Clinical application of transarterial chemoembolization combined with terminal branches portal vein embolization in planned hepatectomy

Abstract

Following the application of TACE in combination with TBPVE as a therapeutic intervention, we observed postoperative general reactions, alterations in tumor biomarkers, hyperplasia of future liver remnant (FLR), and subsequent surgical resection. All patients successfully underwent the combined TACE and TBPVE procedure, achieving a technical success rate of 100%. One week after TACE, alpha-fetoprotein (AFP) levels decreased from 38.52±49.21 to 25.27±37.94 μg/L, and Protein Induced by Vitamin K Absence or Antagonist (PIVKA) levels decreased from 1689.30±1663.83 to 219.03±228.10 μg/L. Two weeks post-TBPVE, FLR exhibited an increment from 350.80±41.17 to 476.00±57.91 mL. The ratio of FLR to standard liver volume (SLV) increased from 30.94%±3.63% to 42.03%±5.62%. The combined application of TACE and TBPVE not only effectively manages tumor progression but also augments the FLR, thereby affording patients with a limited future liver remnant an opportunity for surgical resection of hepatocellular carcinoma.