Open AccessLamivudine treatment enabling right hepatectomy for hepatocellular carcinoma in decompensated cirrhosis
Author(s) -
Koichi Honda,
Masataka Seike,
Shunsuke Maehara,
Koichiro Tahara,
Hideaki Anai,
Akira Moriuchi,
Toyokichi Muro
Publication year - 2012
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v18.i20.2586
Subject(s) - lamivudine , medicine , hepatocellular carcinoma , cirrhosis , indocyanine green , hepatectomy , liver function , gastroenterology , hepatitis b virus , hepatitis b , adefovir , surgery , virus , immunology , resection
A 69-year-old man was admitted to our hospital in October 2003, for further examination of two liver tumors. He was diagnosed with hepatocellular carcinoma (HCC) arising from decompensated hepatitis B virus (HBV)-related cirrhosis. Long-term lamivudine administration improved liver function dramatically despite repeated treatment for HCC. His Child-Pugh score was 9 points at start of lamivudine treatment, improving to 5 points after 1 year. His indocyanine green at 15 min after injection test score was 48% before lamivudine treatment, improving to 22% after 2 years and to 5% after 4 years. Radiofrequency ablation controlled the HCC foci and maintained his liver function. In April 2009, abdominal computed tomography revealed a tumor thrombus in the right portal vein. Since his indocyanine green test results had improved to less than 10%, we performed a right hepatectomy, which was successful. To our knowledge, there have been no documented reports of patients undergoing successful right hepatectomy for HCC arising from decompensated cirrhosis. The findings observed in our patient indicate the importance of nucleoside analogs for treating HBV-related HCC.