原发性肝细胞癌伴盆腔转移转化治疗1例报告

Diagnosis and analysis of primary hepatocellular cancer with pelvic metastasis:a case report

本文报道了1例原发性肝细胞癌伴少见盆腔转移患者的诊治经过。该患者首先入组了我院的一项临床研究, 治疗方案为靶向治疗联合免疫治疗(仑伐替尼联合HX008), 共22个周期。经靶向治疗联合免疫治疗后血清甲胎蛋白明显降低, CT及MRI评估均提示肿瘤显著缩小达部分缓解, 后续顺利完成原发灶及转移灶的同期根治性切除。目前该患者已获得23个月的生存时间, 经复查无复发及远处转移征象。该例患者的诊治经验提示在有效的全身治疗下可能会给晚期患者带来手术切除的机会, 但临床收治这类患者应仔细全面评估。随着全身治疗有效性的提高, 后续采取积极的根治性治疗手段, 可能会使更多的患者获益。

We report the management of a patient with primary hepatocellular carcinoma with rare pelvic metastasis.The patient was first enrolled in a clinical study in our hospital and received a treatment regimen of targeted combination immunotherapy(lenvatinib combined with HX008)for 22 cycles.After therapy,the patient showed a significant reduction in alpha-fetoprotein level,and both CT and MRI evaluations suggested that the tumor was significantly reduced to partial response.This was followed by successful simultaneous radical resection of the primary and metastatic foci.The patient has now achieved 23 months of survival with no signs of recurrence or distant metastasis.The diagnosis and treatment experience of this patient suggests that effective systemic therapy may provide advanced patients with the opportunity for surgical resection.Patients with primary hepatocellular carcinoma and metastasis should be evaluated thoroughly,and radical treatment should be considered when adjuvant therapy effectiveness is guaranteed,more patients may benefit from a comprehensive and effective treatment approach.