{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:53:30Z","timestamp":1791176010426,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Conversion strategy is the optimal treatment for patients with unresectable hepatocellular carcinoma (uHCC). However, a severe lack of future liver remnant (FLR) may result in early withdrawal. In this small sample retrospective study, we investigated FLR changes after conversion therapies. Notably, patients with ipsilateral Vp3 portal vein tumor thrombus (PVTT) showed a significant FLR increase after treatment and provided an advantage for carrying out radical surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>53 uHCC patients with Vp0 to Vp3 tumor thrombus were enrolled and divided into two groups (Vp0\u20132 and Vp3) based on the initial PVTT status. All patients received anti-PD-L1 and anti-VEGF therapy combined with hepatic arterial infusion chemotherapy (HAIC) every three weeks. The FLR was measured at baseline and after 3\u20134 cycles. The odds ratio (OR) between Vp3 and FLR changes was calculated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 53 patients, 28 achieved complete response (CR) or partial response (PR) after conversion treatment. FLR did not change in Vp0\u20132 group, regardless of the response. While a significant FLR increase was observed in Vp3 group, especially in patients with CR and PR. 10 cases of successfully converted Vp3 patients showed an average FLR enlargement of 18.5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>According to our study, Vp3 patients demonstrated greater FLR enlargement after conversion therapy combined with HAIC, probably due to the thrombus\u2019 restriction on blood flow to the tumor side liver. This observation may help to increase both the surgeons\u2019 and the uHCC patients\u2019 confidence in continuing treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1906245","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:37:01Z","timestamp":1791175021000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative HAIC enlarges future liver remnant in initial unresectable HCC patients with Vp3 tumor thrombus"],"prefix":"10.3389","volume":"16","author":[{"given":"Yifan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiquan","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, University Hospital Rheinisch-Westf\u00e4lische Technische Hochschule Aachen","place":["Aachen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjie","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong 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