ArticleThe oncologist2024
Salvage Surgery for Initially Unresectable HCC With PVTT Converted by Locoregional Treatment Plus Tyrosine Kinase Inhibitor and Anti-PD-1 Antibody.
Article in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Pathological and Perioperative Outcomes of Conversion Hepatectomy After Contemporary Combination Downstaging for Initially Unresectable Hepatocellular Carcinoma: A Systematic Review.Current oncology (Toronto, Ont.) · 2026Pooled it
- Non-surgery strategy versus hepatectomy in hepatocellular carcinoma patients with complete response after conversion therapy: a meta-analysis.World journal of surgical oncology · 2024Pooled it
- Laparoscopic Extended Left Hepatectomy and Portal Vein Thrombectomy for Advanced Hepatocellular Carcinoma After Second-Line Conversion Therapy.Annals of surgical oncology · 2026Article
- Review
- Optimal duration of adjuvant targeted-immunotherapy in patients with initially unresectable hepatocellular carcinoma with portal vein tumor thrombus following successful conversion therapy.The oncologist · 2026Article
- Efficacy and Safety of Radiotherapy Combined with PD-1 Inhibitors and Targeted Therapy for Unresectable Hepatocellular Carcinoma: A Retrospective, Real-World Multicenter Study.Journal of hepatocellular carcinoma · 2026Article
- Prognostic model for unresectable hepatocellular carcinoma treated with transarterial therapy plus TKIs and anti-PD-1 antibodies.World journal of surgical oncology · 2025Article
- Pre-transplant downstaging strategies for hepatocellular carcinoma with portal vein tumor thrombus: Current therapies and future challenges.World journal of hepatology · 2025Review
- Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThis study aimed to compare the survival outcomes of patients with initially unresectable hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) who underwent or did not undergo salvage surgery followed by a triple combination conversion treatment consisted of locoregional treatment (LRT), tyrosine kinase inhibitors (TKIs), and anti-PD-1 antibodies.
methodsThe data from 93 consecutive patients with initially unresectable HCC and PVTT across 4 medical centers were retrospectively reviewed. They were converted successfully by the triple combination treatment and underwent or did not undergo salvage resection. The baseline characteristics, conversion schemes, conversion treatment-related adverse events (CTRAEs), overall survival (OS), and progression-free survival (PFS) of the salvage surgery and non-surgery groups were compared. Multivariate Cox regression analysis was performed to identify independent risk factors for OS and PFS. Additionally, subgroup survival analysis was conducted by stratification of degree of tumor response and type of PVTT.
resultsOf the 93 patients, 44 underwent salvage surgery, and 49 did not undergo salvage surgery. The OS and PFS of the salvage surgery and non-surgery groups were not significantly different (P = .370 and .334, respectively). The incidence and severity of CTRAEs of the 2 groups were also comparable. Subgroup analyses revealed that for patients with complete response (CR) or types III-IV PVTT, there was a trend toward better survival in patients who did not undergo salvage surgery. Multivariate analysis showed that baseline α-fetoprotein and best tumor response per mRECIST criteria were independent prognostic factors for OS and PFS.
conclusionsFor patients with initially unresectable HCC and PVTT who were successfully converted by the triple combination therapy, salvage liver resection may not be necessary, especially for the patients with CR or types III-IV PVTT.
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