ARIIZUMI Shunichi    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Associate Professor
Article types	Original article
Language	English
Peer review	Non peer reviewed
Title	Conversion surgery for hepatocellular carcinoma after tyrosine kinase inhibitor treatment
Journal	Formal name：JGH open Abbreviation：JGH Open ISSN code：23979070/23979070
Domestic / Foregin	Foregin
Volume, Issue, Page	6(5),pp.301-308
Author and coauthor	KANEKO Shun, TSUCHIYA Kaoru, YASUIi Yutaka, TANAKA Yuki, INADA Kento, ISHIDO Shun, KIRINO Sakura, YAMASHITAa Koji, HAYAKAWA Yuka, NOBISAWA Tsubasa, MATSUMOTO Hiroaki, KAKEGAWA Tatsuya, HIGUCHI Mayu, TAKAURA Kenta, TANAKA Shohei, MAEYASHIKI Chiaki, TAMAKI Nobuharu, TAKAHASHI Yuka, NAKANISHI Hiroyuki, IRIE Takumi, ARIIZUMI Shunichi, KUROSAKI Masayuki, IUZMI Namiki
Publication date	2022/05
Summary	BACKGROUND AND AIM:Conversion surgery (CS), which aims to cure after systematic therapy, is only scarcely reported in the field of hepatocellular carcinoma (HCC). However, advancements in systemic therapy for HCC are expected to increase the candidates eligible for CS because of the higher response rate. The aim of this study was to clarify the characteristics of patients who underwent CS after tyrosine kinase inhibitor (TKI) therapy.METHODS:In all, 364 patients who were treated with first-line sorafenib (SOR; n = 292) and lenvatinib (LEN; n = 72) from July 2009 to October 2020 were retrospectively enrolled. The endpoint of this analysis was overall survival (OS), and factors associated with CS are revealed.RESULTS:Six patients underwent CS after TKI therapy, and of these four (1.4%) and two (2.7%) patients received SOR and LEN, respectively. At baseline, patients who underwent CS were significantly younger (median 52 [range, 46-83] years of age, P = 0.019), and their etiology included viral hepatitis, especially hepatitis B virus (HBV) (P = 0.049). Improvements or maintenance of preoperative modified albumin-bilirubin grade from baseline were observed in five (83.3%) patients, and partial radiologic response was observed in four (66.7%) patients. The median OS and 3-year survival rate of patients treated with CS were "not reached" and 80.0%, respectively.CONCLUSION:The patients who underwent CS after TKI therapy for HCC experienced long survival, were relatively young, and exhibited radiologic response to TKIs, and their liver function was either maintained or improved. Therefore, CS may lead to a better prognosis in patients with advanced HCC.
DOI	10.1002/jgh3.12735
PMID	35601130