Neoplasms

All Conditions

Digestive System Diseases

Blood and Lymph Conditions

Carcinoma

Carcinoma, Hepatocellular

Thrombocytopenia

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Adenocarcinoma

Liver Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Liver Diseases

Blood Platelet Disorders

Hematologic Diseases

Cytopenia

The baseline platelet count before enrollment was \< 75×10\^9/L and \> 30×10\^9/L.The primary clinical diagnosis of hepatocellular carcinoma was confirmed, and the CNLC stages were Ia and Ib.An elective hepatectomy, including laparotomy or laparoscopic hepatectomy, except hepatectomy combined with splenectomy or radiofrequency ablation.

On the basis of conventional treatment, Avatrombopag was added, 30×10\^9/L \< platelet count \< 50×10\^9/L patients received Avatrombopag 60mg/d, 50×10\^9/L≤ platelet count \< 75×10\^9/L patients received Avatrombopag 40mg/d for 5 consecutive days, and waited for a period of time after drug withdrawal.Surgery is expected to take place on day 10-13 of the initial dose.

Avatrombopag

Jian Zhou, MD PhD

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world, accounting for the second leading cause of cancer death in China.Surgical treatment of hepatocellular carcinoma is the most important means for long-term survival of patients with hepatocellular carcinoma, including hepatectomy and liver transplantation.Chronic liver disease caused by hepatitis B infection is the main pathogenic factor of liver cancer in China. Meanwhile, nearly 80% of patients with hepatocellular carcinoma are complicated with cirrhosis, and the incidence of thrombocytopenia in patients with cirrhosis is reported to be as high as 78%.Many previous studies have found that thrombocytopenia is closely related to perioperative outcome of hepatocellular carcinoma.The purpose of this study was to evaluate the efficacy and safety of avatripopa in the treatment of thrombocytopenia in patients with primary hepatocellular carcinoma undergoing elective hepatectomy and its effect on perioperative outcome.

The indicators included changes in platelet count before and after drug treatment and operation, the nature and amount of postoperative drainage (ascites), duration of indwelling drainage tube, intraoperative blood loss, perioperative complications, length of hospital stay, etc.After comprehensive consideration of all perioperative indicators, we selected the total amount of drainage (ascites) multiple days after surgery as the primary outcome.

Treatment of Avatrombopag for Thrombocytopenia in Patients Undergoing Selective Resection of Hepatocellular Carcinoma

Efficacy and Safety of Avatrombopag in Thrombocytopenia in Patients With Primary Hepatocellular Carcinoma Undergoing Elective Hepatectomy: a Multicenter, Randomized, Controlled Study

The Percentage of patients in the treatment group with platelet count ≥75×10\^9/L (the highest test value of of platelet count was taken on day 9-12 of treatment) and an increase of platelet count more than 20% from baseline before operation.

Comparison of total amount of postoperative drainage fluid on day 1, 3 and 5 after surgery between treatment group and control group

Comparison of intraoperative blood loss between Treatment group and control group.

Comparison of the proportion of patients receiving remedial treatment due to bleeding risk after surgery between the treatment group and the control group

Comparison of postoperative indwelling time of drainage tube between treatment group and control group

Comparison of red blood cell count and hemoglobin content of drainage fluid between treatment group and control group on the 1st, 3rd and 5th day after operation

Comparison of postoperative hospitalization time between treatment group and control group

Preoperative platelet count increase from baseline in treatment group.

The change of platelet count from baseline at different time points in the treatment group.

Shanghai Zhongshan Hospital

Symptoms and General Pathology

Postoperative Complications

Hematinics

All Drugs and Chemicals

Liver Extracts

ORAL IMPACT Powder 74g within 250ml of water, 3 times per day during 7 days before surgery

Powder 74g within 250ml of water, 3 times per day during 7 days before surgery

Oral immunonutrition

Placebo

Denis CASTAING, MD, PhD

To study the efficacy of preoperative immunonutrition in reducing postoperative morbidity after liver resection for cancer.

Perioperative immunonutrition has been developed to improve the immuno metabolic host response and outcome in postoperative period and has been proven to be beneficial in reducing significantly postoperative infectious complications and length of hospital stay in patients undergoing elective gastrointestinal surgery for tumors. To date, the effects of preoperative oral immunonutrition (ORAL IMPACT) in non cirrhotic patients undergoing liver resection for cancer are unknown. The purpose of this study is to determine whether the administration of a short-term preoperative oral immunonutrition can reduce postoperative morbidity in non-cirrhotic patients undergoing liver resection for malignant tumours.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Treatment of Avatrombopag for Thrombocytopenia in Patients Undergoing Selective Resection of Hepatocellular Carcinoma	NCT05087459	Thrombocytopeni...	Avatrombopag	18 Years -	Shanghai Zhongshan Hospital
Interest of PReOPerative Immunonutrition in Liver Surgery for Cancer	NCT02041871	Hepatectomy Elective Hepate... Malignant Tumor...	Oral immunonutr... Placebo	18 Years -	Assistance Publique - Hôpitaux de Paris

Spots Global Cancer Trial Database for elective hepatectomy