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Hepatocellular carcinoma with hepatic vein thrombosis

Marta Hernández Conde, Elba Llop Herrera, Juan de la Revilla Negro, Fernando Pons Renedo, Natalia Fernández Puga, José Luis Martínez Porras, María Trapero Marugan, Valentín Cuervas-Mons, Víctor Sánchez Turrión, José Luis Calleja Panero
INTRODUCTION: The prevalence of portal vein thrombosis (PVT) in patients that have undergone liver transplantation (LT) is 9.7% (SD 4.5). The aim of our study was to determine the prevalence, assess the factors that are associated with PVT and clarify their association with prognosis in patients with liver cirrhosis (LC) and LT. AIMS AND METHODS: From 2005 to 2014, laboratory, radiological and surgical data were collected from patients with LC in our center who had undergone LT for the first time...
October 19, 2016: Revista Española de Enfermedades Digestivas
Chaeyoun Oh, Joong Kee Youn, Ji-Won Han, Gi Beom Kim, Hyun-Young Kim, Sung-Eun Jung
INTRODUCTION: The Fontan procedure (FP) has become the standard operation for patients with single ventricle physiology. However, a long period of elevated systemic venous pressure and low cardiac output after the procedure result in chronic inflammation and liver cirrhosis, which may eventually lead to the occurrence of hepatocellular carcinoma (HCC). CLINICAL FINDINGS: We described the case of a 16-year-old female who developed HCC after the FP. At 21 months, the patient received a lateral tunnel FP, and 14 years later, she began complaining of abdominal distension, telangiectasia, and fatigue...
October 2016: Medicine (Baltimore)
Yasir Furkan Cagin, Yahya Atayan, Mehmet Ali Erdogan, Firat Dagtekin, Cemil Colak
BACKGROUND: Portal vein thrombosis (PVT) is due to many risk factors, but its pathogenesis is still not clearly understood. To identify the risk factors for PVT, we analyzed the clinical characteristics and complications associated with PVT in cirrhotic patients. METHODS: We studied patients with liver cirrhosis who were admitted to our unit from April 2009 to December 2014. The patients were divided into the PVT and non-PVT groups, and were compared by variables including gender, age, the etiology of cirrhosis, stage of cirrhosis, complications, imaging, and treatment...
October 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Hideto Kawaratani, Hiroshi Fukui, Kei Moriya, Ryuichi Noguchi, Tadashi Namisaki, Masakazu Uejima, Mitsuteru Kitade, Kosuke Takeda, Yasushi Okura, Kosuke Kaji, Norihisa Nishimura, Hiroaki Takaya, Yousuke Aihara, Yasuhiko Sawada, Shinya Sato, Kenichiro Seki, Akira Mitoro, Junichi Yamao, Hitoshi Yoshiji
AIMS: The efficacy of the vasopressin V2 receptor antagonist tolvaptan for difficult-to-treat cirrhotic ascites has recently been reported. However, its effect is variable among patients. This study aimed to clarify the predictive factors for obtaining a good response to tolvaptan in patients with difficult-to-treat ascites. METHODS: Data were collected from 50 patients with liver cirrhosis having ascites (hepatitis B, 1; hepatitis C, 22; alcoholism, 11; and others, 16 patients) after administering tolvaptan (3...
October 5, 2016: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Aiman Obed, Abdalla Bashir, Anwar Jarrad
BACKGROUND Hepatitis C virus (HCV) genotype 4 (GT-4) is widespread in the Middle East, where it is responsible for the majority of HCV infections. It shows moderate treatment response rates when compared to other genotypes in the current era of interferon-based regimens. However, in the era of direct acting antiviral (DAA) drugs, its response is at least as good as observed for HCV genotypes 1-3. CASE REPORT We present a case of a 44-year-old patient with HCV cirrhosis. Since 2007, he has been treated for HCV infection with multiple ineffective regimens of interferon (INF) and ribavirin...
September 20, 2016: American Journal of Case Reports
Minjung Shim, Tae Young Yang, Nam Gil Cho, Ara Woo, Eunju Kim, Keunhoi Park, Joo Ho Lee, Yun Bin Lee, Seong Gyu Hwang, Kyu Sung Rim, Hana Park
Portal vein thrombosis (PVT) is a form of venous thrombosis that usually presents in chronic form without any sequalae in patients with hepatocellular carcinoma (HCC) or liver cirrhosis. Accurate differential diagnosis of bland PVT from neoplastic PVT is an important step for planning treatment options, but the acute form can be challenging. Here we present a case of acute hepatic infarction caused by acute bland PVT combined with pylephlebitis, which was misdiagnosed as infiltrative hepatic malignancy with neoplastic PVT owing to the perplexing imaging results and elevated tumor markers...
September 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Stephen L Chan, Charing C N Chong, Anthony W H Chan, Darren M C Poon, Kenneth S H Chok
Portal vein tumor thrombosis (PVTT) is a common phenomenon in hepatocellular carcinoma (HCC). Compared to HCC without PVTT, HCC with PVTT is characterized by an aggressive disease course, worse hepatic function, a higher chance of complications related to portal hypertension and poorer tolerance to treatment. Conventionally, HCC with PVTT is grouped together with metastatic HCC during the planning of its management, and most patients are offered palliative treatment with sorafenib or other systemic agents. As a result, most data on the management of HCC with PVTT comes from subgroup analyses or retrospective series...
August 28, 2016: World Journal of Gastroenterology: WJG
Atene Itoh, Hiroshi Sadamori, Kazuhisa Yabushita, Kazuteru Monden, Masashi Tatsukawa, Masayoshi Hioki, Tsuyoshi Hyodo, Kunihiro Omonishi, Toru Ueki, Satoshi Ohno, Kohsaku Sakaguchi, Norihisa Takakura
BACKGROUND: Hepatocellular carcinoma (HCC) patients with hepatic vein tumor thrombosis (HVTT) extending to the inferior vena cava (IVC) have an extremely poor prognosis. Here we report a case of HCC with HVTT and renal dysfunction after hepatic arterial infusion chemotherapy (HAIC) successfully treated by liver resection and active veno-venous bypass. CASE PRESENTATION: A 77-year-old man was diagnosed to have a large HCC with intrahepatic metastases and HVTT extending to the IVC...
2016: BMC Cancer
Mohamed Magdi El-Sadek Ali Atta, Hazem Mahmoud Atta, Magdy Abdel-Mawgoud Gad, Laila Ahmad Rashed, Ebada M Said, Sharaf El-Sayed Ali Hassanien, Ahmed O Kaseb
BACKGROUND AND AIMS: Several angiogenic factors are involved in the development and progression of hepatocellular carcinoma (HCC), a hypervascular tumor. Vascular endothelial growth factor (VEGF) is a primary driving force for angiogenesis, and its overexpression has been reported in HCC. However, the significance of plasma and tissue VEGF levels in HCC in Egyptian patients with chronic hepatitis C (CHC) infection is understudied. The aim of this study was to evaluate the role of VEGF (measured in plasma and liver tissue) in patients with hepatitis C virus-related HCC and to assess its significance in the diagnosis and prognosis of HCC...
2016: J Hepatocell Carcinoma
Jeong Il Yu, Hee Chul Park
Although the current standard treatment for hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) is sorafenib, many previous studies have established the need for a reliable local modality for PVTT control, which is a major cause of liver function deterioration and metastasis. Additionally, there is growing evidence for the prognostic significance of PVTT classification according to the location of tumor thrombosis. Favorable outcomes can be obtained by applying local modalities, including surgery or transarterial chemoembolization, especially in second-order or distal branch PVTT...
August 14, 2016: World Journal of Gastroenterology: WJG
Bong Kyung Bae, Jae-Chul Kim
PURPOSE: The purpose of current study is to evaluate the response of the patients with portal vein thrombosis (PVT) or hepatic vein thrombosis (HVT) in hepatocellular carcinoma (HCC) treated with three-dimensional conformal radiation therapy (3D-CRT). In addition, survival of patients and potential prognostic factors of the survival was evaluated. MATERIALS AND METHODS: Forty-seven patients with PVT or HVT in HCC, referred to our department for radiotherapy, were retrospectively reviewed...
September 2016: Radiation Oncology Journal
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
Kunpeng Hu, Purun Lei, Zhicheng Yao, Chenhu Wang, Qingliang Wang, Shilei Xu, Zhiyong Xiong, He Huang, Ruiyun Xu, Meihai Deng, Bo Liu
BACKGROUND: The treatment of hepatocellular carcinoma (HCC) is complicated and challenging because of the frequent presence of cirrhosis. Therefore, we propose a novel surgical approach to minimize the invasiveness and risk in patients with HCC, hypersplenism, and esophagogastric varices. METHODS: This was a retrospective study carried out in 25 patients with HCC and hypersplenism and who underwent simultaneous laparoscopic-guided radio-frequency ablation and laparoscopic splenectomy with endoscopic variceal ligation...
2016: World Journal 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
Jhii-Hyun Ahn, Jeong-Sik Yu, Eun-Suk Cho, Jae-Joon Chung, Joo Hee Kim, Ki Whang Kim
OBJECTIVE: To validate the diffusion-weighted MRI (DWI) for differentiation of benign from malignant portal vein thrombosis. MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study and waived informed consent. A total of 59 consecutive patients (52 men and 7 women, aged 40-85 years) with grossly defined portal vein thrombus (PVT) on hepatic MRI were retrospectively analyzed. Among them, liver cirrhosis was found in 45 patients, and hepatocellular carcinoma in 47 patients...
July 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Yaoru Huang, Shang-Wen Chen, Ching-Chao Fan, Lai-Lei Ting, Chia-Chun Kuo, Jeng-Fong Chiou
BACKGROUND: Few data are available on the tolerance of reirradiation in patients with hepatocellular carcinoma (HCC). This study determined the clinical parameters contributing to the development of radiation-induced liver disease (RILD). METHODS: We included 36 patients with HCC who received 2 courses of radiotherapy (RT) to the liver. Using α/β = 15 for tumor and α/β =8 for normal liver tissue for biologically equivalent doses in 2 Gy fractions, mean cumulative to the hepatic tumor and normal liver were 87...
2016: Radiation Oncology
C-Y Yu, H-Y Ou, C-C Weng, T-L Huang, T-Y Chen, L Leung-Chit, H-W Hsu, C-L Chen, Y-F Cheng
BACKGROUND: The majority of hepatocellular carcinoma (HCC) patients is diagnosed in late stages and therefore becomes ineligible for potentially curative treatment such as resection or liver transplantation. Transarterial chemoembolization (TACE) with drug-eluting beads (DC beads, Biocompatibles, Farnham, United Kingdom) has been proven with less side effects and better efficacy than conventional TACE, especially among patients with poor liver function. PURPOSE: The aim of this study is to evaluate outcomes of HCC patients who received TACE with DC beads, which resulted to eligibility for liver transplantation...
May 2016: Transplantation Proceedings
Jung Ho Im, Sang Min Yoon, Hee Chul Park, Jong Hoon Kim, Jeong Il Yu, Tae Hyun Kim, Jun Won Kim, Taek-Keun Nam, Kyubo Kim, Hong Seok Jang, Jin Hee Kim, Mi-Sook Kim, Won Sup Yoon, Inkyung Jung, Jinsil Seong
BACKGROUND & AIMS: This nationwide, multicenter study investigated treatment outcomes as well as the optimal radiotherapeutic strategy in patients with hepatocellular carcinoma (HCC) and portal vein tumour thrombosis (PVTT). METHODS: We retrospectively reviewed the records of 985 patients who received radiotherapy (RT) for PVTT. The median equivalent RT dose was 48.75 Gy. Combined treatment, defined as liver-directed treatments performed within a month of RT, was administered to 657 patients (66...
June 18, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
G Ascenti, C Sofia, S Mazziotti, S Silipigni, T D'Angelo, S Pergolizzi, E Scribano
AIM: To investigate the diagnostic accuracy of dual-energy multidetector computed tomography (MDCT) with iodine quantification compared to conventional enhancement measurements in distinguishing bland from neoplastic portal vein thrombosis in patients with hepatocellular carcinoma. MATERIAL AND METHODS: Thirty-four patients (26 men, eight women; mean age, 62 years) with hepatocellular carcinoma and portal vein thrombosis underwent contrast-enhanced dual-energy MDCT during the late hepatic arterial phase for the assessment of portal thrombosis (bland, n=21; neoplastic, n=13)...
September 2016: Clinical Radiology
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
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