Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2024; 16(10): 3312-3320
Published online Oct 27, 2024. doi: 10.4240/wjgs.v16.i10.3312
Reassessment of palliative surgery in conversion therapy of previously unresectable hepatocellular carcinoma: Two case reports and review of literature
Yang-Bo Zhu, Jia-Yi Qin, Ting-Ting Zhang, Wen-Jin Zhang, Qi Ling
Yang-Bo Zhu, Wen-Jin Zhang, Qi Ling, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Yang-Bo Zhu, Wen-Jin Zhang, Qi Ling, Key Lab of Combined Multi-Organ Transplantation, Ministry of Public Health, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Jia-Yi Qin, Department of Clinical Pharmacy, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Ting-Ting Zhang, Department of Medical Imaging, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Co-first authors: Yang-Bo Zhu and Jia-Yi Qin.
Author contributions: Zhu YB and Qin JY designed and performed the research, managed the data curation, prepared and revised the draft; Zhang TT prepared images for submission; Zhang WJ provided the patient with informed consent and validated the research; Ling Q reviewed and edited the manuscript. All authors have read and approved the final manuscript. Zhu YB and Qin JY contributed equally to this work as co-first authors.
Supported by Zhejiang Medical Science and Technology Project, No. 2023KY704; Zhejiang Traditional Chinese Medicine Science and Technology Project, No. 2023ZR107 and No. 2024ZF094; Special Research Fund for Hospital Pharmacy of Zhejiang Pharmaceutical Association, No. 2021ZYY08; and Zhejiang Medical Association Clinical Research Fund, No. 2021ZYC-A64 and No. 2021ZYC-A67.
Informed consent statement: The informed consent was obtained from all subjects and/or their legal guardian(s).
Conflict-of-interest statement: All authors stated that there was no potential 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi Ling, PhD, Chief Doctor, Chief Physician, Professor, Surgeon, Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. lingqi@zju.edu.cn
Received: April 19, 2024
Revised: August 30, 2024
Accepted: September 9, 2024
Published online: October 27, 2024
Processing time: 162 Days and 2.5 Hours
Core Tip

Core Tip: We herein present two successful cases of "conversion Therapy for unresectable hepatocellular carcinoma (HCC)" achieved mainly by palliative surgery combined with transarterial chemoembolization (TACE) plus immunotherapy and tyrosine kinase inhibitors. For some selected advanced HCC with a high risk of tumor overload and metastasis, if liver function permits, early palliative surgery combined with local subsequent TACE, along with targeted and immunotherapy, may be a tolerable and effective strategy, which may provide the opportunity for the ultimate cure for the initially unresectable HCC and effectively improve the long-term survival based on the promising prospects of combined targeted and immunotherapy.