Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2021; 9(30): 9151-9158
Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9151
Conversion therapy of hepatic artery ligation combined with transcatheter arterial chemoembolization for treating liver cancer: A case report
Guo-Ying Feng, Yu Cheng, Xiu Xiong, Zheng-Rong Shi
Guo-Ying Feng, Zheng-Rong Shi, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Yu Cheng, Nursing Department, University-Town Hospital of Chongqing Medical University, Chongqing 400016, China
Xiu Xiong, Department of General Practice, University-Town Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Feng GY and Shi ZR were the patient’s hepatobiliary surgeons and reviewed the literature; Feng GY drafted the manuscript; Cheng Y reviewed the literature and contributed to manuscript drafting; Xiong X gathered imaging data and pathology reports and contributed to manuscript drafting; Shi ZR was responsible for revising the manuscript for important intellectual content; All authors issued final approval for the version to be submitted.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Rong Shi, PhD, Associate Chief Physician, Surgeon, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Chongqing 400016, China. shizr@hospital.cqmu.edu.cn
Received: April 19, 2021
Peer-review started: April 19, 2021
First decision: June 24, 2021
Revised: July 3, 2021
Accepted: August 24, 2021
Article in press: August 24, 2021
Published online: October 26, 2021
Processing time: 184 Days and 17.8 Hours
Abstract
BACKGROUND

Hepatocellular carcinoma is an aggressive tumor, and its latency and lack of clinical symptoms mean that most patients are already in the late stage when diagnosed. Large tumor volume and metastasis are the main reasons for not attempting surgery. Portal vein embolization and associated liver partition and portal vein ligation for staged hepatectomy are commonly used in clinical practice to increase the volume of remnant liver to allow surgical resection; however, research in this area is currently lacking.

CASE SUMMARY

A 48-year-old male patient with a history of viral hepatitis B for at least 30 years attended our center with a hepatic space-occupying lesion detected 3 d previously. Enhanced computed tomography scanning of the upper abdomen revealed a large mass in the right lobe of the liver, centered on the right posterior lobe, with the larger section measuring about 14 cm × 10 cm × 14 cm. He successfully underwent conversion therapy for a large right liver tumor after combined hepatic artery ligation and transcatheter arterial chemoembolization, and finally had an opportunity to undergo right hemi-hepatectomy and cholecystectomy. He remained asymptomatic with no obvious abnormalities on computed tomography scanning review at 2 mo after surgery.

CONCLUSION

This case highlights new ideas and provides a reference for conversion therapy of large liver tumors.

Keywords: Hepatic carcinoma; Conversion therapy; Surgery; Interventional therapy; Case report

Core Tip: Portal vein embolization associated liver partition and portal vein ligation for staged hepatectomy, and transcatheter arterial chemoembolization (TACE) are commonly used in conversion therapy of advanced liver cancer. However, the therapeutic effects of portal vein embolization and TACE are limited, and associating liver partition and portal vein ligation for staged hepatectomy is associated with high morbidity and mortality. We therefore combined hepatic artery ligation with TACE, which has a longer treatment cycle and slower compensation of the contralateral liver compared with the above treatments but which may make R0 resection feasible with less surgical complications and with good postoperative recovery.