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Portal vein chemotherapy

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
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
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
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
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
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
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)
Yasuo Uno, Kenji Tsuboi, Mitsuya Shimizu, Toshihide Tomosugi, Michita Shoka, Soki Hibino, Hidenobu Matsushita, Takuji Takahashi, Osamu Okochi, Yoshihisa Kawase
A73 -year-old man underwent a sigmoidectomy for sigmoid colon cancer with liver metastasis. After the operation, he received CapeOX combined with bevacizumab therapy. After 6 courses, the liver metastasis was undetectable on computed tomography scans. After 15 courses, computed tomography revealed ascites, and chemotherapy was discontinued. Two months later, computed tomography revealed portal vein thrombosis. Owing to the chronic nature of the thrombosis, thrombolytic therapy was not initiated. However, preservation therapy using antiplatelet drugs for 1 month resolved the ascites and the thrombosis...
July 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Matteo Ravaioli, Matteo Serenari, Matteo Cescon, Carlo Savini, Alessandro Cucchetti, Giorgio Ercolani, Massimo Del Gaudio, Alberto Casati, Antonio Daniele Pinna
BACKGROUND: Leiomyosarcoma of vascular origin is a rare tumor, occurring mainly in the inferior vena cava (IVC). When involving the hepatic vein confluence, it often causes Budd-Chiari syndrome, and IVC removal with a complex hepatectomy is required (Mingoli in J Am Coll Surg 211:145-146, 2010; Griffin in J Surg Oncol 34:53-60, 1987; Heaney in Ann Surg 163:237-241, 1966; Fortner in Ann Surg 180:644-652, 1974). METHODS: A 57-year-old male, without previous oncological history, presented with Budd-Chiari syndrome due to a leiomyosarcoma extending to the supra-diaphragmatic IVC and involving the right and middle hepatic veins...
July 18, 2016: Annals of Surgical Oncology
P Kambakamba, M Linecker, F A Alvarez, P Samaras, C S Reiner, D A Raptis, P Kron, E de Santibanes, H Petrowsky, P A Clavien, M Lesurtel
BACKGROUND: In patients undergoing two-stage hepatectomy (TSH) for colorectal liver metastases (CRLM), chemotherapy is discontinued before portal vein occlusion and restarted after curative resection. Long chemotherapy-free intervals (CFI) may lead to tumor progression and poor oncological outcomes. OBJECTIVE: The aim of this study was to investigate the impact of the length of CFI on oncological outcome in patients undergoing TSH for CRLM. PATIENTS AND METHODS: Overall, 74 patients suffering from bilobar CRLM who underwent ALPPS (associating liver partition with portal vein ligation for staged hepatectomy; n = 43) or conventional TSH (n = 31) at two tertiary centers were investigated...
July 18, 2016: Annals of Surgical Oncology
Dai Hoon Han, Dong Jin Joo, Myoung Soo Kim, Gi Hong Choi, Jin Sub Choi, Young Nyun Park, Jinsil Seong, Kwang Hyub Han, Soon Il Kim
Locally advanced hepatocellular carcinoma (HCC) with portal vein thrombosis carries a 1-year survival rate <10%. Localized concurrent chemoradiotherapy (CCRT), followed by hepatic arterial infusion chemotherapy (HAIC), was recently introduced in this setting. Here, we report our early experience with living donor liver transplantation (LDLT) in such patients after successful down-staging of HCC through CCRT and HAIC. Between December 2011 and September 2012, eight patients with locally advanced HCC at initial diagnosis were given CCRT, followed by HAIC, and underwent LDLT at the Severance Hospital, Seoul, Korea...
September 2016: Yonsei Medical Journal
Saiho Ko, Yuuki Kirihataya, Masanori Matsusaka, Tomohide Mukogawa, Hirofumi Ishikawa, Akihiko Watanabe
BACKGROUND: Resectability of colorectal liver metastasis (CRLM) depends on major vascular involvement and is affected by chemotherapy-induced liver injury. Parenchyma-sparing with combined resection and reconstruction of involved vessels may expand the indications and safety of hepatectomy. METHODS: Of 92 patients who underwent hepatectomy for CRLM, 15 underwent major vascular resection and reconstruction. The reconstructed vessels were the portal vein (PV) in five cases, the major hepatic vein (HV) in nine cases, and the inferior vena cava in six cases...
July 11, 2016: Annals of Surgical Oncology
Ryusei Matsuyama, Ryutaro Mori, Yohei Ota, Yuki Homma, Takafumi Kumamoto, Kazuhisa Takeda, Daisuke Morioka, Jiro Maegawa, Itaru Endo
PURPOSE: The aim of this study was to assess the efficacy of combined resection and reconstruction (CRR) of the hepatic artery (HA) in surgery for hilar cholangiocarcinoma (HC). MATERIALS AND METHOD: Among 172 patients who underwent surgical resection for HC, the following three groups were defined according to the type of vascular reconstruction: VR(-) group, in which neither CRR of the portal vein (PV) nor HA was performed (n = 74); VR-PV group, in which only CRR of the PV was required (n = 54); and VR-A group, in which CRR of the HA was performed either with or without CRR of the PV (n = 44)...
July 7, 2016: Annals of Surgical Oncology
V Y Dinh, Shivank Bhatia, Govindarajan Narayanan, Jose Yrizarry, Niramol Savaraj, Christopher O'Brien, Paul Martin, Lynn Feun
BACKGROUND/AIM: Sorafenib and chemoembolization of the liver (TACE) have both produced increased survival in hepatocellular carcinoma (HCC). Some patients cannot tolerate TACE due to portal vein thrombosis or risk of liver failure. In this pilot trial, we aimed to combine intrahepatic infusion (IA) of cisplatin or carboplatin with sorafenib for unresectable HCC. PATIENTS AND METHODS: Patients with Child's A or early B received IA cisplatin or carboplatin every 6 weeks with oral sorafenib...
July 2016: Anticancer Research
Masahiro Hatooka, Tomokazu Kawaoka, Hiroshi Aikata, Kei Morio, Tomoki Kobayashi, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Eisuke Murakami, Koji Waki, Yoji Honda, Nami Mori, Shintaro Takaki, Keiji Tsuji, Hirotaka Kohno, Hiroshi Kohno, Takashi Moriya, Michihiro Nonaka, Hideyuki Hyogo, Yasuyuki Aisaka, Kazuaki Chayama
AIM: To compare the outcome of 5-fluorouracil (FU)-based hepatic arterial infusion chemotherapy (HAIC) with sorafenib monotherapy in patients with hepatocellular carcinoma (HCC) refractory to transcatheter arterial chemoembolization (TACE). PATIENTS AND METHODS: In this retrospective cohort study, 123 patients with HCC refractory to TACE, with Child-Pugh A and free of extrahepatic metastasis, were divided into two groups: 65 received HAIC and 58 received sorafenib...
July 2016: Anticancer Research
Hajime Uchida, Akinari Fukuda, Kengo Sasaki, Yoshihiro Hirata, Takanobu Shigeta, Hiroyuki Kanazawa, Atsuko Nakazawa, Osamu Miyazaki, Shunsuke Nosaka, Vidyadhar Padmakar Mali, Seisuke Sakamoto, Mureo Kasahara
BACKGROUND: Hepatoblastoma (HB) is a highly malignant primary liver tumor in children. Although liver transplantation (LT) is an effective treatment for unresectable HB with good long-term outcomes, post-transplant survival is mainly affected by recurrence, despite adjuvant chemotherapy. Novel strategies are needed to improve the outcomes in patients undergoing LT for unresectable HB. PATIENTS AND METHODS: Twelve children received LT for unresectable HB. In 9 patients, we applied early exclusion of hepatic inflow (hepatic artery and portal vein) and creation of a temporary portocaval shunt during LT...
May 31, 2016: Journal of Pediatric Surgery
Shinsuke Sato, Erina Nagai, Yusuke Taki, Masaya Watanabe, Michiro Takahashi, Yusuke Kyoden, Ko Ohata, Hideyuki Kanemoto, Noriyuki Oba, Keisei Taku, Makoto Suzuki, Masakazu Takagi
Gastric cancer patients with main portal vein tumor thrombus usually have a short survival time, owing to its aggressive behavior. Herein, we report a long-surviving case of gastric cancer with main portal vein tumor thrombus. A 78-year-old man presenting with anorexia and body weight loss was diagnosed with gastric cancer. The patient was referred to our hospital for further examination and treatment. Endoscopy revealed a type 3 tumor (8.0 cm in length) in the body of the stomach. Biopsy led to the diagnosis of moderately differentiated adenocarcinoma...
August 2016: Clinical Journal of Gastroenterology
Ugo Boggi, Niccolò Napoli, Emanuele F Kauffmann, Giuseppe Lo Presti, Andrea Moglia
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a new procedure aimed at promoting the overgrowth of small future liver remnants (FLR). The role of ALPPS in hilar cholangiocarcinoma (h-CCA) is currently considered marginal because liver split in the presence of bile duct obstruction increases postoperative morbidity and mortality (Schadde et al. in Ann Surg 260:829-836,2014; Nadalin et al. in Z Gastroenterol 52:35-42,2014). Virtual liver split (Gall et al...
June 8, 2016: Annals of Surgical Oncology
Keisuke Arai, Takumi Fukumoto, Motofumi Tanaka, Kaori Kuramitsu, Masahiro Kido, Hisoka Kinoshita, Taku Matsumoto, Hirochika Toyama, Sadaki Asari, Tadahiro Goto, Tetsuo Ajiki, Yonson Ku
BACKGROUND: Although the effectiveness of perioperative adjuvant therapy in the treatment of hepatocellular carcinoma (HCC) has been investigated, the efficacy of preoperative therapy is unclear. Herein, we report a case of pathological complete response after percutaneous isolated hepatic perfusion (PIHP) for HCC involving portal vein tumor thrombosis (PVTT). CASE PRESENTATION: A 77-year-old woman was referred to our institute with a liver mass detected on a routine health screening...
December 2016: Surgical Case Reports
Z K Tan, P Casipit, N S Pandit
INTRODUCTION: Literature has reported tumour thrombus along the inferior vena cava as a result of underlying renal cell carcinoma (RCC) or along the portal vein from hepatocellular carcinoma (HCC). However, tumor thrombus is a rather uncommon complication of a metastatic tumour deposit in the superior vena cava in lung adenocarcinoma. Detection of tumour thrombus at the time of cancer diagnosis is a significant predictor of morbidity and mortality. Unlike RCC with vena caval extension where surgical resection provides meaningful long term survival, lung adenocarcinoma with vena cava involvement has a very dismal outcome...
April 2016: Thrombosis Research
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