Vena Cava

Jennifer,
Lisa was treated at Oregon Health and Science University (OHSU). We live in Portland, OR, so it was very convenient to have the surgery so close to home. My wife’s surgeon was Dr. Kevin Billingsley, and we cannot say enough great things about him. We traveled the country seeking out multiple second opinions, including Mayo Clinic, Sloan Kettering (Dr. Yuman Fong), MD Anderson, USC, and Loma Linda University. No one was willing to perform surgery initially, and only a few of the more aggressive surgeons were willing to take on Lisa’s case after she had a good response to chemotherapy.

After the initial rounds of chemotherapy, Lisa’s largest tumor shrank from 15 cm to about 11 cm. She had 6 tumors in all and the surgeon was able to remove all of them (right trisegmentectomy); however, he was not able to get clean margins in one area near the hepatic vein. Lisa had adjuvant chemo-radiation to this area post surgery.

I hope this information helps. Please let me know if you would like to speak with me or Lisa about her experiences. We are happy to talk via telephone or through e-mail if you would like more details.

Kind Regards,

-Matt

Hi Jennifer,
My wife Lisa had multiple tumors in both lobes of her liver (largest was over 15cm) and her inferior vena cava was partially encased. After failing on gem-cis, she had a good response to multiple rounds of folfirinox and was able to have surgery wherein 75% of her liver was removed. The surgical team was planning to remove and reconstruct the inferior vena cava but fortunately the tumor had shrunk significantly and they only had to remove a small portion of it.

Lisa was diagnosed in June of 2013 and had her surgery in January 2014. Please let me know if you would like further details. I hope that your mother has continued success with her treatment and that she is able to have surgery soon.

Kind Regards,

-Matt

Jennifer,

Yes my mother went through 8 cycles of FOLFIRINOX (5FU, Irinotecan, Oxaliplatin + Folinic acid) chemotherapy regimen, as the surgeon deemed it inoperable in the current state and therefore the aim was to shrink the tumour with chemotherapy. After the chemotherapy, there was success with shrinking, and the tumour became “dead”, we are now under the impression there is no active disease, but she is having a PET and angiogram in the coming 2 weeks to gain better knowledge on if the tumour is still active at all. If the tumour is not removed there is a very high chance it will become active again regardless. I think with regards to the outside of the tumour being dead, this was related to the surgeons impression that the chemotherapy would have targeted the outer of the tumour first, and if there was any active disease it would have more likely been deeper into the tumour.

Tiah

Hi Jennifer,

I’m not particularly able to answer your question specifically, but as for my mothers case, she has a very large intrahepatic tumour (~8x7cm) which is predominantly in segments 5 and 8, however extremely close to the vena cava which has lead to her surgeon deeming it too dangerous to operate. His justifications were that operating so close to the vena cava is extremely dangerous, and also if he was to operate but then unable to remove the entire tumour, and leave some tumour behind, that would be more dangerous than leaving the whole tumour, as the outside of the tumour was dead and if it was cut open it could spread more easily.

Hope this helps and take care,

Tiah