Successful surgical resection of large hepatocellular carcinoma with portal vein tumor thrombus after conversion therapy with mFOLFOX-HAIC combined with donafenib and sintilimab: two case reports and a literature review*

Abstract

Abstract The aim of our study was to evaluate the clinical efficacy of mFOLFOX-HAIC combined with donafenib and sintilimab conversion therapy followed by surgical resection of large hepatocellular carcinoma with portal vein tumor thrombus (PVTT). The clinical data of two patients with large hepatocellular carcinoma who were admitted to the Second Affiliated Hospital of Kunming Medical University were retrospectively collected. Both patients received mFOLFOX-HAIC combined with donafenib and sintilimab conversion therapy, followed by hepatectomy. Clinical data were reported, and clinical efficacy was evaluated. One patient had a 14.5 × 11.1 cm tumor with a tumor thrombus in the right portal vein. The other patient had a 12.1 × 8.3 cm tumor with portal and hepatic vein tumor thrombi. Both patients had CNLC stage IIIa prior to conversion therapy, which was reduced to stage Ib after conversion therapy. Subsequently, the patient underwent open and laparoscopic right hemihepatectomies. Short-term high-intensity conversion therapy with mFOLFOX-HAIC combined with donafenib and sintilimab is a feasible and effective treatment for patients with large hepatocellular carcinoma with PVTT.