Conversion therapy and suitable timing for subsequent salvage surgery for initially unresectable hepatocellular carcinoma: What is new?

Table 1 Three types of liver function tests

Types	Contents
Biochemical parameters	Alanine transaminase-aspartate transaminase, gamma glutamyl transpeptidase, alkaline phosphatase, albumin, bilirubin (total and conjugated), coagulation test (INR), Serum glucose, lactate dehydrogenase, platelet count
Dynamic qualitative tests	99-m TC-GSA scintigraphy (uptake), ICG test (clearance), aminopyrine breath test, MEGX, galactose elimination, LiMAX (metabolism)
Scoring systems	Child-Turcotte-Pugh systems, Model for end-stage liver disease, Model for end-stage liver disease-Na

ICG: Indocyanine Green.

Table 2 Studies on associating liver partition and portal vein ligation for staged hepatectomy and future liver remnant % changes between stage 1 and stage 2 over nearly 5 years

Ref.	Year	Cases	FLR%1	FLR%2	FLR%3	Morbidity	Mortality	Feasibility
[106]	2017	20	15	41 (24-67)	88	NM	0	100
[107]	2016	295	26	39	74	NM	7.5	NM
[108]	2016	17	24.2	38.5 (27.9-56.9)	-	11.8	5.9	100
[69]	2015	12	15	35 (26-53)	160	NM	0	100
[109]	2015	9	21.1	32.2 (26.5-37.9)	96	66.7	1	100
[110]	2015	62	24.2	39.1 (22.3-72.2)	48.6	80	12.9	95.2
[111]	2015	11	33.9	46.3 (36.2-55.8)	140	45	9.1	100
[70]	2014	15	22.6	36.3 (30-59.2)	87.2	66.7	28.7	100
[68]	2014	48	23	41 (34-47)	77.4	NM	17	100
[13]	2013	15	27	46.9 (31.7-67)	78.4	53	0	100
[112]	2013	9	22.9	NM	87.2	68	12	100
[66]	2012	10	27.8	NM	82	40	0	100

¹FLR% before stage 1;

²FLR% before stage 2;

³FLR% between stage 1 and stage 2. NM: Not mentioned; FLR: Future liver remnant.

Table 3 Studies on transcatheter arterial chemoembolization + portal venous embolizations and the rate of conversion to resection

Ref.	Year	Cases	Types of tumor	Convert to surgery (%)	5-yr disease-free survival rates (%)	Median survival time (mo)
[101]	2004	17	Hepatocellular carcinoma	94	46.7	NM
[102]	2006	18	Hepatocellular carcinoma	100	37	NM
[113]	2011	71	Hepatocellular carcinoma	95.7	61	NM
[103]	2012	29	Hepatocellular carcinoma and metastatic disease	93.1	NM	58
[104]	2016	54	Hepatocellular carcinoma	72	NM	41

NM: Not mentioned.