Abstract
Purpose
We aimed to report a new conversion therapy model, which was the combination of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), interventional hepatoma therapy, targeted therapy, and immunotherapy (AITI), to provide more radical resection opportunities for patients with initially unresectable liver cancer.
Methods
Between September 2021 and April 2024, patients treated with the AITI model conversion therapy in our hospital were retrospectively analyzed. ALPPS for patients with insufficient residual liver volume but expected to be resected after physician evaluation was chose to perform. Interventional hepatoma therapy, targeted therapy, and immunotherapy was used before first-stage ALPPS or between stages.
Results
Five patients underwent AITI model conversion therapy. Three patients underwent traditional conversion therapy between the two stages of the ALPPS and achieved satisfactory hypertrophy, while two patients achieved radical resection through ALPPS following suboptimal conversion therapy. Among all patients, the mean residual volume before the first stage surgery was 580 ± 245 mL, and before the second stage surgery, it was 701 ± 295 mL. The mean duration of the first stage surgery was 175.00 ± 17.32 minutes with a blood loss of 210.00 ± 124.50 mL. For the second stage surgery, the mean duration was 234.00 ± 25.35 minutes with a blood loss of 400.00 ± 70.71 mL. The average duration of treatment was 136.8 ± 98.3 days. No recurrences and no metastasis were observed as of April,2024.
Conclusion
The AITI model conversion therapy is safe and affective. This approach can provide more opportunities for unresectable patients to achieve radical resection.