Recent advances in surgical treatment of hepatocellular carcinoma

Song, Tianqiang

doi:10.5582/ddt.2015.01051

Cited by 36 publications

(28 citation statements)

References 127 publications

(125 reference statements)

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“…[11,12] PVE and PVL are now routinely used in TSH to improve the rate of a successful R0 resection. [2,13,14] Although portal occlusion (PVE or PVL) can increase the volume of the FLR by up to 40% within 3 to 8 weeks, the second stage of the procedure was not always performed. [15,16] In a study by Shindoh et al, [17] 27.8% of patients dropped out.…”

Section: Introductionmentioning

confidence: 99%

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence

et al. 2016

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The main obstacle to achieving an R0 resection after a major hepatectomy is inability to preserve an adequate future liver remnant (FLR) to avoid postoperative liver failure (PLF). Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a novel technique for resecting tumors that were previously considered unresectable, and this technique results in a vast increase in the volume of the FLR in a short period of time. However, this technique continues to provoke heated debate because of its high mortality and morbidity.The evolution of ALPPS and its advantages and disadvantages have been systematically reviewed and evaluated in accordance with current evidence. Electronic databases (PubMed and Medline) were searched for potentially relevant articles from January 2007 to January 2016.ALPPS has evolved into various modified forms. Some of these modified techniques have reduced the difficulty of the procedure and enhanced its safety. Current evidence indicates that the advantages of ALPPS are rapid hypertrophy of the FLR, the feasibility of the procedure, and a higher rate of R0 resection in comparison to other techniques. However, ALPPS is associated with worse major complications, more deaths, and early tumor recurrence.Hepatobiliary surgeons should carefully consider whether to perform ALPPS. Some modified forms of ALPPS have reduced the mortality and morbidity of the procedure, but they cannot be recommended over the original procedure currently. Portal vein embolization (PVE) is still the procedure of choice for patients with a tumor-free FLR, and ALPPS could be used as a salvage procedure when PVE fails. More persuasive evidence needs to be assembled to determine whether ALPPS or two-stage hepatectomy (TSH) is better for patients with a tumor involving the FLR. Evidence with regard to long-term oncological outcomes is still limited. More meticulous comparative studies and studies of the 5-year survival rate of ALPPS could ultimately help to determine the usefulness of ALPPS. Indications and patient selection for the procedure need to be determined.

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Section: Introductionmentioning

confidence: 99%

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence

et al. 2016

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“…Early detection allows the use of lifesaving interventions that have the potential to be curative. When these interventions are applied to early‐stage HCC, 5‐year survival rates are reported to exceed 50%, underscoring the importance of early detection and equal access to potentially curative treatments …”

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confidence: 99%

At Diagnosis of Hepatocellular Carcinoma, African Americans With Hepatitis C Have Better Liver Function Than Other Patients

Winters

Sung

Wyatt

et al. 2018

Clinical Liver Disease

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“…Surgery is the most effective treatment for HCC (10). However, the majority of cases of HCC are diagnosed at a late stage, resulting in the majority of patients unable to receive surgical resection (11).…”

Section: Discussionmentioning

confidence: 99%

Chest wall hernia induced by high intensity focused ultrasound treatment of unresectable massive hepatocellular carcinoma: A case report

Chen

Teng

Chen³

2016

Oncology Letters

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Abstract. In the present study, a case of unresectable massive hepatocellular carcinoma (HCC) treated with high intensity focused ultrasound (HIFU) alone is reported. Although the treatment induced chest wall hernia, its efficacy in treating the HCC was demonstrated. The medical records of a patient with an unresectable massive tumor that was effectively treated with serial HIFU ablation were retrospectively studied. Chest wall hernia was detected as a complication of the HIFU treatment, which has not been reported thus far in the literature. The patient has survived for 44 months since the first diagnosis in September 2010. Treatment resulted in partial remission of the tumor, pain relief, decreased levels of alpha-fetoprotein and chest wall hernia, as a complication. Therefore, HIFU may be an effective approach for the treatment of unresectable HCC, although it may occasionally cause complications.

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Recent advances in surgical treatment of hepatocellular carcinoma

Cited by 36 publications

References 127 publications

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence

An updated systematic review of the evolution of ALPPS and evaluation of its advantages and disadvantages in accordance with current evidence

At Diagnosis of Hepatocellular Carcinoma, African Americans With Hepatitis C Have Better Liver Function Than Other Patients

Chest wall hernia induced by high intensity focused ultrasound treatment of unresectable massive hepatocellular carcinoma: A case report

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