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Portal vein chemotherapy

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https://www.readbyqxmd.com/read/28101354/histological-complete-response-in-a-patient-with-advanced-biliary-tract-cancer-treated-by-gemcitabine-cisplatin-s-1-combination-chemotherapy-a-case-report
#1
Tokuhiro Matsubara, Tsutomu Nishida, Yoshito Tomimaru, Masashi Yamamoto, Shiro Hayashi, Sachiko Nakajima, Koji Fukui, Keizo Dono, Shiro Adachi, Tatsuya Ioka, Masashi Kanai, Masami Inada
A 68-year-old woman was referred to our hospital with increased levels of biliary enzymes. On imaging, the patient was diagnosed with unresectable intrahepatic biliary tract cancer (BTC) with invasion of the portal vein and para-aortic lymph node metastasis (cT3N1M1, cStage IVb) and underwent endoscopic biliary drainage for the biliary stricture prior to therapy. The patient was subsequently enrolled in a phase III randomized trial (UMIN000014371/NCT02182778) and randomly assigned to receive gemcitabine/cisplatin/S-1 (GCS) combination therapy intravenously at doses of 1,000 or 25 mg/m(2) on day 1 and orally twice daily at a dose of 80 mg/m(2) on days 1-7 every 2 weeks...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28098057/totally-implantable-catheter-migration-and-its-percutaneous-retrieval-case-report-and-review-of-the-literature
#2
E Intagliata, F Basile, R Vecchio
Totally subcutaneous intravascular portals have been increasingly used to administer long-term chemotherapy and parental nutrition. The reported complications are rare. Accidental endovascular rupture of a fragment of catheter is one of the most formidable complications of the central vein catheterization. The Authors report a case of deployment of a Port-a-Cath catheter and its percutaneous retrieval. The catheter accidentally detached and migrated from the reservoir of the port-a-cath placed in the left subclavian vein to the right heart cavities through the blood stream...
September 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28053537/comparison-of-intra-arterial-chemoembolization-with-and-without-radiotherapy-for-advanced-hepatocellular-carcinoma-with-portal-vein-tumor-thrombosis-a-meta-analysis
#3
Qianqian Zhao, Kunli Zhu, Jinbo Yue, Zhonghua Qi, Shumei Jiang, Xiaoqing Xu, Rui Feng, Renben Wang
PURPOSE: Numerous studies have tried to combine transarterial chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) with radiotherapy (RT) for the treatment of hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT). However, the efficacy of TACE or HAIC combined with RT versus TACE or HAIC alone remains controversial. Thus, we performed a meta-analysis to compare the efficacy and safety of intra-arterial chemoembolization combined with RT versus intra-arterial chemoembolization alone for the treatment of HCC patients with PVTT...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28043760/endoscopic-ultrasonography-complements-computed-tomography-in-predicting-portal-or-superior-mesenteric-vein-resection-in-patients-with-borderline-resectable-pancreatic-carcinoma
#4
Evan S Glazer, Omar M Rashid, Jason B Klapman, Cynthia L Harris, Pamela J Hodul, Jose M Pimiento, Mokenge P Malafa
BACKGROUND: Current guidelines recommend computed tomographic (CT) scans for vascular staging of patients with pancreatic carcinoma; however, endoscopic ultrasonography (EUS) in these patients is not required and its utility in combination with CT scan is less well-defined. The purpose of this study is to explore the utility of EUS in addition to CT in identifying patients with borderline resectable pancreatic carcinoma (BRPC). METHODS: We reviewed our database of patients with BRPC who went to surgery with curative intent...
December 5, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/27995092/surgery-of-colorectal-liver-metastases-pushing-the-limits
#5
REVIEW
Guido Torzilli, René Adam, Luca Viganò, Katsunori Imai, Jeremias Goransky, Andrea Fontana, Christian Toso, Pietro Majno, Eduardo de Santibañes
BACKGROUND: The recent advent of more effective chemotherapy and the development of surgical procedures have expanded the pool of resectable patients with colorectal liver metastases (CLM). Two-stage hepatectomy (TSH), associated liver partition and portal vein ligation for staged hepatectomy (ALPPS), and ultrasound-guided enhanced one-stage hepatectomy (e-OSH) are the surgical solutions proposed for these patients, but the range of indications for these procedures vary from institution to institution...
November 2016: Liver Cancer
https://www.readbyqxmd.com/read/27960221/-extended-left-hemihepatectomy-with-reconstruction-of-the-right-liver-vein-in-a-patient-with-an-intrahepatic-cholangiocellular-carcinoma
#6
F Bartsch, T Huber, H Lang
Extended left hemihepatectomy (left trisectionectomy) with resection of liver segments 1, 2, 3, 4 a/b, 5 and 8 is a challenging procedure. In well-selected patients, the indication for this procedure may offer the chance of curative resection for primary or secondary liver tumours in complicated locations. Morbidity and mortality are increased compared to non-extended liver resections. This procedure requires precise imaging and accurate surgical planning in due consideration of the remaining liver volume and additional factors such as preliminary damage of the liver parenchyma caused by chemotherapy or fibrosis/cirrhosis...
December 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27920652/diffuse-infiltrative-hepatocellular-carcinoma-with-portal-vein-tumor-thrombosis-completely-cured-by-transcatheter-arterial-chemoembolization-case-report-with-8-year-follow-up
#7
Suk Bae Kim
Hepatocellular carcinoma (HCC) is the most common type of liver cancer and its treatment options are determined by shape, liver function, loci, and stages of cancer. Diffuse type of infiltrative HCC accompanied by portal vein tumor thrombosis (PVTT) has the poorest prognosis among other HCCs and there are no other prominent treatment options than systemic chemotherapy. In this study, we report a case of a 56-year-old man with diffuse infiltrative HCC accompanied by PVTT who achieved complete remission for 8 years after receiving conventional transcatheter arterial chemoembolization using adriamycin and gelfoam...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27916773/a-case-of-unresectable-combined-hepatocellular-cholangiocarcinoma-showing-favorable-response-to-lfp-therapy
#8
Sayuri Kato, Yasuto Takeuchi, Nozomu Wada, Yuuki Morimoto, Kenji Kuwaki, Hideki Ohnishi, Shinichiro Nakamura, Hidenori Shiraha, Akinobu Takaki, Hiroyuki Okada
A woman in her 50s was admitted to our hospital because of multiple tumors detected in her liver. She was diagnosed with combined hepatocellular cholangiocarcinoma using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and biopsy of the liver tumors. We judged the tumors to be unresectable because they were found in both lobes of the liver, with a tumor thrombus being found in the main left portal vein. The pathological findings showed that the tumors exhibited characteristics of hepatocellular carcinoma...
2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/27895433/complete-response-with-sorafenib-and-transcatheter-arterial-chemoembolization-in-unresectable-hepatocellular-carcinoma
#9
Michitoshi Takano, Takashi Kokudo, Yoshihiro Miyazaki, Yumiko Kageyama, Amane Takahashi, Katsumi Amikura, Hirohiko Sakamoto
Patients with advanced hepatocellular carcinoma (HCC) showing portal vein tumor thrombosis (PVTT) have an extremely poor prognosis. According to treatment guidelines, the only option for HCC patients with PVTT is sorafenib chemotherapy. However, in Asia, various treatments have been attempted and possible prolongation of overall survival has been repeatedly reported. We herein report the first case of a patient with an initially unresectable advanced HCC with PVTT who underwent curative hepatectomy after sorafenib and transcatheter arterial chemoembolization (TACE) showing complete histological response...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#10
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27766595/a-literature-review-of-associating-liver-partition-and-portal-vein-ligation-for-staged-hepatectomy-alpps-so-far-so-good
#11
Martin de Santibañes, Luis Boccalatte, Eduardo de Santibañes
Recently, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) emerged as a novel surgical strategy to induce a rapid and large hypertrophy of the future liver remnant (FLR). We conducted a computerized search using PubMed and Google Scholar for reports published between March 2012 and July 2016 using mesh headings and key words relating to the ALPPS surgical procedure. The promising results obtained up to date are difficult to interpret due to the heterogeneous group of patients with different underlying pathologies and different chemotherapy schemes...
October 20, 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27761713/rescue-alpps-is-efficient-and-safe-after-failed-portal-vein-occlusion-in-patients-with-colorectal-liver-metastases
#12
Ernesto Sparrelid, Stefan Gilg, Torkel B Brismar, Lars Lundell, Bengt Isaksson
PURPOSE: The aim of this study was to investigate whether associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can be used as an effective and safe rescue procedure in patients with colorectal liver metastases (CRLM) and insufficient effect on the future liver remnant (FLR) after previous portal vein occlusion (PVO). METHODS: Eleven patients with bilobar CRLM treated with neoadjuvant chemotherapy and previous PVO with insufficient effect on the FLR were analyzed retrospectively from a prospective database...
October 19, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27756893/first-left-hepatic-trisectionectomy-including-segment-one-with-new-associated-liver-partition-and-portal-vein-ligation-with-staged-hepatectomy-alpps-modification-how-to-do-it
#13
Aiman Obed, Anwar Jarrad, Abdalla Bashir
BACKGROUND Associated Liver Partition and Portal vein ligation with Staged hepatectomy (ALPPS) leads to rapid hepatic hypertrophy and decreases incidence of post-hepatectomy liver failure in patients with a marginal future liver remnant. Various procedural ALPPS modifications were previously described. Here, we present the first case of a new ALPPS modification, carrying out a left hepatic trisectionectomy with segment 1. CASE REPORT We present the case of a 36-year-old woman with locally advanced sigmoid adeno-carcinoma and extensive left liver metastases extending to segment V and VIII, who received state-of-the-art systemic conversion chemotherapy...
October 19, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27750243/recent-trends-in-the-management-of-hepatocellular-carcinoma-with-special-emphasis-on-treatment-with-regorafenib-and-immune-checkpoint-inhibitors
#14
REVIEW
Masatoshi Kudo
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer deaths worldwide. Sonazoid-enhanced ultrasound and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI are the most important imaging modalities in diagnosing HCC. There are 2 non-contradictory HCC treatment algorithms in Japan. Hepatic arterial infusion chemotherapy plays an important role in the treatment of advanced HCC with main or branch portal vein invasion. Regorafenib, as a second-line systemic treatment, prolongs survival in patients with intermediate and advanced HCC who progressed on sorafenib...
2016: Digestive Diseases
https://www.readbyqxmd.com/read/27734177/total-laparoscopic-reversal-alpps
#15
M A Machado, R Surjan, T Basseres, F Makdissi
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) allows R0 resection even for patients with extremely small future liver remnants. The ALPPS procedure was initially described for two-stage right trisectionectomy. Reversal ALPPS is a denomination in which the future liver remnant is the right posterior section of the liver. PATIENT: A 42-year-old woman with colorectal metastases in all segments except segment 1 underwent chemotherapy with objective response and was referred for surgical treatment...
October 12, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27733977/efficacy-of-low-dose-capecitabine-and-sorafenib-in-patients-with-advanced-alfa-fetoprotein-secreting-hepatocellular-carcinoma-a-1%C3%A2-year-experience
#16
Amr Shaaban Hanafy
BACKGROUND: There is no global consensus for the optimal management of HCC. Most of patients at the time of diagnosis are not candidate for potentially curative therapy. The study aimed to evaluate the efficacy of low dose capecitabine combined with sorafenib in subset of Egyptian HCV patients presented with advanced HCC unfit for surgical or locoregional therapies. METHODS: 15 patients with advanced HCC, unfit for surgical or locoregional intervention, with PS <2 recieved Capecitabine 500 mg/day with sorafeneb 200 mg twice daily till normalization of AFP then the treatment was modified to capecitabine 250 mg every other day and sorafenib 400 mg once daily...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27570432/neuroendocrine-carcinoma-of-the-extrahepatic-bile-duct-a-case-report
#17
Yukio Oshiro, Ryozo Gen, Shinji Hashimoto, Tatsuya Oda, Taiki Sato, Nobuhiro Ohkohchi
Neuroendocrine carcinoma (NEC) originating from the gastrointestinal hepatobiliary-pancreas is a rare, invasive, and progressive disease, for which the prognosis is extremely poor. The patient was a 72-year-old man referred with complaints of jaundice. He was diagnosed with middle extrahepatic cholangiocarcinoma (cT4N1M0, cStage IV). He underwent a right hepatectomy combined with extrahepatic bile duct and portal vein resection after percutaneous transhepatic portal vein embolization. Microscopic examination showed a large-cell neuroendocrine carcinoma according to the WHO criteria for the clinicopathologic classification of gastroenteropancreatic neuroendocrine tumors...
August 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27525001/clinical-presentation-risk-factors-and-treatment-modalities-of-hepatocellular-carcinoma-a-single-tertiary-care-center-experience
#18
Abdulrahman A Aljumah, Hadi Kuriry, Mohammed AlZunaitan, Mohammed Al Ghobain, Mohamed Al Muaikeel, Ashwaq Al Olayan, Fahad Azzumeea, Bader Almutairi, Abduljaleel AlAlwan, Hamdan AlGhamdi
Objective. To investigate the risk factors, clinical characteristics, treatment modalities, and outcomes in Saudi patients with HCC and propose points for early detection of the disease. Methods. Patients were stratified according to underlying risk factors for the development of HCC. Barcelona Clinic Liver Cancer (BCLC) was used for cancer staging. Treatment was classified into surgical resection/liver transplantation; locoregional ablation therapy; transarterial embolization; systemic chemotherapy; and best supportive care...
2016: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/27484960/the-alpps-procedure-for-hepatocellular-carcinoma-larger-than-10-centimeters
#19
Orlando Jorge M Torres, Rodrigo Rodrigues Vasques, Thiago Henrique S Silva, Miguel Eugenio L Castelo-Branco, Camila Cristina S Torres
INTRODUCTION: The only means of achieving long-term survival in hepatocellular carcinoma is complete tumor resection or liver transplantation. Patients with large hepatocellular carcinomas are currently not considered for liver transplantation. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is indicated in selected patients. We present the case of a patient with a huge hepatocellular carcinoma who underwent an ALPPS procedure. PRESENTATION OF CASE: A 57-year-old man initially presented with a tumor measuring 19cm×10cm in the right lobe of the liver...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27442648/first-totally-laparoscopic-alpps-procedure-with-selective-hepatic-artery-clamping-case-report-of-a-new-technique
#20
Rodrigo C Surjan, Fabio F Makdissi, Tiago Basseres, Denise Leite, Luiz F Charles, Regis O Bezerra, Erik Schadde, Marcel Autran Machado
BACKGROUND: ALPPS (Associating Liver Partition and Portal vein ligation for Staged hepatectomy) is a new surgical approach for the treatment of liver tumors. It is indicated in cases where the future liver remnant is not sufficient to maintain postoperative liver function. We report a totally laparoscopic ALPPS with selective hepatic artery clamping. Pneumoperitoneum itself results in up to 53% of portal vein flow and selective hepatic artery clamping can reduce blood loss while maintaining hepatocellular function...
July 2016: Medicine (Baltimore)
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