Surgical outcomes of lenvatinib treatment followed by liver resection for large advanced hepatocellular carcinoma.

Abstract

e16309 Background: According to the new definition of borderline resectable HCC, large hepatocellular carcinoma ( > 10 cm) is classified as resectable, but prognosis was poor. Therefore, we have been performing hepatic resection after administration of lenvatinib. However, it is unclear whether liver resection results after lenvatinib administration are better than upfront resection. Methods: To clarify the outcome of hepatic resection after lenvatinib administration for large hepatocellular carcinoma (> 10 cm). Thirty patients with large hepatocellular carcinoma (> 10 cm), nine in the lenvatinib group and 21 in the upfront resection group, were evaluated for preoperative background factors, surgical factors and postoperative complications, recurrence and prognosis, and treatment efficacy and adverse events in the lenvatinib group. Results: Median age of lenvatinib-treated patients was 75 years, and viruses were B/C/NBNC in 3/2/4 patients. median ICGR15 was 16.2%. The dose was 4mg/8mg/12mg in 3/3/3 cases, and the efficacy of lenvatinib was determined by mRECIST in 4 PR and 5 SD cases. In terms of adverse events, there was one case of intra-tumor bleeding in G3, which was stopped with TAE and could be managed with a reduced dose of lenvatinib. No significant difference in postoperative complications. The 3-year recurrence-free survival rate in the lenvatinib/upfront resection group was significantly better at 66.7%/16.7% (P = 0.044), and the 3-year cumulative survival rate was better, although not significant, at 85.7%/56.1% (P = 0.103). There were no significant differences in postoperative complications between the two groups. Conclusions: Liver resection after lenvatinib in patients with large hepatocellular carcinoma (> 10 cm) may reduce recurrence and prolong prognosis.