Hepatectomy After Conversion Therapy for Initially Unresectable HCC: What is the Difference?

• DOI: 10.2147/jhc.s388965
• Publication Date: 2022-12-21T12:20:32Z
• Authors: Laihui Luo; Yongzhu He; Guoqing Zhu; Yongqiang Xiao; Shengjiang Song; Xian Ge; Tao Wang; Jin Xie; Wei Deng; Zhigao Hu; Renfeng Shan
• Keywords: Liver function

Conversion therapy gives some patients with initially unresectable hepatocellular carcinoma (HCC) access to surgery. The purpose of this study was evaluate the safety and efficacy hepatectomy after conversion how it differed from those who undergoing direct hepatectomy. From January 2018 April 2022, 745 underwent for HCC were enrolled. Among them, 41 therapy. A demographically clinically comparable cohort created remaining in a 1:1 ratio using propensity score matching. median duration 108 (42-298) days, 8 achieved complete response (CR) 33 partial (PR). resulted degree myelosuppression, but liver function index remained good. Compared group, group had more blood loss (600 mL vs 400 mL, p=0.015), longer operative time (270 min 240 min, p=0.02), higher transfusion rates, hospital stay (8 days 11 p<0.001). Patients significantly complications any grade (82.9% 51.2%, p=0.002) 3/4 (26.8% 4.9%, p=0.013), 6 developed post-hepatectomy failure (PHLF). There no deaths either group. All R0 resection, (6/41, 14.6%) pathological (pCR), 14 major pathologic responses (MPR). During follow-up 12.8 months, experienced recurrence or metastasis, deaths. Hepatectomy difficult than hepatectomy, accurate preoperative assessment could ensure damage severe expected, PHLF should be prevented treated. effective necessary, postoperative examination provide guidance adjuvant