Sequential hepatectomy for hepatocellular carcinoma with inadequate future-liver-remnant after portal vein ligation in combination with apatinib plus camrelizumab (PLACES): a single-arm prospective pilot study

作者：Zhiming Zeng, Huasheng Huang, Guangzhi Zhu, Jie Zeng, Xinping Ye, Hao Su, Yongfei He, Yanfeng Jiang, Ming Su, Cuizhen Liu, Chuangye Han, Xiwen Liao, Ning Mo, Fuchao Ma, Tianman Li, Xin Zhou, Jinyuan Liao, Zili Lv, Weifei Luo, Wen Zhang, Banghao Xu, Bin Chen, Minhao Peng, Jie Ma, Tao Peng · 发表于：HepatoBiliary Surgery and Nutrition · 年份：2025 · DOI：10.21037/hbsn-24-363 · 被引用次数：4 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Liver physiology and pathology

Background: The efficacy and safety of combining portal vein ligation (PVL) with apatinib and camrelizumab to make hepatocellular carcinoma (HCC) with insufficient future-liver-remnant (FLR) resectable are uncertain. This study aimed to explore the potential of PVL combined with systemic therapy in the treatment of HCC with insufficient FLR. Methods: In this single-arm, prospective phase II clinical trial (PLACES study), patients with HCC and inadequate FLR underwent initial PVL followed by apatinib and camrelizumab until they met the stage-II resection criteria. Post-hepatectomy, adjuvant therapy with apatinib and camrelizumab continued for one year. The primary endpoint was 1 year event-free survival (EFS) rate, defined as the time from phase I surgery to disease progression, postoperative recurrence, or death from any cause. Clinical profiles were compared to historical cases of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) at the same center using propensity score matching (PSM). Results: . 19.5 months, P=0.046). Conclusions: PVL combined with apatinib and camrelizumab emerged as a promising therapy for HCC with inadequate FLR, demonstrating both efficacy and safety (chictr.org number, ChiCTR2000033692).