Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2019; 7(16): 2384-2392
Published online Aug 26, 2019. doi: 10.12998/wjcc.v7.i16.2384
Hepatocellular carcinoma successfully treated with ALPPS and apatinib: A case report
Ling Liu, Nian-Feng Li, Qi Zhang, Ling Lin
Ling Liu, Nian-Feng Li, Qi Zhang, Ling Lin, Department of Hepatobiliary and Pancreatic Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Liu L conceived and coordinated the study, designed, performed, and analyzed the experiments, and wrote the paper; Li NF, Zhang Q, and Lin L carried out data collection and analysis and revised the paper; all authors reviewed the results and approved the final version of the manuscript.
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 which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: Nian-Feng Li, MD, Doctor, Department of Hepatobiliary and Pancreatic Surgery, Xiangya Hospital, Central south university, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China. dlnf66@163.com
Telephone: +86-731-89753060 Fax: +86-216-4085875
Received: December 3, 2018
Peer-review started: December 3, 2018
First decision: January 30, 2019
Revised: March 12, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: August 26, 2019
Processing time: 265 Days and 20.9 Hours
Abstract
BACKGROUND

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC). Nevertheless, long-term survival rate and postoperative complications are far from ideal, mainly since the majority of patients treated with ALPPS surgery have large or multiple lesions and microvascular tumor thrombus.

CASE SUMMARY

We present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver, who was successfully treated with ALPPS surgery and apatinib. Postoperative pathology revealed HCC with several significant microvascular embolisms. Twenty months after operation, no tumor reoccurrence was observed.

CONCLUSION

Our case indicated that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.

Keywords: Hepatocellular carcinoma; Associating liver partition and portal vein ligation for staged hepatectomy; Apatinib; Case report

Core tip: Our aim was to explore the feasibility of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) combined with targeted therapy in the treatment of advanced hepatocellular carcinoma (HCC). Herein, we present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver, who was successfully treated with ALPPS surgery and apatinib. Postoperative pathology revealed HCC with several significant microvascular embolisms. Twenty months later, no tumor reoccurrence was observed, indicating that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.