCC recurrence, and thus Girardi L, Cillo U, Burra P, Giacomin A, Farinati F. Transcatheter
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the operation was the only chance of cure for him. the role of angiogenesis and invasiveness. Am J Gastroenterol
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4. Wilhelm SM, Adnane L, Newell P, Villanueva A, Llovet JM, Lynch M.
For the time being, clinicians cannot predict which patients Preclinical overview of sorafenib, a multikinase inhibitor that targets
will benefit from neoadjuvant treatment, and potential both Raf and VEGF and PDGF receptor tyrosine kinase signaling.
immunohistochemical markers should be explored to identify 5. Mol Cancer Ther 2008;7:3129-40.
Cabrera R, Pannu DS, Caridi J, Firpi RJ, Soldevila-Pico C, Morelli G,
potential good responders for neoadjuvant treatment with Clark V, Suman A, George TJ Jr, Nelson DR. The combination of
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6. Erhardt A, Kolligs F, Dollinger M, Schott E, Wege H, Bitzer M,
In conclusion, combined treatment can downstage initially Gog C, Lammert F, Schuchmann M, Walter C, Blondin D, Ohmann C,
unresectable HCCs to resectable ones in selected patients. Häussinger D. TACE plus sorafenib for the treatment of hepatocellular
Patients with the best chance of good outcomes should be given carcinoma: results of the multicenter, phase II SOCRATES trial. Cancer
vigilant reassessment with fine-tuning of treatment options 7. Chemother Pharmacol 2014;74:947-54.
Barbier L, Muscari F, Le Guellec S, Pariente A, Otal P, Suc B. Liver
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as major vascular resection and immediate reconstruction. 8. Kudo A, Matsumura S, Ban D, Irie T, Ochiai T, Tanaka S, Arii S,
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106 Hepatoma Research | Volume 1 | Issue 2 | July 15, 2015