• 1. Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
  • 3. Division of Abdominal Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 4. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 5. Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 6. Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
ZHANG Xiaoyun, Email: zhangxiaoyun@wchscu.cn; WEN Tianfu, Email: wentianfu@scu.edu.cn
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Objective To investigate the effects of lenvatinib combined with transarterial chemoembolization (TACE) and programmed death protein-1 (PD-1) monoclonal antibody (Abbreviated as LEN-TAP regimen) on residual liver volume and surgical safety in intermediate and advanced hepatocellular carcinoma (HCC). Methods The clinicopathologic data of patients with intermediate and advanced HCC were collected retrospectively, who underwent the LEN-TAP conversion therapy and surgical resection in the Department of Liver Surgery, West China Hospital, Sichuan University from October 2020 to December 2021. The total liver volume, tumor volume, and residual liver volume of the patients before and after conversion therapy were analyzed. Results A total of 48 patients were included, 26 of whom had partial remission and 22 had stable disease, the objective response rate was 54.2% (26/48) according to the Response Evaluation Criteria in Solid Tumours 1.1 after conversion therapy. Before and after conversion therapy, the total liver volumes including tumor were (1 607.15±712.22) mL and (1 558.03±573.89) mL [mean difference (MD) and 95% confidence interval (CI)=–57.42(–134.30, 19.46), t=–1.503, P=0.140], the total liver volumes excluding tumor tissue were (1 095.28±227.60) mL and (1 260.31±270.71) mL [MD(95%CI)=165.03(128.13, 201.93), t=8.997, P<0.001], the tumor volumes were 260.25(107.75, 699.50) mL and 121.73 (33.00, 332.88) mL [MD(95%CI)=–222.45(–296.46, –148.44), Z=–5.641, P<0.001], and the residual liver volumes were (493.62±154.51) mL and (567.83±172.23) mL [MD(95%CI)=74.21(54.64, 93.79), t=7.627, P<0.001], respectively. The increase rates of tumor volume and residual liver volume after conversion therapy were (–53.34±33.05)% and (16.34±15.16)%, respectively. The conversional resections were successfully completed in all patients, with 13 (27.1%) cases experiencing postoperative complications and without occurrence of postoperative liver failure. Conclusion The data analysis results of this study indicate that the LEN-TAP conversion therapy can shrink tumor volume and increase the residual liver volume for patients with intermediate and advanced HCC, which helps to improve the safety of conversion resection.

Citation: LÜ Haopeng, KANG Yuhang, LIU Qingsong, LIU Chang, LI Qiu, CHEN Weixia, LI Zhiping, LUO Yan, LU Qiang, LU Wusheng, ZHANG Xiaoyun, WEN Tianfu, MDT of Liver Cancer in West China Hospital. Effect of lenvatinibtransarterial chemoembolizationPD-1 antibody (LEN-TAP) on residual liver volume in patients with intermediate and advanced hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(1): 16-23. doi: 10.7507/1007-9424.202310052 Copy

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