Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Metussin, Adli; Patanwala, Imran; Cross, Tim

doi:10.1016/j.jhep.2014.08.057

Cited by 7 publications

(6 citation statements)

References 11 publications

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“…Previous studies have reported that PLT-based models can be used to predict patient survival (15,(29)(30)(31). Similar to the present study, Qin et al (66) demonstrated that FIB-4 >3.…”

Section: Discussionsupporting

confidence: 89%

“…Although recent studies have demonstrated that abnormal PLT counts are associated with a poor prognosis in patients with cancer, this association remains controversial (27,28). In addition, previous studies have reported a correlation between PLT-based models and the recurrence and overall survival rate in patients with malignant hepatic tumors (15,(29)(30)(31)(32). In the present study, 18 PLT-based models were used to predict the overall survival and recurrence-free survival in patients with malignant hepatic tumors.…”

Section: Introductionmentioning

confidence: 86%

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Relationship between platelet‑based models and the prognosis of patients with malignant hepatic tumors

Wang

et al. 2020

Oncol Lett

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Platelets (PLTs) are involved in tumor growth, metabolism and vascular activation. PLT-based models have been reported to have significant value on the recurrence of malignant hepatic tumors. The present study aimed to investigate the effect of PLT count and 18 PLT-based models on the prognosis of patients with malignant hepatic tumors. The clinical data from 189 patients with malignant hepatic tumors were retrospectively analyzed and used to calculate the scores of the 18 PLT-based models. Receiver operating characteristic curve was used to determine the suitable cutoff values of mortality and recurrence in patients with malignant hepatic tumors. The overall survival and cumulative recurrence rates of patients were calculated using Kaplan-Meier survival curves and the difference was analyzed using log-rank test. Multivariate analysis was performed to determine the independent risk factors of recurrence-free survival and overall survival. In the present study, 11 models were considered as predictors of mortality (P<0.05) and six models were considered as predictors of recurrence (P<0.05). The results from multivariate analysis demonstrated that vascular cancer embolus, uric acid >231 µmol/l, hemoglobin >144 g/l and the Lok index model >0.695 were considered as independent risk factors of mortality (P<0.05). Furthermore, vascular cancer embolus, PLT to lymphocyte ratio (PLR) >175 and fibrosis-4 (FIB-4) >4.82 were independent factors of recurrence (P<0.05). In addition, the results from this study indicated that the Lok-index could be considered as a predictor of the overall survival rate. In conclusion, the FIB-4 and PLR model may be valuable for predicting the recurrence-free rate of patients with malignant hepatic tumors.

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“…Previous studies have reported that PLT-based models can be used to predict patient survival (15,(29)(30)(31). Similar to the present study, Qin et al (66) demonstrated that FIB-4 >3.…”

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 86%

Relationship between platelet‑based models and the prognosis of patients with malignant hepatic tumors

Wang

et al. 2020

Oncol Lett

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“…Although transarterial chemoembolization (TACE) is recommended as the standard treatment for BCLC‐B HCC, various other treatments including liver resection have been used in clinical settings. Recent studies have provided evidence supporting the survival benefit of resection for BCLC‐B HCC, but the issue remains controversial. Well designed studies comparing liver resection with non‐surgical treatments such as TACE are sparse.…”

Section: Introductionmentioning

confidence: 99%

Survival benefit of liver resection for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma

Kim

Ahn

Hong

et al. 2017

British Journal of Surgery

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“…, TACE). However, for tumors confined to the same segment or the ipsilateral half of the liver, surgical resection may achieve better outcomes than other treatment modalities[ 6 , 7 ]. In the present case, as the tumor was not only located in the right lobe but also in the left medial lobe (Figure 5A ), an anatomical right trisectionectomy was required.…”

Section: Discussionmentioning

confidence: 99%

Successful totally laparoscopic right trihepatectomy following conversion therapy for hepatocellular carcinoma: A case report

Zhang

Ze-xin

Jing

et al. 2021

WJCC

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BACKGROUND About 20%-30% of newly diagnosed hepatocellular carcinoma (HCC) patients are surgically feasible due to a variety of reasons. Active conversion therapy may provide opportunities of surgery for these patients. Nevertheless, the choice of surgical procedure is controversial after successful conversion therapy. We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization. CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/ discomfort and nausea/vomiting for more than 1 mo. Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors (the largest was ≥ 10 cm in diameter) located in the right liver and left medial lobe, and the left lateral lobe was normal. The future remnant liver (FRL) of the left lateral lobe accounted for only 18% of total liver volume after virtual resection on the three-dimensional liver model. Conversion therapy was adopted after orally administered entecavir for antiviral treatment. First, the right portal vein was embolized. Then tumor embolization was performed via the variant hepatic arteries. After 3 wk, the FRL of the left lateral lobe accounted for nearly 30% of the total liver volume. Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia. The in situ resection was performed via an anterior approach. The operating time was 240 min. No clamping was required during the surgery, and the intraoperative blood loss was 300 mL. There were no postoperative complications such as bile leakage, and the incision healed well. The patient was discharged on the 8 th postoperative day. During the 3-mo follow-up, there was no recurrence and obvious hyperplasia of residual liver was observed. Alpha-fetoprotein decreased significantly and tended to be normal. CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs, the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver. Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.

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Partial hepatectomy vs. transcatheter arterial chemoembolization for resectable multiple hepatocellular carcinoma beyond Milan criteria: A RCT

Cited by 7 publications

References 11 publications

Relationship between platelet‑based models and the prognosis of patients with malignant hepatic tumors

Relationship between platelet‑based models and the prognosis of patients with malignant hepatic tumors

Survival benefit of liver resection for Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma

Successful totally laparoscopic right trihepatectomy following conversion therapy for hepatocellular carcinoma: A case report

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