A Review on the Concepts for Initially Unresectable Liver Tumors - Bridge to Surgery

Chirurgia (Bucur). 2022 Dec;117(6):635-642. doi: 10.21614/chirurgia.2767.

Abstract

Surgical treatments of advanced tumors have expanded in the last two decades as a result of ad-vances in surgical techniques, advanced interventional radiology methods, improved intensive care unit settings and increased overall life expectancy. Advanced liver tumors represent a broad category from various malignancies such as liver metastasis or native liver tumors. Not uncom-monly these tumors are not amenable to curative treatment and require down-staging, or local control at the initial diagnosis. Herein we discuss the portal vein embolization (PVE), transarterial radioembolization (TARE) with Yttrium-90 (Y-90), and surgical options namely, two-staged hepatectomy (TSH), and associating liver partition and portal vein ligation for staged hepatecto-my (ALPPS) as bridging strategies for definitive surgical treatment.

Keywords: livercancer; liverpartition; liversurgery; portalveinembolisation; transarterialradioembolisation.

Publication types

  • Review

MeSH terms

  • Hepatectomy / methods
  • Humans
  • Ligation
  • Liver
  • Liver Neoplasms* / secondary
  • Liver Neoplasms* / surgery
  • Portal Vein / surgery
  • Treatment Outcome
  • Yttrium Radioisotopes* / therapeutic use

Substances

  • Yttrium-90
  • Yttrium Radioisotopes