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International Journal of Hepatology
Volume 2011, Article ID 791013, 5 pages
http://dx.doi.org/10.4061/2011/791013
Case Report

Liver Resection after Downstaging Hepatocellular Carcinoma with Sorafenib

1Department of Digestive Surgery and Liver Transplantation, Rangueil Hospital, 1 avenue du Professor Jean Poulhès, 31059 Toulouse Cedex 9, France
2Department of Pathology, Rangueil Hospital, 31059 Toulouse, France
3Department of Hepato-Gastro-Enterology, Pau Hospital, 4 Boulevard Hauterive, 64046 Pau, France
4Department of Radiology, Rangueil Hospital, 31059 Toulouse, France

Received 20 October 2010; Accepted 24 January 2011

Academic Editor: Ryosuke Tateishi

Copyright © 2011 L. Barbier et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Sorafenib is a molecular-targeted therapy used in palliative treatment of advanced hepatocellular carcinoma in Child A patients. Aims. To address the question of sorafenib as neoadjuvant treatment. Methods. We describe the cases of 2 patients who had surgery after sorafenib. Results. The patients had a large hepatocellular carcinoma in the right liver with venous neoplastic thrombi (1 in the right portal branch, 1 in the right hepatic vein). After 9 months of sorafenib, reassessment showed that tumours had decreased in size with a necrotic component. A right hepatectomy with thrombectomy was performed, and histopathology showed 35% to 60% necrosis. One patient had a recurrence after 6 months and had another liver resection; they are both recurrence-free since then. Conclusion. Sorafenib can downstage hepatocellular carcinoma and thus could represent a bridge to surgery. It may be possible to select patients in good general condition with partial regression of the tumour with sorafenib for a treatment in a curative intent.