BACKGROUND: The goal of this study was to examine the safety and efficacy of selective internal radioembolization (SIR) for hepatocellular carcinoma (HCC) with portal vein or caval thrombosis (VT), or both. Recent reports have demonstrated that SIR is safe for patients with HCC, but the impact on efficacy of venous thrombosis is unknown. STUDY DESIGN: Prospective single-arm study of the use of Therasphere in patients with unresectable HCC enrolled from January 2004 to June 2007. Patients were categorized into three groups based on VT status and therapy. RESULTS: Fifty-two patients were enrolled: 20 patients without VT who received SIR, 15 patients with VT who were treated, and 17 patients (10 with VT) who were not treated because of preprocedure screening failure. Fifty-eight treatments were administered, with a median of two treatments per patient (range of one to three treatments). Child's score was different between groups. Of the VT patients treated, 67% had portal VT, 7% had cava VT, and 26% had both. There were no treatment-related deaths. There was no difference in complications among groups (p = 0.34). Treated patients without thrombosis had a median overall survival of 13.9 months versus 2.7 months for those treated with thrombosis and 5.2 months for the untreated group given best supportive care only (p = 0.01). CONCLUSIONS: SIR is safe in patients with HCC. Although SIR can be delivered with minimal morbidity, there might be no benefit for patients with VT. Continued emphasis on multimodality therapy in this population is needed to improve survival.
BACKGROUND: The goal of this study was to examine the safety and efficacy of selective internal radioembolization (SIR) for hepatocellular carcinoma (HCC) with portal vein or caval thrombosis (VT), or both. Recent reports have demonstrated that SIR is safe for patients with HCC, but the impact on efficacy of venous thrombosis is unknown. STUDY DESIGN: Prospective single-arm study of the use of Therasphere in patients with unresectable HCC enrolled from January 2004 to June 2007. Patients were categorized into three groups based on VT status and therapy. RESULTS: Fifty-two patients were enrolled: 20 patients without VT who received SIR, 15 patients with VT who were treated, and 17 patients (10 with VT) who were not treated because of preprocedure screening failure. Fifty-eight treatments were administered, with a median of two treatments per patient (range of one to three treatments). Child's score was different between groups. Of the VTpatients treated, 67% had portal VT, 7% had cava VT, and 26% had both. There were no treatment-related deaths. There was no difference in complications among groups (p = 0.34). Treated patients without thrombosis had a median overall survival of 13.9 months versus 2.7 months for those treated with thrombosis and 5.2 months for the untreated group given best supportive care only (p = 0.01). CONCLUSIONS: SIR is safe in patients with HCC. Although SIR can be delivered with minimal morbidity, there might be no benefit for patients with VT. Continued emphasis on multimodality therapy in this population is needed to improve survival.
Authors: A Bauschke; A Altendorf-Hofmann; M Freesmeyer; T Winkens; C Malessa; J-H Schierz; U Teichgraeber; U Settmacher Journal: Chirurg Date: 2016-11 Impact factor: 0.955
Authors: C Floridi; F Pesapane; S A Angileri; D De Palma; F Fontana; F Caspani; A Barile; A Del Sole; C Masciocchi; G Lucignani; G Carrafiello Journal: Med Oncol Date: 2017-09-05 Impact factor: 3.064
Authors: Al B Benson; Michael I D'Angelica; Daniel E Abbott; Thomas A Abrams; Steven R Alberts; Daniel Anaya Saenz; Chandrakanth Are; Daniel B Brown; Daniel T Chang; Anne M Covey; William Hawkins; Renuka Iyer; Rojymon Jacob; Andrea Karachristos; R Kate Kelley; Robin Kim; Manisha Palta; James O Park; Vaibhav Sahai; Tracey Schefter; Carl Schmidt; Jason K Sicklick; Gagandeep Singh; Davendra Sohal; Stacey Stein; G Gary Tian; Jean-Nicolas Vauthey; Alan P Venook; Andrew X Zhu; Karin G Hoffmann; Susan Darlow Journal: J Natl Compr Canc Netw Date: 2017-05 Impact factor: 11.908
Authors: Tyler D Fields; Prejesh Philips; Charles R Scoggins; Cliff Tatum; Lawrence Kelly; Kelly M McMasters; Robert C G Martin Journal: World J Surg Date: 2017-05 Impact factor: 3.352