中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 8
Aug.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(8): 1589-1596

Clinical features and influencing factors of patients with advanced hepatocellular carcinoma achieving five-year sustained complete remission after local treatment combined with systemic therapy

DOI: 10.12449/JCH250818
  • 1.

    Department of Interventional Radiology，The First Affiliated Hospital of Soochow University，Suzhou，Jiangsu 215000，China

  • 2.

    Department of Radiology，The First People’s Hospital of Kunshan，Suzhou，Jiangsu 215300，China

Research funding:

National Natural Science Foundation of China (82272094)

More Information
  • Corresponding author: NI Caifang， szncf@suda.edu.cn （ORCID： 0009-0008-9620-0512）
  • Received Date: 2025-01-12
  • Accepted Date: 2025-03-07
  • Published Date: 2025-08-25
    Abstract
  •   Objective  To investigate the clinical features of patients with China Liver Cancer Staging （CNLC） stage Ⅲ hepatocellular carcinoma （HCC） achieving five-year sustained complete remission （CR） after local treatment combined with systemic therapy， as well as potential contributing factors， and to provide a reference for optimizing the treatment of advanced HCC.  Methods  A retrospective analysis was performed for the clinical data of six patients with CNLC stage Ⅲ HCC who were treated in Department of Interventional Radiology， The First Affiliated Hospital of Soochow University， from January 2016 to December 2019 and achieved five-year sustained CR. Baseline characteristics， treatment modalities， and follow-up data were summarized， and a literature review was performed.  Results  The six patients had a mean age of 58.3±10.1 years， among whom five had stage Ⅲa HCC and one had stage Ⅲb HCC， and all patients had a history of hepatitis. The mean preoperative MELD score was 8.2±0.8 for the six patients， and there were five patients with Child-Pugh class A liver function and one with Child-Pugh class B liver function. All patients underwent transcatheter arterial chemoembolization， followed by sequential targeted drug therapy after surgery， with sorafenib for four patients and lenvatinib for two patients. Four patients with main portal vein tumor thrombus also received 125I seed implantation， one patient with the single-nodule type underwent radiofrequency ablation， and three patients received immunotherapy with camrelizumab. The median time to AFP normalization was 6 months， the median time from treatment to CR was 5.5 months， and the median follow-up time was 63 months.  Conclusion  Good liver function at baseline， an early and rapid reduction in AFP， and the combination of local treatment and systemic therapy are key factors for achieving long-term CR in patients with advanced HCC. Multi-center large-scale studies are needed in the future to further explore prognostic factors and optimize treatment regimens.

     

    • FullText(HTML)
  • loading
    • References(37)
  • [1]
    HAN BF, ZHENG RS, ZENG HM, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4( 1): 47- 53. DOI: 10.1016/j.jncc.2024.01.006.
    [2]
    Alliance of Liver Cancer Conversion Therapy, Committee of Liver Cancer, China Anti-Cancer Association. Chinese expert consensus on conversion and perioperative therapy of primary liver cancer(2024 edition)[J]. Chin J Dig Surg, 2024( 4): 492- 513. DOI: 10.3760/cma.j.cn115610-20240228-00135.

    中国抗癌协会肝癌专业委员会转化治疗协作组. 原发性肝癌转化及围手术期治疗中国专家共识(2024版)[J]. 中华消化外科杂志, 2024( 4): 492- 513. DOI: 10.3760/cma.j.cn115610-20240228-00135.
    [3]
    HUANG ZJ, ZHANG LD, WU ZY, et al. Conversion therapy for unresectable hepatocellular carcinoma[J/OL]. Chin J Hepat Surg(Electronic Edition), 2025, 14( 1): 41- 45.

    黄忠晶, 张丽东, 伍子奕, 等. 不可切除肝细胞癌的转化治疗[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14( 1): 41- 45.
    [4]
    National Health Commission of the People’s Republic of China. Standard for diagnosis and treatment of primary liver cancer(2024 edition)[J]. J Clin Hepatol, 2024, 40( 5): 893- 918. DOI: 10.12449/JCH240508.

    中华人民共和国国家卫生健康委员会. 原发性肝癌诊疗指南(2024年版)[J]. 临床肝胆病杂志, 2024, 40( 5): 893- 918. DOI: 10.12449/JCH240508.
    [5]
    LLOVET JM, LENCIONI R. mRECIST for HCC: Performance and novel refinements[J]. J Hepatol, 2020, 72( 2): 288- 306. DOI: 10.1016/j.jhep.2019.09.026.
    [6]
    SANO S, NAKATA S, WADA SC, et al. Pathological complete response by advanced hepatocellular carcinoma with massive macrovascular invasion to hepatic arterial infusion chemotherapy: A case report[J]. World J Surg Oncol, 2019, 17( 1): 229. DOI: 10.1186/s12957-019-1772-8.
    [7]
    LIU ZN, LI XJ, HE XQ, et al. Complete response to the combination of Lenvatinib and Pembrolizumab in an advanced hepatocellular carcinoma patient: A case report[J]. BMC Cancer, 2019, 19( 1): 1062. DOI: 10.1186/s12885-019-6287-8.
    [8]
    HIROSE S, ISHIGE K, YAMAURA M, et al. A case report: Long-term complete response of metastatic hepatocellular carcinoma obtained after discontinuation of 2-month sorafenib monotherapy[J]. Clin J Gastroenterol, 2020, 13( 5): 902- 906. DOI: 10.1007/s12328-020-01154-z.
    [9]
    ANDO Y, YAMAUCHI M, SUEHIRO Y, et al. Complete response to pembrolizumab in advanced hepatocellular carcinoma with microsatellite instability[J]. Clin J Gastroenterol, 2020, 13( 5): 867- 872. DOI: 10.1007/s12328-020-01099-3.
    [10]
    GOH MJ, KANG W, SINN DH, et al. Advanced stage hepatocellular carcinoma successfully treated with transarterial radioembolization and multi-tyrosine kinase inhibitor therapy[J]. J Liver Cancer, 2020, 20( 2): 160- 166. DOI: 10.17998/jlc.20.2.160.
    [11]
    HWANG SY, LEE SM, LIM JW, et al. Complete response in hepatocellular carcinoma with lymph node metastasis by combination therapy of atezolizumab and bevacizumab: A case report[J]. J Liver Cancer, 2021, 21( 2): 177- 180. DOI: 10.17998/jlc.2021.09.10.
    [12]
    ENDO K, KURODA H, ABE T, et al. Two hepatectomy cases for initially unresectable hepatocellular carcinoma after achieving a radiological complete response to sequential therapy with lenvatinib and transcatheter arterial chemoembolization[J]. Hepatol Res, 2021, 51( 10): 1082- 1086. DOI: 10.1111/hepr.13665.
    [13]
    TSAI KF, TSAI JCH, LI MF, et al. Complete response in metastatic hepatocellular carcinoma with cardiac and lung involvement via multimodality treatment[J]. Medicina(Kaunas), 2021, 57( 8): 849. DOI: 10.3390/medicina57080849.
    [14]
    NONG X, ZHANG YM, LIANG JC, et al. Complete response by patients with advanced hepatocellular carcinoma after combination immune/targeted therapy and transarterial chemoembolization: Two case reports and literature review[J]. Transl Cancer Res, 2022, 11( 8): 2973- 2984. DOI: 10.21037/tcr-21-2691.
    [15]
    ZHONG KH, XU YY, CHENG Y, et al. Case report: Primary hepatocellular carcinoma with portal vein tumor Thrombus characterized by active tumor immune microenvironment achieving a complete response following treatment of combined immunotherapy[J]. Front Immunol, 2022, 13: 999763. DOI: 10.3389/fimmu.2022.999763.
    [16]
    ZHAO Y, HE GS, LI G. Triplet regimen as a novel modality for advanced unresectable hepatocellular carcinoma: A case report and review of literature[J]. World J Clin Cases, 2023, 11( 27): 6558- 6564. DOI: 10.12998/wjcc.v11.i27.6558.
    [17]
    TOMONARI T, TANAKA H, TANAKA T, et al. A case of complete response with rechallenge-lenvatinib plus transcatheter arterial chemoembolization for unresectable hepatocellular carcinoma refractory to multiple molecular-targeted agent treatments[J]. Clin J Gastroenterol, 2023, 16( 3): 438- 443. DOI: 10.1007/s12328-023-01777-y.
    [18]
    KURISAKI K, SOYAMA A, HARA T, et al. Pathologic complete response after chemotherapy with atezolizumab plus bevacizumab for hepatocellular carcinoma with tumor Thrombus in the main portal trunk[J]. Dig Surg, 2023, 40( 1-2): 84- 89. DOI: 10.1159/000529405.
    [19]
    MARTÍNEZ BENITO B, GONZÁLEZ PINTOR V, DEL CAMPO DEL VAL L, et al. Complete tumor response after concomitant treatment with lenvatinib and radioembolization with Ytrio-90 of advanced stage hepatocarcinoma[J]. Gastroenterol Hepatol, 2024, 47( 6): 620- 622. DOI: 10.1016/j.gastrohep.2023.09.005.
    [20]
    OKUNO M, OHAMA H, NAKAMURA I, et al. A patient who underwent conversion surgery after atezolizumab plus bevacizumab for hepatocellular carcinoma with portal vein thrombosis and perihepatic lymph node metastases achieved a pathological complete response[J]. Int Cancer Conf J, 2024, 13( 3): 306- 312. DOI: 10.1007/s13691-024-00683-5.
    [21]
    QIAO JH, WANG Y, FU CX, et al. Complete response and long-term survival after short-course camrelizumab plus apatinib, hepatic arterial infusion chemotherapy, and transarterial chemoembolization in large and advanced hepatocellular carcinoma: A case report[J]. J Gastrointest Oncol, 2024, 15( 5): 2323- 2329. DOI: 10.21037/jgo-24-613.
    [22]
    XIAO XH, FU HX, QIN HX, et al. Case report: Complete response after transcatheter arterial chemoembolization combined with donafenib plus tislelizumab therapy for hepatocellular carcinoma with main trunk portal vein tumor Thrombus in a patient coinfected with HIV and HBV[J]. Front Immunol, 2024, 15: 1422801. DOI: 10.3389/fimmu.2024.1422801.
    [23]
    ARIMA S, KANDA T, TOTSUKA M, et al. Elderly patient with unresectable advanced-stage hepatocellular carcinoma who received atezolizumab plus bevacizumab and achieved a complete response: A case report[J]. Med Int(Lond), 2024, 4( 3): 23. DOI: 10.3892/mi.2024.147.
    [24]
    FAN J, GAO Q. Immunotherapy for hepacellular carcinoma: Where there is hope, there is brightness[J]. Chin J Dig Surg, 2022, 21( 2): 199- 204. DOI: 10.3760/cma.j.cn115610-20220215-00080.

    樊嘉, 高强. 肝癌的免疫治疗: 有希望便是光明[J]. 中华消化外科杂志, 2022, 21( 2): 199- 204. DOI: 10.3760/cma.j.cn115610-20220215-00080.
    [25]
    PINTER M, SIEGHART W. Long-term remission in advanced stage hepatocellular carcinoma? Achance for cure?[J]. Memo Mag Eur Med Oncol, 2018, 11( 3): 185- 192. DOI: 10.1007/s12254-018-0431-z.
    [26]
    RIMOLA J, DÍAZ-GONZÁLEZ Á, DARNELL A, et al. Complete response under sorafenib in patients with hepatocellular carcinoma: Relationship with dermatologic adverse events[J]. Hepatology, 2018, 67( 2): 612- 622. DOI: 10.1002/hep.29515.
    [27]
    CABIBBO G, MAIDA M, GENCO C, et al. Survival of patients with hepatocellular carcinoma(HCC) treated by percutaneous radio-frequency ablation(RFA) is affected by complete radiological response[J]. PLoS One, 2013, 8( 7): e70016. DOI: 10.1371/journal.pone.0070016.
    [28]
    YOUNES EH, ZAHRA HF, SOUMAYA BM, et al. Study of predictive factors of complete response after chemoembolization for unresectable hepatocellular carcinoma in 162 patients[J]. Clin Exp Hepatol, 2020, 6( 4): 313- 320. DOI: 10.5114/ceh.2020.102169.
    [29]
    Liver Oncology Branch of China Association for the Promotion of International Healthcare Exchanges, Multi-disciplinary Collaboration Group of Digestive Tract Oncology, Cancer Hospital of Peking Union Medical College, Chinese Academy of Medical Sciences, and Liver Cancer Professional Committee of Chinese Medical Doctor Association. Expert consensus on whole course management of liver function in liver cancer transformation therapy(2022 edition)[J]. Electron J Liver Tumor, 2023, 10( 1): 1- 9.

    中国医疗保健国际交流促进会肝脏肿瘤学分会, 中国医学科学院北京协和医院肿瘤医院消化道肿瘤多学科协作组, 中国医师协会肝癌专业委员会. 肝癌转化治疗中肝功能全程管理中国专家共识(2022版)[J]. 肝癌电子杂志, 2023, 10( 1): 1- 9.
    [30]
    KUZUYA T, KAWABE N, MUTO H, et al. Characteristics and prognosis of patients with advanced hepatocellular carcinoma treated with atezolizumab/bevacizumab combination therapy who achieved complete response[J]. Curr Oncol, 2024, 31( 10): 6218- 6231. DOI: 10.3390/curroncol31100463.
    [31]
    KUZUYA T, KAWABE N, HASHIMOTO S, et al. Early changes in alpha-fetoprotein are a useful predictor of efficacy of atezolizumab plus bevacizumab treatment in patients with advanced hepatocellular carcinoma[J]. Oncology, 2022, 100( 1): 12- 21. DOI: 10.1159/000519448.
    [32]
    XU JH, YIN DX, LI YC, et al. Systemic therapy for advanced hepatocellular carcinoma[J]. J Clin Hepatol, 2024, 40( 11): 2306- 2314. DOI: 10.12449/JCH241127.

    徐家豪, 尹东旭, 李宇辰, 等. 晚期肝细胞癌的系统治疗[J]. 临床肝胆病杂志, 2024, 40( 11): 2306- 2314. DOI: 10.12449/JCH241127.
    [33]
    KUANG M. Advances in neoadjuvant therapy for hepatocellular carcinoma[J]. Chin J Dig Surg, 2023, 22( 2): 202- 208. DOI: 10.3760/cma.j.cn115610-20221203-00728.

    匡铭. 肝细胞癌新辅助治疗研究进展[J]. 中华消化外科杂志, 2023, 22( 2): 202- 208. DOI: 10.3760/cma.j.cn115610-20221203-00728.
    [34]
    DING D, FU SZ, DAI F, et al. Therapeutic effect of intervention combined with sorafenib in the treatment of hepatocellular carcinoma with main portal vein tumor Thrombus[J]. Chin Comput Med Imag, 2023, 29( 4): 433- 437. DOI: 10.19627/j.cnki.cn31-1700/th.20230329.003.

    丁丁, 付守忠, 戴锋, 等. 介入联合索拉菲尼治疗肝癌伴门脉癌栓的疗效观察[J]. 中国医学计算机成像杂志, 2023, 29( 4): 433- 437. DOI: 10.19627/j.cnki.cn31-1700/th.20230329.003.
    [35]
    Liver Cancer Committee, Chinese Medical Doctor Association. Guidelines for diagnosis and treatment of hepatocellular carcinoma complicated with portal vein cancer thrombus in China(2021 edition)[J]. Natl Med J China, 2022, 102( 4): 243- 254. DOI: 10.3760/cma.j.cn112137-20211117-02567.

    中国医师协会肝癌专业委员会. 中国肝细胞癌合并门静脉癌栓诊疗指南(2021年版)[J]. 中华医学杂志, 2022, 102( 4): 243- 254. DOI: 10.3760/cma.j.cn112137-20211117-02567.
    [36]
    JIN ZC, CHEN JJ, ZHU XL, et al. Immune checkpoint inhibitors and anti-vascular endothelial growth factor antibody/tyrosine kinase inhibitors with or without transarterial chemoembolization as first-line treatment for advanced hepatocellular carcinoma(CHANCE2201): A target trial emulation study[J]. EClinicalMedicine, 2024, 72: 102622. DOI: 10.1016/j.eclinm.2024.102622.
    [37]
    SANGRO B, KUDO M, ERINJERI JP, et al. Durvalumab with or without bevacizumab with transarterial chemoembolisation in hepatocellular carcinoma(EMERALD-1): A multiregional, randomised, double-blind, placebo-controlled, phase 3 study[J]. Lancet, 2025, 405( 10474): 216- 232. DOI: 10.1016/S0140-6736(24)02551-0.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (337) PDF downloads(39) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return