Liu Ling, Li Nian-Feng, Zhang Qi, Lin Ling
Department of Hepatobiliary and Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
World J Clin Cases. 2019 Aug 26;7(16):2384-2392. doi: 10.12998/wjcc.v7.i16.2384.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC). Nevertheless, long-term survival rate and postoperative complications are far from ideal, mainly since the majority of patients treated with ALPPS surgery have large or multiple lesions and microvascular tumor thrombus.
We present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver, who was successfully treated with ALPPS surgery and apatinib. Postoperative pathology revealed HCC with several significant microvascular embolisms. Twenty months after operation, no tumor reoccurrence was observed.
Our case indicated that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.
联合肝脏分隔和门静脉结扎分期肝切除术(ALPPS)在肝细胞癌(HCC)治疗中的认可度越来越高。然而,长期生存率和术后并发症仍远不尽人意,主要是因为接受ALPPS手术治疗的大多数患者存在大的或多发的病灶以及微血管肿瘤血栓。
我们报告了一名47岁男性患者的病例,该患者有巨大的右肝肿块且预计残余肝脏不足,经ALPPS手术和阿帕替尼成功治疗。术后病理显示为伴有多处显著微血管栓塞的HCC。术后20个月,未观察到肿瘤复发。
我们的病例表明,ALPPS联合靶向药物治疗可使大肝癌患者获得长期生存。