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Hepatocellular Carcinoma Case Studies

Case Studies: Initial Strategies in Advanced HCC

In this case-based interview series, Richard S. Finn, MD, illustrates how various comorbidities impact the management of advanced hepatocellular carcinoma and discusses initial treatment options, including liver transplantation, locoregional therapy, and systemic therapy.

Initial Strategies in Advanced HCC: Case 1

December 2014

  • A 64-year old male positive with HCV presents to his PCP with nausea, vomiting, syncope
  • ECOG=1
  • Child-Pugh B
  • T bilirubin 2.1; albumin 3.2; INR 1.1; no ascites, no encephalopathy; platelets 78
  • CT scan revealed one 4-cm lesion in the liver
  • No extrahepatic disease; no portal vein invasion
  • Laboratory results: AFP=400 ng/ml
  • Patient is within Milan criteria
  • Bridge using TACE until liver transplantation
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