ZHANG Gan , SHEN Xianfeng , HU Jun , ZHOU Ping , JIANG Bin , HUANG Linsheng
  • Department of Hepatobiliary and Pancreatic Surgery, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan, Hubei 442000,P. R. China;
ZHANG Gan, Email: zgn05113085@foxmail.com
advanced hepatocellular carcinoma; associating liver partition and portal vein ligation for staged hepatectomy; transcatheter arterial chemoembolization
10.7507/1007-9424.201708092
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Objective  To compare therapeutic effects of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and transcatheter arterial chemoembolization (TACE) on patients with advanced hepatocellular carcinoma. Methods  Thirty-five patients with advanced hepatocellular carcinoma admitted in the Department of Hepatobiliary and Pancreatic Surgery of Shiyan Taihe Hospital Affiliated to Hubei University of Medicine from August 1, 2014 to August 1, 2015 were randomly divided into ALPPS group and TACE group, in which 17 cases treated by the ALPPS and 18 cases treated by the TACE. The survival, changes of liver function and life quality, postoperative complications and mortality were compared in these two groups. The follow-up was performed by the telephone and the outpatient. Results  ① The baselines such as the age, gender, diameter of tumor, complications had no significant differences in these two groups (P>0.05). ② The changes of liver function and life quality after operation in the ALPPS group were significantly better than those in the TACE group (P<0.05). ③ The complications after operation were observed in 5 cases (there were 2 cases of bile leakage, 1 case of intraabdominal bleeding, 1 case of peritoneal effusion, and 1 case of pulmonary infection) in the ALPPS group, which in 13 cases (there were 6 cases of nausea and vomiting, 4 cases of liver function damage, 2 cases of granulocytopenia, 1 case of fever) in the TACE group. The rate of the overall complications in the ALPPS group was significantly lower than that in the TACE group (5/17versus 13/18, P=0.018). ④ The overall survival in the the ALPPS group was significantly better than that in the TACE group (P=0.024). During follow-up period, the deaths happened in 3 cases duo to hepatocellular carcinoma and 1 case duo to traffic accident, 1 case was lost on month 8, 12 cases were still alive in the ALPPS group; the deaths happened in 10 cases duo to hepatocellular carcinoma, 1 case duo to coronary disease, and 1 case duo to cerebral infarction, 6 cases were still alive in the TACE group. Conclusion  Preliminary results of limited cases in this study show that ALPPS has a better effect than TACE on patients with advanced hepatocellular carcinoma.

Citation： ZHANG Gan, SHEN Xianfeng, HU Jun, ZHOU Ping, JIANG Bin, HUANG Linsheng. Clinical effects of ALPPS and TACE in treatment of patients with advanced hepatocellular carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(12): 1450-1455. doi: 10.7507/1007-9424.201708092 Copy

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