There are various methods for treating advanced hepatocellular carcinoma with portal vein invasion, such as systemic chemotherapy, transarterial chemoembolization, transarterial radioembolization, and concurrent chemoradiotherapy. These methods have similar clinical efficacy but are designed with a palliative aim. Herein, we report a case that experienced complete remission through “associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)” after concurrent chemoradiotherapy and hepatic artery infusion chemotherapy. In this patient, concurrent chemoradiotherapy and hepatic artery infusion chemotherapy induced substantial tumor shrinkage, and hypertrophy of the nontumor liver was sufficiently induced by portal vein ligation (stage 1 surgery) followed by curative resection (stage 2 surgery). Using this approach, long-term survival with no evidence of recurrence was achieved at 16 months. Therefore, the optimal use of ALPPS requires sufficient consideration in cases of significant hepatocellular carcinoma shrinkage for curative purposes.
Among numerous examples of transition-metal-mediated cyclization to obtain medium-sized ring compounds, [1] intramolecular hydroacylation provides the most promising way to prepare cyclopentanones from 4-pentenal through the CÀHbond activation of an aldehyde. [2, 3] However, its application has been limited to the synthesis of five-membered rings with a few exceptions, [3] because the competing decarbonylation of the acyl metal hydride intermediate prevails during the formation of the larger ring. In the course of our studies into chelation-assisted CÀH-and CÀC-bond activation, [4] allylic amine 1 a, which bears a coordination site, was devised and used as a masked form of formaldehyde in the hydroacylation of 1-alkenes to synthesize dialkyl ketones. [4d] We envisaged a cyclization of dienes 2 [5±7] with 1 a to furnish cycloalkanones 3 with various sizes, since decarbonylation cannot occur in the reaction of 1 a (Scheme 1). Herein we present a facile synthesis of various cycloalkanones from the reaction of allylic amines with dienes through chelation-assisted CÀHand CÀC-bond activation.The reactions of 1 a with various dienes (2) are summarized in Table 1. For example, when 1 a was allowed to react with 1,4-pentadiene (2 a) in the presence of [{(C 8 H 14 ) 2 RhCl} 2 ] (4, 5 mol %) and PCy 3 (5, 15 mol %) at 150 8C for 2 h, cyclohexanone (3 a) and 2-methylcyclopentanone (3 b) were obtained in 87 % and 13 % yield, respectively, after hydrolysis (Table 1, entry 1). Furthermore, the reaction with 1,5-hexadiene (2 b) provided cycloheptanone (3 c), 2-methylcyclohexanone (3 d), and 2-ethylcyclopentanone (3 e) in a ratio of 38:40:22 (Table 1, entry 2). [8] The mechanism for this reaction is depicted in Scheme 2. Aldimine 6 a is generated by Rh-catalyzed isomerization of 1 a. Subsequent intermolecular hydroiminoacylation [9] of 2 b ZUSCHRIFTEN
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.