Ten-year retrospect of ALPPS in the treatment of hepatocellular carcinoma:an eternal concept with cautious technologic choice.
10.3760/cma.j.cn112139-20211021-00497
- Author:
De Fei HONG
1
;
Shu You PENG
2
;
Yun Yi LIU
3
Author Information
1. Department of General Surgery,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China.
2. Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310006,China.
3. Chinese University of Hong Kong,Hong Kong, China.
- Publication Type:Journal Article
- MeSH:
Carcinoma, Hepatocellular/surgery*;
Hepatectomy;
Humans;
Ligation;
Liver;
Liver Neoplasms/surgery*;
Portal Vein/surgery*;
Technology;
Treatment Outcome
- From:
Chinese Journal of Surgery
2022;60(2):113-116
- CountryChina
- Language:Chinese
-
Abstract:
Clinical practice using associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) or its modified procedures in treatment of primary hepatocellular carcinoma(HCC) with insufficient future liver remnant(FLR) in the past 10 years has failed to meet our expectations both in achieving decreased perioperative complications and mortality.The efficacy of ALPPS in improving long-term survival outcome of HCC still remains poor.Due to the trauma of two surgery within a short period,and patients with inadequate FLR are all diagnosed at advanced disease stages,ALPPS can only achieve surgical rather than biological tumor-curability.Previous studies have demonstrated comparable 5-year survival rates between early and advanced stages of HCC who underwent regional treatments.Therefore,tumor biological conversion is the key strategy prior to liver remnant volume conversion in improving treatment outcomes for HCC patients with insufficient FLR.Target therapy,immunotherapy together with locally treatment were expected to improve the conversion efficacy.Looking back at the development of ALPPS for the last decade,the rapid proliferation of FLR should be passed on,while the technology costs high risks and result in poor long-term outcome must be cautiously selected.
