Portal vein thrombosis and arterioportal shunts : effects on tumor response after chemoembolization of hepatocellular carcinoma

AIM: To evaluate the effect of portal vein thrombosis and arterioportal shunts on local tumor response in advanced cases of unresectable hepatocellular carcinoma treated by transarterial chemoembolization.
METHODS: A re
AIM: To evaluate the effect of portal vein thrombosis and arterioportal shunts on local tumor response in advanced cases of unresectable hepatocellular carcinoma treated by transarterial chemoembolization.
METHODS: A retrospective study included 39 patients (mean age: 66.4 years, range: 45-79 years, SD: 7) with unresectable hepatocellular carcinoma (HCC) who were treated with repetitive transarterial chemoembolization (TACE) in the period between March 2006 and October 2009. The effect of portal vein thrombosis (PVT) (in 19 out of 39 patients), the presence of arterioportal shunt (APS) (in 7 out of 39), the underlying liver pathology, Child-Pugh score, initial tumor volume, number of tumors and tumor margin definition on imaging were correlated with the local tumor response after TACE. The initial and end therapy local tumor responses were evaluated according to the response evaluation criteria in solid tumors (RECIST) and magnetic resonance imaging volumetric measurements.
RESULTS: The treatment protocols were well tolerated by all patients with no major complications. Local tumor response for all patients according to RECIST criteria were partial response in one patient (2.6%), stable disease in 34 patients (87.1%), and progressive disease in 4 patients (10.2%). The MR volumetric measurements showed that the PVT, APS, underlying liver pathology and tumor margin definition were statistically significant prognostic factors for the local tumor response (P = 0.018, P = 0.008, P = 0.034 and P = 0.001, respectively). The overall 6-, 12- and 18-mo survival rates from the initial TACE were 79.5%, 37.5% and 21%, respectively.
CONCLUSION: TACE may be exploited safely for palliative tumor control in patients with advanced unresectable HCC; however, tumor response is significantly affected by the presence or absence of PVT and APS.
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Metadaten
Author:Thomas J. Vogl, Nour-Eldin Abdelrehim Nour-Eldin Mohammed, Sally Emad-Eldin, Nagy Naguib Naeem Naguib, Jörg Trojan, Hans Ackermann, Omar Abdelaziz
URN:urn:nbn:de:hebis:30:3-311757
DOI:http://dx.doi.org/10.3748/wjg.v17.i10.1267
ISSN:2219-2840
ISSN:1007-9327
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=21455325
Parent Title (English):World journal of gastroenterology : WJG
Publisher:WJG Press
Place of publication:Beijing
Document Type:Article
Language:English
Date of Publication (online):2011/03/04
Date of first Publication:2011/03/04
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2013/08/26
Tag:Hepatocellular carcinoma; Portal; Shunt; Thrombosis; Transarterial chemoembolization
Volume:17
Issue:10
Pagenumber:9
First Page:1267
Last Page:1275
Note:
WJG is an international, peer-reviewed, Open-Access, online journal. Articles published by this journal are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license.
HeBIS PPN:352173734
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell 2.0

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