Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce rapid hypertrophy of the liver remnant. However, with a background of liver cirrhosis or other chronic liver diseases, patients with a huge hepatocellular carcinoma (HCC) may sometimes face insufficiency o...

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Autores principales:	Wenfeng Zhuo, Ang Li, Weibang Yang, Jinxin Duan, Jun Min, Jinxing Wei
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	ALPPS hepatocellular carcinoma HAIC FLR hypertrophy case report Surgery RD1-811
Acceso en línea:	https://doaj.org/article/a07bac57e5a541e4920538095662c7a4
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spelling	oai:doaj.org-article:a07bac57e5a541e4920538095662c7a42021-12-01T05:15:04ZCase Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC2296-875X10.3389/fsurg.2021.746618https://doaj.org/article/a07bac57e5a541e4920538095662c7a42021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.746618/fullhttps://doaj.org/toc/2296-875XAssociating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce rapid hypertrophy of the liver remnant. However, with a background of liver cirrhosis or other chronic liver diseases, patients with a huge hepatocellular carcinoma (HCC) may sometimes face insufficiency of hepatocellular regeneration after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Herein, we report a 56-year-old male with a vast HCC (13.3 × 8.5 × 13 cm) whose ratio of the future liver remnant (FLR)/standard liver volume (SLV) was 28.7% when the disease was first diagnosed. Inadequate hypertrophy of FLR was shown in postoperative volumetric assessment a month after stage I ALPPS. After multidisciplinary team discussion (MDT), the patient was decided to follow three courses of hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4). The last HAIC was performed together with transhepatic arterial embolization (TAE). Finally, ratio of the FLR/SLV increased from 28.7% to 40% during three-month intervals, meeting the requirements of the surgery. Stage II ALPPS, right trisectionectomy, was then successfully performed. There was no recurrence at half years of follow-up. In our case, HAIC seems to be more potent than transcatheter arterial chemoembolization (TACE) in maintaining the hyperplasia of the liver remnant, reducing tumor load, and preventing tumor progression in patients with a large HCC during ALPPS procedure. HAIC, following the first step of ALPPS, a pioneering treatment modality aiming for inadequate hypertrophy of FLR induced by ALPPS, could be an alternative procedure for patients with a vast HCC in clinical practice.Wenfeng ZhuoAng LiWeibang YangJinxin DuanJun MinJinxing WeiFrontiers Media S.A.articleALPPShepatocellular carcinomaHAICFLRhypertrophycase reportSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	ALPPS hepatocellular carcinoma HAIC FLR hypertrophy case report Surgery RD1-811
spellingShingle	ALPPS hepatocellular carcinoma HAIC FLR hypertrophy case report Surgery RD1-811 Wenfeng Zhuo Ang Li Weibang Yang Jinxin Duan Jun Min Jinxing Wei Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
description	Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can induce rapid hypertrophy of the liver remnant. However, with a background of liver cirrhosis or other chronic liver diseases, patients with a huge hepatocellular carcinoma (HCC) may sometimes face insufficiency of hepatocellular regeneration after associating liver partition and portal vein ligation for staged hepatectomy (ALPPS). Herein, we report a 56-year-old male with a vast HCC (13.3 × 8.5 × 13 cm) whose ratio of the future liver remnant (FLR)/standard liver volume (SLV) was 28.7% when the disease was first diagnosed. Inadequate hypertrophy of FLR was shown in postoperative volumetric assessment a month after stage I ALPPS. After multidisciplinary team discussion (MDT), the patient was decided to follow three courses of hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4). The last HAIC was performed together with transhepatic arterial embolization (TAE). Finally, ratio of the FLR/SLV increased from 28.7% to 40% during three-month intervals, meeting the requirements of the surgery. Stage II ALPPS, right trisectionectomy, was then successfully performed. There was no recurrence at half years of follow-up. In our case, HAIC seems to be more potent than transcatheter arterial chemoembolization (TACE) in maintaining the hyperplasia of the liver remnant, reducing tumor load, and preventing tumor progression in patients with a large HCC during ALPPS procedure. HAIC, following the first step of ALPPS, a pioneering treatment modality aiming for inadequate hypertrophy of FLR induced by ALPPS, could be an alternative procedure for patients with a vast HCC in clinical practice.
format	article
author	Wenfeng Zhuo Ang Li Weibang Yang Jinxin Duan Jun Min Jinxing Wei
author_facet	Wenfeng Zhuo Ang Li Weibang Yang Jinxin Duan Jun Min Jinxing Wei
author_sort	Wenfeng Zhuo
title	Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
title_short	Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
title_full	Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
title_fullStr	Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
title_full_unstemmed	Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC
title_sort	case report: hepatic artery infusion chemotherapy after stage i alpps in a patient with huge hcc
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/a07bac57e5a541e4920538095662c7a4
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Case Report: Hepatic Artery Infusion Chemotherapy After Stage I ALPPS in a Patient With Huge HCC

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