Prolonged Survival of a Patient with Advanced-Stage Combined Hepatocellular-Cholangiocarcinoma.

Chemotherapy Combined hepatocellular-cholangiocarcinoma Liver transplantation Next-generation sequencing Targeted therapy

Journal

Case reports in gastroenterology
ISSN: 1662-0631
Titre abrégé: Case Rep Gastroenterol
Pays: Switzerland
ID NLM: 101474819

Informations de publication

Date de publication:
Historique:
received: 30 07 2020
accepted: 13 08 2020
entrez: 14 1 2021
pubmed: 15 1 2021
medline: 15 1 2021
Statut: epublish

Résumé

Combined hepatocellular-cholangiocarcinoma (cHCC/CCA) represents a rare type of primary liver cancer with a very limited prognosis. Although just recently genomic studies have contributed to a better understanding of the disease's genetic landscape, therapeutic options, especially for advanced-stage patients, are limited and often experimental, as no standardized treatment protocols have been established to date. Here, we report the case of a 38-year-old male patient who was diagnosed with extensive intrahepatic cHCC/CCA in an otherwise healthy liver without signs of chronic liver disease. An interdisciplinary stepwise therapeutic approach including locoregional liver-targeted therapy, systemic chemotherapy, liver transplantation, surgical pulmonary metastasis resection, and next-generation sequencing-based targeted therapy led to a prolonged overall survival beyond 5 years with an excellent quality of life. This case report comprises several provocative treatment decisions that are extensively discussed in light of the existing literature on this rare but highly aggressive malignancy.

Identifiants

pubmed: 33442346
doi: 10.1159/000511034
pii: crg-0014-0658
pmc: PMC7772835
doi:

Types de publication

Case Reports

Langues

eng

Pagination

658-667

Informations de copyright

Copyright © 2020 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

Références

Lancet Oncol. 2010 Dec;11(12):1142-8
pubmed: 21071270
World J Surg Oncol. 2019 Feb 27;17(1):43
pubmed: 30813932
J Pathol. 2019 Jun;248(2):164-178
pubmed: 30690729
PLoS One. 2018 Jun 7;13(6):e0198138
pubmed: 29879137
Nat Med. 2016 Nov;22(11):1314-1320
pubmed: 27748748
Hepatobiliary Pancreat Dis Int. 2019 Feb;18(1):12-18
pubmed: 30442549
Radiology. 2010 Apr;255(1):270-7
pubmed: 20308463
Lancet Gastroenterol Hepatol. 2018 May;3(5):337-348
pubmed: 29548617
Cancer Sci. 2018 Aug;109(8):2549-2557
pubmed: 29856900
Hepatol Res. 2005 Jul;32(3):185-95
pubmed: 15978872

Auteurs

Sven H Loosen (SH)

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Nadine T Gaisa (NT)

Institute of Pathology, University Hospital RWTH Aachen, Aachen, Germany.

Maximilian Schmeding (M)

Department of Surgery, Klinikum Dortmund, Dortmund, Germany.

Christoph Heining (C)

Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden, Dresden, Germany.
Center for Personalized Oncology, NCT Dresden and University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany.
German Cancer Consortium (DKTK), Dresden, Germany.

Sebastian Uhrig (S)

Division of Applied Bioinformatics, DKFZ, Heidelberg, Germany.
Molecular Diagnostics Program, NCT Heidelberg and DKFZ, Heidelberg, Germany.

Theresa H Wirtz (TH)

Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Sebastian Kalverkamp (S)

Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany.

Jan Spillner (J)

Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany.

Frank Tacke (F)

Department of Gastroenterology/Hepatology, Campus Virchow Klinikum and Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin, Germany.

Albrecht Stenzinger (A)

Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany.
German Cancer Consortium (DKTK), Heidelberg, Germany.

Hanno Glimm (H)

Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden, Dresden, Germany.
Center for Personalized Oncology, NCT Dresden and University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany.
German Cancer Consortium (DKTK), Dresden, Germany.
Translational Functional Cancer Genomics Group, NCT Heidelberg and DKFZ, Heidelberg, Germany.

Stefan Fröhling (S)

German Cancer Consortium (DKTK), Heidelberg, Germany.
Department of Translational Medical Oncology, NCT Heidelberg and DKFZ, Heidelberg, Germany.

Christian Trautwein (C)

Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Christoph Roderburg (C)

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Thomas Longerich (T)

Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.

Ulf Peter Neumann (UP)

Department of Visceral and Transplantation Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Department of Surgery, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.

Tom Luedde (T)

Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Department of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Classifications MeSH