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Selvakumar et al. Hepatoma Res 2017;3:18-21 Hepatoma Research
DOI: 10.20517/2394-5079.2016.14
www.hrjournal.net
Case Report Open Access

Sorafenib from palliative to neoadjuvant

chemotherapy in hepatocellular carcinoma

with major vascular invasion: experience

of two cases

Naganathan Selvakumar, Sandeep Vohra, Deep Sika Arora, Subash Gupta
Indraprasta Apollo Hospital, Sarita Vihar, New Delhi 110074, India

Correspondence to: Dr. Naganathan Selvakumar, Liver Transplantation Surgery, Indraprasta Apollo Hospital, Sarita Vihar, New Delhi 110074, India.
E-mail: enselva1@gmail.com

How to cite this article: Selvakumar N, Vohra S, Arora DS, Gupta S. Sorafenib from palliative to neoadjuvant chemotherapy in hepatocellular
carcinoma with major vascular invasion: experience of two cases. Hepatoma Res 2017;3:18-21.

ABSTRACT
Article history: Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide and the
Received: 12-05-2016 incidence is higher in cirrhosis. Treatment options depend on tumor stage, status of liver
Accepted: 14-11-2016 function, and the general condition of the patient. Major vascular invasion is a contraindication
Published: 12-01-2017 for liver transplantation. Sorafenib has been found to be useful in association with transarterial
chemoembolization as an effective chemotherapeutic agent to prolong survival in inoperable
Key words: HCCs. Here we describe our experience where sorafenib was used as palliation but later turned
Hepatocellular carcinoma, out to be a neoadjuvant. Both cases had major portal vein thrombosis and received sorafenib
sorafenib, as palliative therapy. After a mean use of 6 months, both patients had marked tumor response
hepatic artery ligation, and proceeded to have liver transplantations. Both cases are tumor-free at a median follow up
liver transplantation, of 13 months.
major vascular invasion

INTRODUCTION have advanced and incurable. Hence there are many
palliative options available to prolong the survival in
Hepatocellular carcinomas (HCCs) are the fifth most such group of patients. In patients with early cancers
common cancers in the world. The incidence of HCC curative treatment options are possible. Curative
is more in the eastern population compared to the options include liver resection, liver transplantation,
west. Incidence is also higher in the cirrhotic livers radiofrequency ablation (RFA). Palliative therapeutic
as compared to the non cirrhotics. Management options include transarterial chemoembolization
depends on the tumor stage, status of the liver and (TACE), transarterial radioembolisation, sorafenib,
general physical status of the patient. Majority of external beam radiotherapy (EBRT), combination
HCC patients at the time of primary consultation chemotherapy regimens. With recent advances in

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