“Interventional dual conversion therapy” strategy for liver cancer: integration of oncological and functional medicine_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Chang ^1,2 , DAI Ruihong ¹ , XIE Qingyun ^2,3 ,  WU Hong ^2,3

1. Interventional Diagnosis and Treatment Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Laboratory of Hepatic Artificial Intelligence Translation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Liver Transplant Center, Transplant Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WU Hong, Email: wuhong@scu.edu.cn

Keywords：

interventional dual conversion therapy; liver cancer; oncological conversion; functional conversion

DOI：

10.7507/1007-9424.202601055

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the clinical research progress, current status and prospects of “interventional dual conversion therapy”. Methods We systematically sorted out and summarized interventional dual conversion therapy by retrieving domestic and foreign basic and clinical studies on oncological conversion and functional conversion therapy for liver cancer in the past 10 years. Results Interventional dual conversion therapy comprises oncological conversion [including transarterial chemoembolization (TACE), hepatic artery infusionchemotherapy, selective internal radiation therapy, and systemic therapy] and functional conversion [including portal vein embolization (PVE), liver venous deprivation, liver function improvement and antiviral therapy]. This strategy improves the conversion resection rate, reduces the risk of losing radical resection opportunity due to primary tumor progression, and prolongs long-term survival. Preliminary clinical studies have confirmed the efficacy of its synergistic strategy: drug-eluting beads transarterial chemoembolization combined with PVE, TACE combined with PVE (superior to PVE alone), ⁹⁰Y sequential PVE, drug-eluting beads transarterial chemoembolization+PVE+targeted therapy+immunotherapy therapy and AITI model combined with ALPPS (associating liver partition and portal vein ligation for staged hepatectomy) all achieved good conversion resection effects. Currently, relevant clinical studies are still in the preliminary exploration stage, and prospective large-scale studies are urgently needed. Conclusion Interventional dual conversion therapy can improve the resection rate and long-term prognosis of advanced liver cancer patients through minimally invasive methods, and establish a new paradigm for liver cancer conversion management.

Citation： LIU Chang, DAI Ruihong, XIE Qingyun, WU Hong. “Interventional dual conversion therapy” strategy for liver cancer: integration of oncological and functional medicine. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2026, 33(3): 331-337. doi: 10.7507/1007-9424.202601055 Copy

1.	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2.	姚一菲, 孫可欣, 鄭榮壽. 《2022全球癌癥統計報告》解讀: 中國與全球對比. 中國普外基礎與臨床雜志, 2024, 31(7): 769-780.
3.	郝運, 李川, 文天夫, 等. 全球及中國的肝癌流行病學特征: 基于《2022全球癌癥統計報告》解讀. 中國普外基礎與臨床雜志, 2024, 31(7): 781-789.
4.	Chen M, Therneau T, Orsini LS, et al. Design and rationale of the HCC BRIDGE study in China: a longitudinal, multicenter cohort trial in hepatocellular carcinoma. BMC Gastroenterol, 2011, 11: 53. doi: 10.1186/1471-230X-11-53.
5.	Zhu XD, Huang C, Shen YH, et al. Downstaging and resection of initially unresectable hepatocellular carcinoma with tyrosine kinase inhibitor and anti-PD-1 antibody combinations. Liver Cancer, 2021, 10(4): 320-329.
6.	Boubaddi M, Marichez A, Pecquenard F, et al. Liver venous deprivation (LVD) before extended hepatectomy: a French multicentric retrospective cohort. Hepatobiliary Surg Nutr, 2024, 13(6): 937-949.
7.	Kobayashi K, Yamaguchi T, Denys A, et al. Liver venous deprivation compared to portal vein embolization to induce hypertrophy of the future liver remnant before major hepatectomy: a single center experience. Surgery, 2020, 167(6): 917-923.
8.	Lee HS, Choi GH, Choi JS, et al. Surgical resection after down-staging of locally advanced hepatocellular carcinoma by localized concurrent chemoradiotherapy. Ann Surg Oncol, 2014, 21(11): 3646-3653.
9.	Sui WF, Li JY, Fu JH. Transarterial chemoembolization plus stent placement for hepatocellular carcinoma with main portal vein tumor thrombosis: a meta-analysis. World J Clin Oncol, 2024, 15(3): 447-455.
10.	Liu C, Sun L, Xu J, et al. Clinical efficacy of postoperative adjuvant transcatheter arterial chemoembolization on hepatocellular carcinoma. World J Surg Oncol, 2016, 14: 100. doi: 10.1186/s12957-016-0855-z.
11.	Affonso BB, Galastri FL, da Motta Leal Filho JM, et al. Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging. World J Gastroenterol, 2019, 25(37): 5687-5701.
12.	Wang S, Zong H, Tang L, et al. An innovative treatment approach using iliac artery embolization and implanted port for chemotherapy in a patient with gluteal muscle metastasis of advanced colon cancer: a case report and literature review. Front Oncol, 2025, 15: 1630104. doi: 10.3389/fonc.2025.1630104.
13.	Li Q, Liu Y, Guo X, et al. Tirapazamine-loaded CalliSpheres microspheres enhance synergy between tirapazamine and embolization against liver cancer in an animal model. Biomed Pharmacother, 2022, 151: 113123. doi: 10.1016/j.biopha.2022.113123.
14.	Cui W, Fan W, Huang K, et al. Large hepatocellular carcinomas: treatment with transarterial chemoembolization alone or in combination with percutaneous cryoablation. Int J Hyperthermia, 2018, 35(1): 239-245.
15.	Yang DL, Ye L, Zeng FJ, et al. Multicenter, retrospective GUIDANCE001 study comparing transarterial chemoembolization with or without tyrosine kinase and immune checkpoint inhibitors as conversion therapy to treat unresectable hepatocellular carcinoma: survival benefit in intermediate or advanced, but not early, stages. Hepatology, 2025, 82(2): 357-369.
16.	Liao M, Yang Y, Jiang H, et al. 1478P neoadjuvant TACE plus lenvatinib and camrelizumab for borderline resectable hepatocellular carcinoma: updated results of the BRHCC-Ⅰ phase Ⅰ b/Ⅱ trial. Ann Oncol, 2025, 36(Supplement 2): S824. doi: 10.1016/j.annonc.2025.08.2108.
17.	Lee BH, Lee DS, Cho CW, et al. Role and limitation of neoadjuvant hepatic arterial infusion chemotherapy in advanced hepatocelluar carcinoma patients with Child-Pugh class A. World J Surg Oncol, 2019, 17(1): 143. doi: 10.1186/s12957-019-1685-6.
18.	Xiao J, Li Q, Zheng W, et al. A novel quadruple conversion therapy: converting initially unresectable hepatocellular carcinoma to resectable with pTAE-HAIC, tyrosine kinase inhibitors, and anti-PD-1 antibodies. J Hepatocell Carcinoma, 2025, 12: 1807-1819.
19.	He M, Li Q, Zou R, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion: a randomized clinical trial. JAMA Oncol, 2019, 5(7): 953-960.
20.	Hamaoka M, Kobayashi T, Kuroda S, et al. Hepatectomy after down-staging of hepatocellular carcinoma with portal vein tumor thrombus using chemoradiotherapy: a retrospective cohort study. Int J Surg, 2017, 44: 223-228.
21.	Zhang W, Zhao X, Gao W, et al. Conversion study of hepatocellular carcinoma using HAIC combined with lenvatinib and PD-1/L1 immunotherapy under the guidance of BCLC staging. Front Immunol, 2025, 16: 1596864. doi: 10.3389/fimmu.2025.1596864.
22.	Patel MV, Davies H, Williams AO, et al. Transarterial therapies in patients with hepatocellular carcinoma eligible for transarterial embolization: a US cost-effectiveness analysis. J Med Econ, 2023, 26(1): 1061-1071.
23.	Tabone M, Calvo A, Russolillo N, et al. Downstaging unresectable hepatocellular carcinoma by radioembolization using 90-yttrium resin microspheres: a single center experience. J Gastrointest Oncol, 2020, 11(1): 84-90.
24.	Labgaa I, Tabrizian P, Titano J, et al. Feasibility and safety of liver transplantation or resection after transarterial radioembolization with Yttrium-90 for unresectable hepatocellular carcinoma. HPB (Oxford), 2019, 21(11): 1497-1504.
25.	Son SY, Geevarghese R, Marinelli B, et al. Conversion therapy to transplant or surgical resection in patients with unresectable hepatocellular carcinoma treated with boosted dose of Yttrium-90 radiation segmentectomy. Cancers (Basel), 2024, 16(17): 3024. doi: 10.3390/cancers16173024.
26.	Lau WY, Lai EC. Salvage surgery following downstaging of unresectable hepatocellular carcinoma–a strategy to increase resectability. Ann Surg Oncol, 2007, 14(12): 3301-3309.
27.	Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant, 2009, 9(8): 1920-1928.
28.	Sun HC, Zhu XD. Downstaging conversion therapy in patients with initially unresectable advanced hepatocellular carcinoma: an overview. Front Oncol, 2021, 11: 772195. doi: 10.3389/fonc.2021.772195.
29.	中華人民共和國國家衛生健康委員會. 原發性肝癌診療指南 (2024年版). 腫瘤防治研究, 2024, 51(6): 495-526.
30.	Armstrong SA, He AR. Immuno-oncology for hepatocellular carcinoma: the present and the future. Clin Liver Dis, 2020, 24(4): 739-753.
31.	Zhang XW, Wu LY, Liu HR, et al. NSUN5 promotes progression and predicts poor prognosis in hepatocellular carcinoma. Oncol Lett, 2022, 24(6): 439. doi: 10.3892/ol.2022.13559.
32.	Xu H, Zhang H, Li B, et al. Systemic conversion therapies for initially unresectable hepatocellular carcinoma: a systematic review and meta-analysis. BMC Cancer, 2024, 24(1): 1008. doi: 10.1186/s12885-024-12772-y.
33.	Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg, 2008, 247(1): 49-57.
34.	Aloia TA. Associating liver partition and portal vein ligation for staged hepatectomy: portal vein embolization should remain the gold standard. JAMA Surg, 2015, 150(10): 927-928.
35.	Piron L, Deshayes E, Escal L, et al. Portal vein embolization: present and future. Bull Cancer, 2017, 104(5): 407-416.
36.	Vauthey JN, Dixon E, Abdalla EK, et al. Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. HPB (Oxford), 2010, 12(5): 289-299.
37.	Li AY, Ahmad MU, Sofilos MC, et al. Postoperative hepatic insufficiency despite preoperative portal vein embolization: not just about the volumetrics. Surgery, 2025, 182: 109345. doi: 10.1016/j.surg.2025.109345.
38.	Peng SY, Wang XA, Huang CY, et al. Evolution of associating liver partition and portal vein ligation for staged hepatectomy: simpler, safer and equally effective methods. World J Gastroenterol, 2017, 23(23): 4140-4145.
39.	Goumard C, Komatsu S, Brustia R, et al. Technical feasibility and safety of laparoscopic right hepatectomy for hepatocellular carcinoma following sequential TACE-PVE: a comparative study. Surg Endosc, 2017, 31(5): 2340-2349.
40.	Isfordink CJ, Samim M, Braat MNGJA, et al. Portal vein ligation versus portal vein embolization for induction of hypertrophy of the future liver remnant: a systematic review and meta-analysis. Surg Oncol, 2017, 26(3): 257-267.
41.	Guiu B, Chevallier P, Denys A, et al. Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique. Eur Radiol, 2016, 26(12): 4259-4267.
42.	Guiu B, Quenet F, Escal L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function. Eur Radiol, 2017, 27(8): 3343-3352.
43.	Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surg Nutr, 2020, 9(5): 564-576.
44.	Heil J, Korenblik R, Heid F, et al. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis. Br J Surg, 2021, 108(7): 834-842.
45.	Korenblik R, James S, Smits J, et al. Safety and efficacy of combined portal and hepatic vein embolisation in patients with colorectal liver metastases (DRAGON1): a multicentre, single-arm clinical trial. Lancet Reg Health Eur, 2025, 53: 101284. doi: 10.1016/j.lanepe.2025.101284.
46.	Sy TV, Dung LT, Giang BV, et al. Safety and efficacy of liver venous deprivation following transarterial chemoembolization before major hepatectomy for hepatocellular carcinoma. Ther Clin Risk Manag, 2023, 19: 425-433.
47.	劉暢, 張曉赟, 金諶, 等. 肝靜脈系統栓堵術在第二階段根治性肝癌切除術中的應用. 中國普外基礎與臨床雜志, 2019, 26(7): 841-846.
48.	Qi W, Shen J, Dai J, et al. Comparison of nucleoside and nucleotide analogs in the recurrence of hepatitis B virus-related hepatocellular carcinoma after surgical resection: a multicenter study. Cancer Med, 2021, 10(23): 8421-8431.
49.	Wang W, Tian SL, Wang H, et al. Association of hepatitis B virus DNA level and follow-up interval with hepatocellular carcinoma recurrence. JAMA Netw Open, 2020, 3(4): e203707. doi: 10.1001/jamanetworkopen.2020.3707.
50.	Korshak O, Sokolova O, Zhylenko A, et al. To turn weakness into a strength-preoperative future liver remnant (FLR) augmentation with special focus on local tumor control and in-situ immunization for patients with advanced hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Ann Hepatobiliary Pancreat Surg, 2021, 25(1): S65. doi: 10.14701/ahbps.lv-op-3-6.
51.	Liao Y, Cai Q, Zhang X, et al. Sequential transcatheter arterial chemoembolization and portal vein embolization before hepatectomy for the management of patients with hepatocellular carcinoma: a systematic review and meta-analysis. Updates Surg, 2023, 75(7): 1741-1750.
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55.	Zhang S, Song R, Hou C, et al. Simultaneous liver venous deprivation following hepatic arterial chemoembolization before major hepatectomy for hepatocellular carcinoma: a new methods to achieve hypertrophy liver remnant. J Hepatocell Carcinoma, 2025, 12: 219-229.
56.	Liu W, Tao H, Zeng X, et al. Synchronous portal vein embolization of terminal branches with transcatheter arterial chemoembolization before planned major hepatectomy for hepatitis B virus-related hepatocellular carcinoma: a single-center retrospective cohort study. J Gastrointest Surg, 2025, 29(7): 102036. doi: 10.1016/j.gassur.2025.102036.

1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2024, 74(3): 229-263.
2. 姚一菲, 孫可欣, 鄭榮壽. 《2022全球癌癥統計報告》解讀: 中國與全球對比. 中國普外基礎與臨床雜志, 2024, 31(7): 769-780.
3. 郝運, 李川, 文天夫, 等. 全球及中國的肝癌流行病學特征: 基于《2022全球癌癥統計報告》解讀. 中國普外基礎與臨床雜志, 2024, 31(7): 781-789.
4. Chen M, Therneau T, Orsini LS, et al. Design and rationale of the HCC BRIDGE study in China: a longitudinal, multicenter cohort trial in hepatocellular carcinoma. BMC Gastroenterol, 2011, 11: 53. doi: 10.1186/1471-230X-11-53.
5. Zhu XD, Huang C, Shen YH, et al. Downstaging and resection of initially unresectable hepatocellular carcinoma with tyrosine kinase inhibitor and anti-PD-1 antibody combinations. Liver Cancer, 2021, 10(4): 320-329.
6. Boubaddi M, Marichez A, Pecquenard F, et al. Liver venous deprivation (LVD) before extended hepatectomy: a French multicentric retrospective cohort. Hepatobiliary Surg Nutr, 2024, 13(6): 937-949.
7. Kobayashi K, Yamaguchi T, Denys A, et al. Liver venous deprivation compared to portal vein embolization to induce hypertrophy of the future liver remnant before major hepatectomy: a single center experience. Surgery, 2020, 167(6): 917-923.
8. Lee HS, Choi GH, Choi JS, et al. Surgical resection after down-staging of locally advanced hepatocellular carcinoma by localized concurrent chemoradiotherapy. Ann Surg Oncol, 2014, 21(11): 3646-3653.
9. Sui WF, Li JY, Fu JH. Transarterial chemoembolization plus stent placement for hepatocellular carcinoma with main portal vein tumor thrombosis: a meta-analysis. World J Clin Oncol, 2024, 15(3): 447-455.
10. Liu C, Sun L, Xu J, et al. Clinical efficacy of postoperative adjuvant transcatheter arterial chemoembolization on hepatocellular carcinoma. World J Surg Oncol, 2016, 14: 100. doi: 10.1186/s12957-016-0855-z.
11. Affonso BB, Galastri FL, da Motta Leal Filho JM, et al. Long-term outcomes of hepatocellular carcinoma that underwent chemoembolization for bridging or downstaging. World J Gastroenterol, 2019, 25(37): 5687-5701.
12. Wang S, Zong H, Tang L, et al. An innovative treatment approach using iliac artery embolization and implanted port for chemotherapy in a patient with gluteal muscle metastasis of advanced colon cancer: a case report and literature review. Front Oncol, 2025, 15: 1630104. doi: 10.3389/fonc.2025.1630104.
13. Li Q, Liu Y, Guo X, et al. Tirapazamine-loaded CalliSpheres microspheres enhance synergy between tirapazamine and embolization against liver cancer in an animal model. Biomed Pharmacother, 2022, 151: 113123. doi: 10.1016/j.biopha.2022.113123.
14. Cui W, Fan W, Huang K, et al. Large hepatocellular carcinomas: treatment with transarterial chemoembolization alone or in combination with percutaneous cryoablation. Int J Hyperthermia, 2018, 35(1): 239-245.
15. Yang DL, Ye L, Zeng FJ, et al. Multicenter, retrospective GUIDANCE001 study comparing transarterial chemoembolization with or without tyrosine kinase and immune checkpoint inhibitors as conversion therapy to treat unresectable hepatocellular carcinoma: survival benefit in intermediate or advanced, but not early, stages. Hepatology, 2025, 82(2): 357-369.
16. Liao M, Yang Y, Jiang H, et al. 1478P neoadjuvant TACE plus lenvatinib and camrelizumab for borderline resectable hepatocellular carcinoma: updated results of the BRHCC-Ⅰ phase Ⅰ b/Ⅱ trial. Ann Oncol, 2025, 36(Supplement 2): S824. doi: 10.1016/j.annonc.2025.08.2108.
17. Lee BH, Lee DS, Cho CW, et al. Role and limitation of neoadjuvant hepatic arterial infusion chemotherapy in advanced hepatocelluar carcinoma patients with Child-Pugh class A. World J Surg Oncol, 2019, 17(1): 143. doi: 10.1186/s12957-019-1685-6.
18. Xiao J, Li Q, Zheng W, et al. A novel quadruple conversion therapy: converting initially unresectable hepatocellular carcinoma to resectable with pTAE-HAIC, tyrosine kinase inhibitors, and anti-PD-1 antibodies. J Hepatocell Carcinoma, 2025, 12: 1807-1819.
19. He M, Li Q, Zou R, et al. Sorafenib plus hepatic arterial infusion of oxaliplatin, fluorouracil, and leucovorin vs sorafenib alone for hepatocellular carcinoma with portal vein invasion: a randomized clinical trial. JAMA Oncol, 2019, 5(7): 953-960.
20. Hamaoka M, Kobayashi T, Kuroda S, et al. Hepatectomy after down-staging of hepatocellular carcinoma with portal vein tumor thrombus using chemoradiotherapy: a retrospective cohort study. Int J Surg, 2017, 44: 223-228.
21. Zhang W, Zhao X, Gao W, et al. Conversion study of hepatocellular carcinoma using HAIC combined with lenvatinib and PD-1/L1 immunotherapy under the guidance of BCLC staging. Front Immunol, 2025, 16: 1596864. doi: 10.3389/fimmu.2025.1596864.
22. Patel MV, Davies H, Williams AO, et al. Transarterial therapies in patients with hepatocellular carcinoma eligible for transarterial embolization: a US cost-effectiveness analysis. J Med Econ, 2023, 26(1): 1061-1071.
23. Tabone M, Calvo A, Russolillo N, et al. Downstaging unresectable hepatocellular carcinoma by radioembolization using 90-yttrium resin microspheres: a single center experience. J Gastrointest Oncol, 2020, 11(1): 84-90.
24. Labgaa I, Tabrizian P, Titano J, et al. Feasibility and safety of liver transplantation or resection after transarterial radioembolization with Yttrium-90 for unresectable hepatocellular carcinoma. HPB (Oxford), 2019, 21(11): 1497-1504.
25. Son SY, Geevarghese R, Marinelli B, et al. Conversion therapy to transplant or surgical resection in patients with unresectable hepatocellular carcinoma treated with boosted dose of Yttrium-90 radiation segmentectomy. Cancers (Basel), 2024, 16(17): 3024. doi: 10.3390/cancers16173024.
26. Lau WY, Lai EC. Salvage surgery following downstaging of unresectable hepatocellular carcinoma–a strategy to increase resectability. Ann Surg Oncol, 2007, 14(12): 3301-3309.
27. Lewandowski RJ, Kulik LM, Riaz A, et al. A comparative analysis of transarterial downstaging for hepatocellular carcinoma: chemoembolization versus radioembolization. Am J Transplant, 2009, 9(8): 1920-1928.
28. Sun HC, Zhu XD. Downstaging conversion therapy in patients with initially unresectable advanced hepatocellular carcinoma: an overview. Front Oncol, 2021, 11: 772195. doi: 10.3389/fonc.2021.772195.
29. 中華人民共和國國家衛生健康委員會. 原發性肝癌診療指南 (2024年版). 腫瘤防治研究, 2024, 51(6): 495-526.
30. Armstrong SA, He AR. Immuno-oncology for hepatocellular carcinoma: the present and the future. Clin Liver Dis, 2020, 24(4): 739-753.
31. Zhang XW, Wu LY, Liu HR, et al. NSUN5 promotes progression and predicts poor prognosis in hepatocellular carcinoma. Oncol Lett, 2022, 24(6): 439. doi: 10.3892/ol.2022.13559.
32. Xu H, Zhang H, Li B, et al. Systemic conversion therapies for initially unresectable hepatocellular carcinoma: a systematic review and meta-analysis. BMC Cancer, 2024, 24(1): 1008. doi: 10.1186/s12885-024-12772-y.
33. Abulkhir A, Limongelli P, Healey AJ, et al. Preoperative portal vein embolization for major liver resection: a meta-analysis. Ann Surg, 2008, 247(1): 49-57.
34. Aloia TA. Associating liver partition and portal vein ligation for staged hepatectomy: portal vein embolization should remain the gold standard. JAMA Surg, 2015, 150(10): 927-928.
35. Piron L, Deshayes E, Escal L, et al. Portal vein embolization: present and future. Bull Cancer, 2017, 104(5): 407-416.
36. Vauthey JN, Dixon E, Abdalla EK, et al. Pretreatment assessment of hepatocellular carcinoma: expert consensus statement. HPB (Oxford), 2010, 12(5): 289-299.
37. Li AY, Ahmad MU, Sofilos MC, et al. Postoperative hepatic insufficiency despite preoperative portal vein embolization: not just about the volumetrics. Surgery, 2025, 182: 109345. doi: 10.1016/j.surg.2025.109345.
38. Peng SY, Wang XA, Huang CY, et al. Evolution of associating liver partition and portal vein ligation for staged hepatectomy: simpler, safer and equally effective methods. World J Gastroenterol, 2017, 23(23): 4140-4145.
39. Goumard C, Komatsu S, Brustia R, et al. Technical feasibility and safety of laparoscopic right hepatectomy for hepatocellular carcinoma following sequential TACE-PVE: a comparative study. Surg Endosc, 2017, 31(5): 2340-2349.
40. Isfordink CJ, Samim M, Braat MNGJA, et al. Portal vein ligation versus portal vein embolization for induction of hypertrophy of the future liver remnant: a systematic review and meta-analysis. Surg Oncol, 2017, 26(3): 257-267.
41. Guiu B, Chevallier P, Denys A, et al. Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique. Eur Radiol, 2016, 26(12): 4259-4267.
42. Guiu B, Quenet F, Escal L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function. Eur Radiol, 2017, 27(8): 3343-3352.
43. Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surg Nutr, 2020, 9(5): 564-576.
44. Heil J, Korenblik R, Heid F, et al. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis. Br J Surg, 2021, 108(7): 834-842.
45. Korenblik R, James S, Smits J, et al. Safety and efficacy of combined portal and hepatic vein embolisation in patients with colorectal liver metastases (DRAGON1): a multicentre, single-arm clinical trial. Lancet Reg Health Eur, 2025, 53: 101284. doi: 10.1016/j.lanepe.2025.101284.
46. Sy TV, Dung LT, Giang BV, et al. Safety and efficacy of liver venous deprivation following transarterial chemoembolization before major hepatectomy for hepatocellular carcinoma. Ther Clin Risk Manag, 2023, 19: 425-433.
47. 劉暢, 張曉赟, 金諶, 等. 肝靜脈系統栓堵術在第二階段根治性肝癌切除術中的應用. 中國普外基礎與臨床雜志, 2019, 26(7): 841-846.
48. Qi W, Shen J, Dai J, et al. Comparison of nucleoside and nucleotide analogs in the recurrence of hepatitis B virus-related hepatocellular carcinoma after surgical resection: a multicenter study. Cancer Med, 2021, 10(23): 8421-8431.
49. Wang W, Tian SL, Wang H, et al. Association of hepatitis B virus DNA level and follow-up interval with hepatocellular carcinoma recurrence. JAMA Netw Open, 2020, 3(4): e203707. doi: 10.1001/jamanetworkopen.2020.3707.
50. Korshak O, Sokolova O, Zhylenko A, et al. To turn weakness into a strength-preoperative future liver remnant (FLR) augmentation with special focus on local tumor control and in-situ immunization for patients with advanced hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Ann Hepatobiliary Pancreat Surg, 2021, 25(1): S65. doi: 10.14701/ahbps.lv-op-3-6.
51. Liao Y, Cai Q, Zhang X, et al. Sequential transcatheter arterial chemoembolization and portal vein embolization before hepatectomy for the management of patients with hepatocellular carcinoma: a systematic review and meta-analysis. Updates Surg, 2023, 75(7): 1741-1750.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

“Interventional dual conversion therapy” strategy for liver cancer: integration of oncological and functional medicine

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