Clinical analysis of surgical resection after conversion therapy for patients with initially unresectable HCC
10.3760/cma.j.cn113884-20250208-00043
- VernacularTitle:初始不可切除HCC转化治疗后手术切除的临床特征分析
- Author:
Xianzhou ZHANG
1
;
Bo MENG
;
Hao ZHUANG
;
Yongnian REN
;
Ju MA
;
Haibo YU
;
Min ZHANG
;
Xiangjun QIAN
;
Xiaopei HAO
;
Feng HAN
Author Information
1. 郑州大学附属肿瘤医院（河南省肿瘤医院）肝胆胰外科，郑州 450008
- Publication Type:Journal Article
- Keywords:
Carcinoma, hepatocellular;
Conversion therapy;
Hepatectomy;
Combination therapy
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(10):727-731
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of radical hepatectomy after conversion therapy in patients with initially unresectable advanced hepatocellular carcinoma (HCC).Methods:Clinical data of 72 patients with initially unresectable advanced HCC admitted to the Department of Hepatobiliary and Pancreatic Surgery, Affiliated Cancer Hospital of Zhengzhou University and the Department of Hepatobi-liary and Pancreatic Surgery, Henan Provincial People's Hospital from January 2020 to July 2024 were retrospectively collected, including 61 males and 11 females, aged (58.4±9.1) years. The clinicopathological data of the patients, such as tumor characteristics, conversion treatment regimens, perioperative data, and follow-up situations were analyzed to evaluate the therapeutic effect and safety.Results:Among the patients, there were five cases of China liver cancer staging Ⅰb, six cases of Ⅱa, 22 cases of Ⅱb, 32 cases of Ⅲa and sevene cases of Ⅲb. There were 53 patients scored as Child-Pugh A and 19 as Child-Pugh B. Conversion treatment fashion included immunotherapy combined with targeted therapy and immunotherapy plus targeted therapy combined with hepatic arterial chemoembolization or hepatic arteryinfusion chemotherapy. Liver resection after conversion therapy was as follows: 16 cases of right hemihepatectomy, 20 cases of left hemihepatectomy, 11 cases of mesohepatectomy, seven cases of right posterior hepatectomy, 1 case of caudate lobectomy, 17 cases of local resection. Postoperative pathology showed that there were 17 cases of pathologic complete response and 55 cases of pathologic partial response. One patient died of liver failure after surgery, while the rest had no major complications. The postoperative hospital stay was (13.1±5.1) d. The follow-up time was 21.5(10.2, 32.1) months. The multivariate Cox analysis demonstrated that pathologic partial response and adjuvant therapy duration shorter than 5 cycles were identified as independent risk factors-affecting both recurrence-free survival and overall survival in patients with HCC undergoing sequential surgery after conversion therapy (all P<0.05). Conclusion:Sequential surgical resection provides survival benefits for patients with initially unresectable and advanced HCC after conversion therapy, which is a safe and effective therapeutic strategy.
