关键词: 肝细胞癌, 肝移植, 靶向药物, 介入治疗, 桥接

Abstract: Objective To explore new plans for liver cancer down-staging or bridging therapy before ultra-Milan standard liver cancer transplantation, and to evaluate the safety and efficacy of Transarterial chemoembolization combined with Lenvatinib in the treatment of ultra-Milan standard liver cancer after liver transplantation. Methods Retrospective analysis was performed on the clinical data of 2 cases of patients with ultra-Milan standard liver cancer successfully bridged by liver transplantation after transarterial chemoembolization for treatment combined with targeted therapy of Lenvatinib in our center. The prognosis of the patients was evaluated by regular reexamination of serological markers, CT examination or liver color ultrasound, so as to evaluate the clinical possibility and usability of the new bridging protocol. Results The first patient for liver cancer with portal venous tumor emboli right branch of, for liver cancer stage （CNLC stage IIIa） in our country, after Transarterial chemoembolization combined with Lenvatinib bridging for 2 months, patients received liver transplantation, postoperative incision healed well, postoperative pathological suggest most tumor necrosis, only a few members of the heterocyst around the cell mass. Regular follow-up of 16 months, no tumor recurrence was observed. The Second patientwith liver cancer associated with liver vein invasion, as CNLC stage IIIa, after Transarterial chemoembolization combined with Lenvatinib bridging for one month, oncology evaluation for SD, patient received allogeneic orthotopic liver transplantation, postoperative incision healing is good. Postoperative pathology showed that most of the tissues were necrotic, and only a few tumor cells were arranged in cord like and adenoid. No recurrence of tumor was found in regular follow-up for 14 months. Both patients had normal liver function and no other complications occurred. Conclusion Transarterial chemoembolization for treatment combination with Lenvatinib can better control tumor progression in advanced liver cancer, and can be used as an effective bridging therapy for ultra-Milan standard liver cancer before liver transplantation. The short-term prognosis is good, and the influence on abdominal incision and the long-term efficacy of patients need to increase the sample size and long-term follow-up.

Key words: hepatocellular carcinoma, liver transplantation, targeted drugs, transarterial chemoembolization for treatment, bridging therapy