Long-term survival after CCRT and HAIC followed by ALPPS for hepatocellular carcinoma with portal vein invasion: a case report

Abstract

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.

Is multidisciplinary treatment effective for hepatocellular carcinoma with portal vein tumor thrombus?

“…Such patients are presumed to have a poor prognosis, regardless of the treatment they receive. After controlling the main tumor and the macrovascular invasion In the report by Kim et al, 12 concurrent chemo-radiotherapy (CCRT) and HAIC was applied to a patient with HCC with PVTT. Subsequently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was performed.…”

“…In the report by Kim et al, 12 concurrent chemo-radiotherapy (CCRT) and HAIC was applied to a patient with HCC with PVTT. Subsequently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was performed.…”