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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Jiao, Tianyu Tang, Haowen Zhang, Wenwen Hu, Bingyang Wan, Tao Cao, Yinbiao Zhang, Ze Wang, Yafei Cao, Junning Cui, Mengqiu Lu, Shichun |
| Abstract | Background It is controversial whether patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) should undergo salvage surgery following the combination therapy of tyrosine kinase inhibitors (TKIs) and programmed cell death protein 1 (PD-1) inhibitors. This study aimed to elucidate the efficiency and safety of salvage surgery following combination therapy, while also summarizing a novel surgical approach for Vp3/4 PVTT. Methods Between April 2019 and December 2022, a consecutive series of unresectable HCC patients with PVTT who received salvage surgery following combination therapy were enrolled. Evaluation included perioperative and long-term follow-up outcomes. The complete removal of Vp3/4 PVTT was achieved using a novel surgical approach characterized by “longitudinal incision and transverse suturing” and “angle-to-straight conversion”. Results Forty patients including 22 patients with Vp3 and 18 patients with Vp4 were included. Long-term follow-up showed similar rates of portal vein patency (Vp3: 95.5%, Vp4:94.4%, p = 0.900), and 3-year portal vein patency rates were 95.0%. There were no significant differences observed in combination therapy-related adverse events (p = 0.253) and perioperative complications (p = 0.613) between the Vp3 and Vp4 groups. The recurrence patterns were similar between the two groups (p = 0.131). There were no significant differences in overall survival (OS) and recurrence-free (RFS) survival between the Vp3 and Vp4 groups (OS p = 0.457, RFS p = 0.985). Patients who achieved a pathological complete response had significantly better RFS (p = 0.011). Conclusion Salvage surgery after combination therapy demonstrated favorable efficacy and safety. The novel surgical approach for PVTT can effectively achieve complete removal of PVTT and ensured long-term portal vein patency. |
| Related Links | https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-023-02291-1.pdf |
| Ending Page | 12 |
| Page Count | 12 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712482 |
| DOI | 10.1186/s12893-023-02291-1 |
| Journal | BMC Surgery |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-12-19 |
| Access Restriction | Open |
| Subject Keyword | Surgery Internal Medicine Hepatocellular carcinoma Portal vein tumor thrombus Salvage surgery Programmed cell death protein 1 inhibitors Tyrosine kinase inhibitors |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery |
| Journal Impact Factor | 1.6/2023 |
| 5-Year Journal Impact Factor | 1.9/2023 |
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