Considerations Following Locoregional Therapy in HCC - Episode 1
Ghassan K. Abou-Alfa, MD:This is a classic scenario of a lady with, unfortunately, morbid obesity and nonalcoholic steatohepatitis that led to hepatocellular carcinoma. She is a Child-Pugh A, thankfully, and still has options that are available. Unfortunately, the tumor is rather large, but more importantly, it’s really very close to blood vessels, deemed unresectable by an evaluation with the surgeon. And with the lack of metastatic disease, a local therapy might be appropriate over here.
This is a very classic scenario. We see it all the time, which is why chemoembolization, bland embolization, or some form of embolization would be totally appropriate. In that case, the patient did receive a chemoembolization with drug-eluting beads, which are now becoming more and more used in that domain. And it appears to be that she did rather very well. She obviously, the day after the intervention, had fevers, abdominal pain, and some elevation of the liver function tests, which are classic postembolization syndrome. She recovered from them, appropriately so. Within about 2 to 3 months, a certain CT scan did occur and it showed a very reasonable response to the embolization and the alpha-fetoprotein, if I heard, dropped from about 1500 to about 200. So, that’s a great story! If anything, there was totally appropriate management and the patient did receive the appropriate care over here.
Transcript edited for clarity.