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Liver chemoembolization

Sunyoung Lee, Matthew Loecher, Renuka Iyer
Hepatocellular carcinoma (HCC) is the fastest growing malignancy in the United States in relation to mortality. HCC relies on a complex immunosuppressive network to modify the host immune system and evade destruction. Intrinsic to the liver's function and anatomy, native hepatic and immune cells produce many inhibitory cytokines that promote tolerogenicity and limit immune response. Since the introduction of sorafenib in 2008, no treatment has been able to demonstrate improved survival in patients with advanced HCC post disease progression treated with sorafenib...
February 2018: Journal of Gastrointestinal Oncology
Yan Hu, Yalan Liu, Hongcheng Shi
RATIONALE: Castleman disease is a rare lymphoproliferative disorder which etiology is unknown. It is divided into 2 subtypes: the plasma cell variant and the hyaline vascular variant. The most common site is the hilum of the lungs and mediastinum. Castleman disease is often ignored by clinicians because of not frequently encountering in clinical and the lower uptake of F-FDG. Here, we report a case of hepatocellular carcinoma accompanied by Castleman disease in the hilum of the liver, which was misdiagnosed as the lymph node metastasis in F-FDG PET/CT imaging...
March 2018: Medicine (Baltimore)
Moon Hyung Choi, Ga Eun Park, Soon Nam Oh, Michael Yong Park, Sung Eun Rha, Young Joon Lee, Seung Eun Jung, Joon-Il Choi
RATIONALE AND OBJECTIVES: To evaluate the reproducibility of Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) using multiphasic computed tomography. MATERIALS AND METHODS: The institutional review board approved this retrospective study. We evaluated 97 patients who underwent TACE (60 conventional TACE [cTACE] and 37 drug-eluting bead TACE [DEB-TACE]) for HCC from 2010 to 2014...
March 16, 2018: Academic Radiology
Brian C Baumann, Jenny Wei, John P Plastaras, John N Lukens, Nevena Damjanov, Maarouf Hoteit, Christine Hsu, Matthew Levine, Jeffrey Mondschein, Gregory Nadolski, Kim Olthoff, Kim A Reiss, Mark Rosen, Evan Siegelman, James M Metz, Edgar Ben-Josef
OBJECTIVES: Stereotactic body radiotherapy (SBRT) is potentially curative treatment for small hepatocellular carcinomas (HCC), but data are limited on its efficacy and toxicity. We hypothesized that SBRT can achieve excellent local control (LC) with acceptable toxicity treating HCC lesions, even in advanced cirrhosis. MATERIALS AND METHODS: Thirty-seven nonmetastatic HCC patients received SBRT to 43 lesions between October 2012 and April 2016. Median dose was 50 Gy/5 fractions...
March 16, 2018: American Journal of Clinical Oncology
Ryu Sasaki, Naota Taura, Yuri Miyazoe, Shinobu Yamamichi, Suguru Nakashiki, Mio Yamashima, Tomoyuki Suehiro, Takuya Honda, Hidetaka Shibata, Eisuke Ozawa, Satoshi Miuma, Yuko Akazawa, Hisamitsu Miyaaki, Takehiro Matsumoto, Kazuhiko Nakao, Kazuto Ashizawa
OBJECTIVE: Arterial ketone bodies, which reflect liver function, have been investigated. However, the relationship between venous ketone bodies and hepatocellular carcinoma (HCC) is unclear. We investigated whether prognosis of patients with HCC after transcatheter arterial chemoembolization (TACE) was associated with venous blood ketone bodies. METHODS: Sixty-eight patients with HCC who underwent TACE were recruited for this study. The venous blood ketone body levels were measured 1 d before (pretreatment) and 7 d after TACE (posttreatment)...
February 5, 2018: Nutrition
Aaron Abajian, Nikitha Murali, Lynn Jeanette Savic, Fabian Max Laage-Gaupp, Nariman Nezami, James S Duncan, Todd Schlachter, MingDe Lin, Jean-François Geschwind, Julius Chapiro
PURPOSE: To use magnetic resonance (MR) imaging and clinical patient data to create an artificial intelligence (AI) framework for the prediction of therapeutic outcomes of transarterial chemoembolization by applying machine learning (ML) techniques. MATERIALS AND METHODS: This study included 36 patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization. The cohort (age 62 ± 8.9 years; 31 men; 13 white; 24 Eastern Cooperative Oncology Group performance status 0, 10 status 1, 2 status 2; 31 Child-Pugh stage A, 4 stage B, 1 stage C; 1 Barcelona Clinic Liver Cancer stage 0, 12 stage A, 10 stage B, 13 stage C; tumor size 5...
March 14, 2018: Journal of Vascular and Interventional Radiology: JVIR
Myung Han Hyun, Young-Sun Lee, Ji Hoon Kim, Chan Uk Lee, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun
According to the American Association for the Study of Liver Disease treatment guidelines for hepatocellular carcinoma (HCC), the role of surgery has been expanded beyond the Barcelona Clinic Liver Cancer (BCLC) algorithm. We compared primary hepatectomy (PH) with transarterial chemoembolization (TACE) in patients with intermediate to advanced (BCLC stage-B/C) stage HCC to determine the current evidence. Through database search, we included 18 high-quality studies (1 randomized controlled trial [RCT], 5 propensity-score matching non-randomized comparative trials [NRCT], and 12 NRCTs) that compared survival outcomes of 5,986 patients after PH and TACE...
March 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Sang Min Yoon, Baek-Yeol Ryoo, So Jung Lee, Jong Hoon Kim, Ji Hoon Shin, Ji Hyun An, Han Chu Lee, Young-Suk Lim
Importance: Patients with hepatocellular carcinoma showing macroscopic vascular invasion have a poor prognosis. Sorafenib is the sole treatment option for these patients, with unsatisfactory response and survival benefit. Combined treatment with transarterial chemoembolization (TACE) plus external beam radiotherapy (RT) has shown promising results for these patients in observational studies. Objective: To evaluate the efficacy and safety of TACE plus RT compared with sorafenib for patients with hepatocellular carcinoma and macroscopic vascular invasion...
March 15, 2018: JAMA Oncology
Hiroto Matsuda, Satoshi Tamada, Minoru Kato, Akira Yamamoto, Taro Iguchi, Tatsuya Nakatani
A 73-year-old woman with chief complaint of macroscopic hematuria was diagnosed as having left renal tumor with pancreatic invasion. Nephrectomy was performed. Pathological diagnosis was clear cell carcinoma, pT3a. Three months after the operation, liver metastasis appeared and sunitinib was started. Most of the liver metastases disappeared; however, a new lesion appeared, and sunitinib was switched to axitinib, which was effective on the residual lesion, but the new lesion had poor response. Transarterial chemoembolization was performed to treat the liver metastases, and all metastatic lesions disappeared...
March 2018: Urology Case Reports
Safi Dokmak, Béatrice Aussilhou, Tiziana Marchese, Nizar Kardoun, François Cauchy, Anne Sophie Schneck, Olivier Soubrane
BACKGROUND: Hepatocellular carcinoma (HCC) can be complicated by major vascular invasion, and resection can be beneficial in some patients.1 Some of these patients are traditionally operated under total vascular exclusion (TVE), refrigeration, extracorporeal circulatory bypass, and cardiac surgery, with high morbidity and mortality.2 However, HCC thrombi are not adherent to the venous wall, and with advances in surgical techniques, resection can be simplified and performed during short-duration TVE alone...
March 13, 2018: Annals of Surgical Oncology
Chun Han Nigel Tan, Yue Yu, Yan Rui Nicholas Tan, Boon Leng Kieron Lim, Shridhar Ganpathi Iyer, Krishnakumar Madhavan, Alfred Wei Chieh Kow
Backgrounds/Aims: Liver Transplantation (LT) is a recognized treatment for Hepatocellular Carcinoma (HCC). The role of Bridging Therapies (BT) remains controversial. Methods: From January 2001 to October 2012, 192 patients were referred to the National University Hospital, Singapore for consideration of LT for HCC. Sixty-five patients (33.8%) were found suitable for transplant and were placed on the waitlist. Analysis was performed in these patients. Results: The most common etiology of HCC was Hepatitis B (n=28, 43...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
H Abdella, M K Shaker, Iman Fawzy Montasser, M Sobhi, H Aly, A Sayed, S Saleh, A El Dorry
BACKGROUND/AIM: Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival. METHODS: Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE...
March 13, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Gulziya Ismailova, Eugene Yenin, Shokan Kaniev, Dinara Bayguisova, Talgat Tajibaev
OBJECTIVES: Hepatocellular carcinoma is the predominant malignancy in patients with cirrhosis and chronic liver disease. Our aim was to assess the morphologic, radiologic, and immunologic charac teristics of hepatocellular carcinoma and liver cirrhosis concerning surgical treatment tactics. MATERIALS AND METHODS: We performed a cross-sectional analysis of a prospective study performed at the JSC National Scientific Center of Surgery (named after A. Syzganov). The study included 58 patients: 31 with hepatocellular carcinoma (53...
March 2018: Experimental and Clinical Transplantation
N Golse, A El Bouyousfi, F Marques, B Bancel, K Mohkam, C Ducerf, P Merle, M Sebagh, D Castaing, A Sa Cunha, R Adam, D Cherqui, E Vibert, J-Y Mabrut
BACKGROUND: Hepatectomy remains the standard treatment for large hepatocellular carcinoma (LHCC) ≥5cm. Fibrosis may constitute a contraindication for resection because of high risk of post-hepatectomy liver failure, but its impact on patient outcome and cancer recurrence remains ill defined. Our aim was to compare predictors of survival in patients with and without cirrhosis following hepatectomy for LHCC. METHODS: The data on consecutive patients undergoing hepatectomy for LHCC in two tertiary centres between 2012 and 2016 were reviewed...
March 7, 2018: Journal of Visceral Surgery
Peter Popovic, Ana Leban, Klara Kregar, Manca Garbajs, Rok Dezman, Matjaz Bunc
Background: The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE). Patients and methods: Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE...
March 2018: Radiology and Oncology
Hannu Jarvinen, Jad Farah, Teemu Siiskonen, Olivera Ciraj-Bjelac, Jérémie Dabin, Eleftheria Carinou, Joanna Domienik-Andrzejewska, Dariusz Kluszczynski, Željka Knežević, Renata Kopec, Marija Majer, Francoise Malchair, Anna Negri, Piotr Pankowski, Sandra Sarmento, Annalisa Trianni
PURPOSE: The feasibility of setting-up generic, hospital-independent dose alert levels to initiate vigilance on possible skin injuries in interventional procedures was studied for three high-dose procedures (chemoembolization (TACE) of the liver, neuro-embolization (NE) and percutaneous coronary intervention (PCI)) in 9 European countries. METHODS: Gafchromic® films and thermoluminescent dosimeters (TLD) were used to determine the Maximum Skin Dose (MSD). Correlation of the online dose indicators (fluoroscopy time, kerma- or dose-area product (KAP or DAP) and cumulative air kerma at interventional reference point (Ka,r )) with MSD was evaluated and used to establish the alert levels corresponding to a MSD of 2 Gy and 5 Gy...
February 2018: Physica Medica: PM
Kai Zhang, Xiangyang Sun, Fubo Xie, Wencheng Jian, Caixia Li
Objective: The aim is to study the effectiveness and side effects of sorafenib administration after transarterial chemoembolization (TACE) in advanced hepatocellular carcinoma (HCC) patients. To evaluate the safety of the combination of sorafenib and TACE to treat HCC. Materials and Methods: A total of 36 unresectable HCC patients were enrolled. After TACE, administration of sorafenib was carried out. Follow-up was taken for every 4 weeks. Liver and renal function and alpha-fetoprotein were tested...
January 2018: Journal of Cancer Research and Therapeutics
Jana Taron, Jonas Johannink, Michael Bitzer, Konstantin Nikolaou, Mike Notohamiprodjo, Rüdiger Hoffmann
BACKGROUND: To investigate the added diagnostic value of diffusion-weighted imaging (DWI) of the liver and its impact on therapy decisions in patients with hepatic malignancy. METHODS: Interdisciplinary gastrointestinal tumorboard cases concerning patients with hepatic malignancies discussed between 11/2015 and 06/2016 were included in this retrospective, single-center study. Two radiologists independently reviewed the respective liver MR-examination first without, then with DWI...
March 7, 2018: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Jennifer M Watchmaker, Andrew J Lipnik, Micah R Fritsche, Jennifer C Baker, Samdeep K Mouli, Sunil Geevarghese, Filip Banovac, Reed A Omary, Daniel B Brown
BACKGROUND AND OBJECTIVES: Prophylactic antibiotics are frequently administered for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC). In patients without previous biliary instrumentation, infection risk from TACE is low. We hypothesized that there is a negligible rate of infection in these patients without prophylactic antibiotics. METHODS: We reviewed consecutive patients undergoing TACE between 7/1/2013-6/15/2016. All patients had an intact Sphincter of Oddi, received no peri-procedural antibiotics, and had 30+ days follow-up...
March 7, 2018: Journal of Surgical Oncology
Martha M Kirstein, Torsten Voigtländer, Nora Schweitzer, Jan B Hinrichs, Jens Marquardt, Marcus-Alexander Wörns, Roman Kloeckner, Thorben W Fründt, Harald Ittrich, Frank Wacker, Thomas Rodt, Michael P Manns, Henning Wege, Arndt Weinmann, Arndt Vogel
Background: Sorafenib is the recommended treatment for advanced hepatocellular carcinoma (HCC), but transarterial chemoembolization (TACE) is performed in individual cases with limited extrahepatic spread. The aim of this study was to compare the outcome of patients with HCC and extrahepatic disease (EHD) treated with sorafenib and TACE. Methods: A total of 172 patients with HCC and EHD treated with sorafenib ( n  = 98) or TACE ( n  = 74) at three German referral centers (Hannover, Mainz and Hamburg) were included in this study...
March 2018: United European Gastroenterology Journal
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