Neoadjuvant sorafenib combined with gemcitabine plus oxaliplatin in advanced hepatocellular carcinoma

Figure 1 Computed tomography scan. A: A 4.5-cm hypervascular hepatic tumor (arrow) that occupied the sixth hepatic segment, without signs of underlying cirrhosis; B: After eight cycles of gemcitabine and oxaliplatin combined with sorafenib, we observed tumor shrinkage of > 40% (arrow), as compared to baseline assessment; C: Secondary surgery was performed: hemostatic clips were still visible on this postoperative CT scan.

Figure 2 Computed tomography scan. A: Initially, there were two metastatic lymph nodes (MLNs): one celiac (thin arrow) measuring 4 cm and one measuring 3 cm located in the liver hilum (thick arrow); B: Computed tomography scan taken after the end of the eight cycles of gemcitabine plus oxaliplatin combined with sorafenib, showed that the MLNs (thin arrow for celiac node and thick arrow for hilar node) decreased in size dramatically with a more necrotic aspect, which allowed secondary surgery followed by radiotherapy.