Published online Sep 27, 2022. doi: 10.4240/wjgs.v14.i9.1008
Peer-review started: January 20, 2022
First decision: April 10, 2022
Revised: April 22, 2022
Accepted: August 24, 2022
Article in press: August 24, 2022
Published online: September 27, 2022
Processing time: 245 Days and 1.8 Hours
The role of tumor-infiltrating lymphocytes (TILs) in the growth and progression of hepatocellular carcinoma (HCC) has attracted widespread attention.
To evaluate the feasibility of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for massive HCC by exploring the role of TIL in the tumor microenvironment.
Fifteen massive HCC patients who underwent ALPPS treatment and 46 who underwent hemi-hepatectomy were selected for this study. Propensity score matching was utilized to match patients in ALPPS and hemi-hepatectomy groups (1:1). Quantitative analysis of TILs in tumor and adjacent tissues between the two groups was performed by immunofluorescence staining and further analyses with oncological characteristics. In the meantime, trends of TILs in peripheral blood were compared between the two groups during the perioperative period.
Continuous measurement of tumor volume and necrosis volume showed that the proportion of tumor necrosis volume on the seventh day after stage-I ALPPS was significantly higher than the pre-operative value (P = 0.024). In the preoperative period of stage-I ALPPS, the proportion of tumor necrosis volume in the high CD8+ T cell infiltration group was significantly higher than that in the low group (P = 0.048).
TIL infiltration level maintained a dynamic balance during the preoperative period of ALPPS. Compared with right hemi-hepatectomy, the ALPPS procedure does not cause severe immu
Core Tip: This study was conducted to evaluate the feasibility of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) for massive hepatocellular carcinoma by exploring the role of tumor-infiltrating lymphocyte (TIL) subpopulations in the tumor microenvironment. The ALPPS procedure did not cause severe immunosuppression due to reduced TIL infiltration and pathological alterations in peripheral blood immune components. In addition, high perioperative CD8+ T cell infiltration with ALPPS was associated with increased tumor necrosis.