Cardiooncological balance in a 75-year-old male with a hepatocellular carcinoma CS IV and a congestive heart failure NYHA III „de novo” Case report
Article Sidebar
Main Article Content
Abstract
The case reports about a 75-years-old man without a previous medical history, in whom a heart failure NYHA III de novo was diagnosed together with persistent atrial fibrillation and hepatocellular carcinoma in clinical stage IV. Based on echocardiography and computed tomography there were pulmonary hypertension in course of lymphangiosis carcinomatosa as well as diffuse metastases in the abdomen diagnosed. Before the treatment initiation the patient was classified 3 in WHO performance status. After an improvement in control of the rhythm frequency and the heart failure treatment stabilisation with a β-blocker, an ACE-inhibitor, spironolactone and furosemide, the patient’s performance status improved to WHO 2. He was further disqualified from surgical procedures due to the advanced clinical stage of the oncological disease. Considering high probability of further cardiotoxic influence of sorafenib on the heart failure despite its satisfactory control, the patient was assigned to palliative chemotherapy with FOLFOX. Parallel he was strictly followed up cardiologically in an outpatient clinic what certainly supported the oncological treatment. The patient survived 32 weeks from the first hospitalization and the progression free survival was 12 weeks from the chemotherapy initiation.
Downloads
Metrics
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
2. Thomas MB. Hepatocellular carcinoma: the need for progress. J Clin Oncol 2005; 23(13): 2892-2899.
3. Pons F, Varela M, Llovet JM. Staging systems in hepatocellular carcinoma. HPB 2005; 7: 35-41.
4. Stewart S, MacIntyre K, Hole DJ et al. More ‘malignant’ than cancer? Five-year survival following a first admission for heart failure. Eur J Heart Fail 2001; 3(3): 315-322.
5. Bruix J, Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases: Management of hepatocellular carcinoma. Hepatology 2005; 42: 1208-1233.
6. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis 1999; 19: 329-338.
7. Sohn W, Paik YH, Cho JY et al. Sorafenib therapy for hepatocellular carcinoma with extrahepatic spread: treatment outcome and prognostic factors. J Hepatol 2014 Dec 13. pii: S0168-8278(14)00927-1. https://doi.org/10.1016/j.jhep.2014.12.009.
8. Rahme E, Feugère G, Sirois C et al. Anticoagulant use in patients with cancer associated venous thromboembolism: a retrospective cohort study. Thromb Res 2013; 131(3): 210-217.
9. Osterspey A, Krome A. Role of the new oral anticoagulants in comparison to vitamin K antagonists in practice. Herz 2012; 37(4): 384-392.
10. Louafi S, Boige V, Ducreux M et al. Gemcitabine plus oxaliplatin (GEMOX) in patients with advanced hepatocellular carcinoma (HCC): results of a phase II study. Cancer 2007; 109: 1384-1390.
11. Verslype C, Rosmorduc O, Rougier P.; ESMO Guidelines Working Group: Hepatocellular carcinoma: ESMO ESDO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2012; 23(supl. 7): vii41-vii48.
12. Del Carlo CH, Cardoso JN, Ochia ME et al. Temporal Variation in the Prognosis and Treatment of Advanced Heart Failure – Before and After 2000. Arquivos Brasileiros de Cardiologia 2014; 102(5): 495-504.
13. Eschenhagen T, Force T, Ewer M et al. Cardiovascular side effects of cancer therapies: a position statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2011; 13: 1-10.
14. Llovet JM, Ricci S, Mazzaferro V et al. SHARP Investigators Study Group: Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359: 378-390.
15. Hasin T, Gerber Y, McNallan SM et al. Patients with heart failure have an increased risk of incident cancer. J Am Coll Cardiol 2013; 62: 881-886.
16. Qin S, Bai Y, Lim HY et al. Randomized, multicenter, open-label study of oxaliplatin plus fluorouracil/leucovorin versus doxorubicin as palliative chemotherapy in patients with advanced hepatocellular carcinoma from Asia. Clin Oncol 2013; 31(28): 3501-3508.
17. Opolski G, Krzakowski M, Szmit S et al. Recommendations of National Team of Cardiologic and Oncologic Supervision on cardiologic safety of patients with breast cancer. The prevention and treatment of cardiovascular complications in breast cancer. The Task Force of National Consultants in Cardiology and Clinical Oncology for the elaboration of recommendations of cardiologic proceeding with patients with breast cancer. Kardiol Pol 2011; 69(5): 520-530.