Adjuvant arterial infusion chemotherapy after resection of hepatocellular carcinoma with portal thrombosis: a pilot study

Niguma, Takefumi; Mimura, Tetusige; Tutui, N.

doi:10.1007/s00534-004-0969-5

Cited by 21 publications

(25 citation statements)

References 30 publications

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“…Furthermore, adjuvant chemotherapy or TACE after operation can significantly improve the prognosis of HCC patients with PVTT [16,24,[34][35][36]. Therefore, postoperative adjuvant therapy is necessary for HCC patients with PVTT.…”

Section: Discussionmentioning

confidence: 98%

Clinicopathologic Characteristics and Surgical Outcomes of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Chen

Wang

Chen

et al. 2012

Journal of Surgical Research

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Section: Discussionmentioning

confidence: 98%

Clinicopathologic Characteristics and Surgical Outcomes of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Chen

Wang

Chen

et al. 2012

Journal of Surgical Research

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“…The significant difference in OS duration suggests that survival can be prolonged in some patients by widening the surgical margins and removing the thrombus and tumor en bloc. Further, adjuvant treatment, such as TACE and TAI, after the operation could also significantly improve the prognosis of HCC patients with PVTT/HVTT [42,43]. A better surgical strategy could decrease portal vein pressure and reduce the tumor burden, thus improving liver function, creating conditions for further adjuvant therapy, and producing longer survival [16,44].…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for Hepatocellular Carcinoma Patients with Portal/Hepatic Vein Tumor Thrombosis

Wang

Sun

et al. 2015

PLoS ONE

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BackgroundPortal/hepatic vein tumor thrombosis (PVTT/HVTT) in hepatocellular carcinoma (HCC) is a sign of advanced stage disease and is associated with poor prognosis. This study investigated the surgical outcomes of patients with HCC and PVTT/HVTT to determine the most appropriate surgical treatment strategy for these patients.Materials and MethodsThe study population included 77 HCC patients from January 2004 to June 2009 who underwent hepatectomy in our department and were diagnosed with PVTT/HVTT based on pathological examination. The patients were divided into two groups: in group 1, PVTT/HVTT was located in the hepatic resection area and removed with the tumor en bloc (38 cases); in group 2, PVTT/HVTT was beyond the resection line and removed by suction or thrombectomy (39 cases). Concerning the factor of surgical margins, the patients were further divided into four subgroups: group 1A: patients in group 1 with surgical margins ≤1 cm (28 cases); group 1B: patients in group 1 with surgical margins >1 cm (9 cases); group 2A: patients in group 2 with surgical margins ≤1 cm (28 cases); and group 2B: patients in group 2 with surgical margins >1 cm (9 cases).ResultsMost of the characteristics of groups 1 and 2 were similar. Patients in group 2 had significantly higher median blood loss (p=0.002) and higher blood transfusion rate (p=0.002) during the operation, which were not considered prognostic factors (p=0.323 and 0.571, respectively). The median overall survival (OS) duration in group 1 was significantly longer than that in group 2 (14.3 vs. 10.4 months, p=0.047). The median OS durations in groups 1A, 1B, 2A, and 2B were 14.3, 42.7, 7.5, and 18.0 months, respectively, which were significantly different(p=0.018).ConclusionsWhen PVTT/HVTT is located in the hepatic resection area and removed with the tumor en bloc, the median OS duration is longer. Based on this finding, widening the surgical margins when technically possible may increase OS.

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“…Sorafenib is contraindicated in patients with the exceptions of Child–Pugh score of 5–6, grade A or with brain metastases [2]. In contrast, TOCE and TAC can be provided over a broad range of cases as these are performed without arterial embolization and their efficacy has been reported [5,13-15,26]. Among various chemotherapeutic agents such as epirubicin [15] and mitomycin C [5], which carry a 15%–20% response rate, platinum agents appear to be the most promising as CDDP-TAC achieved a response rate of 33.8% in a multicentre phase II study enrolling unresectable HCC cases [13].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the first-pass kinetics [25] of CDDP by TAC contribute to the anti-tumor effect and decrease the adverse systemic events [5]. Since highly concentrated CDDP powder for TAC (DDP-H, IA-call ® ; Nippon Kayaku Co., Ltd) is available in Japan, TAC is now widely used in Japan to treat multiple small tumours or patients with poor hepatic reserve [5,13,26]. …”

Section: Introductionmentioning

confidence: 99%

Phase I study of miriplatin combined with transarterial chemotherapy using CDDP powder in patients with hepatocellular carcinoma

et al. 2012

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BackgroundThere is no standard therapeutic procedure for the hepatocellular carcinoma (HCC) in patients with poor hepatic reserve function. With the approval of newly developed chemotherapeutic agent of miriplatin, we have firstly conducted the phase I study of CDDP powder (DDP-H) and miriplatin combination therapy and reported its safety and efficacy for treating unresectable HCC in such cases. To determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) for the combination of transarterial oily chemoembolization (TOCE) and transarterial chemotherapy (TAC) using miriplatin and DDP-H for treating unresectable hepatocellular carcinoma (HCC).MethodsTransarterial chemotherapy using DDP-H was performed through the proper hepatic artery targeting the HCC nodules by increasing the dose of DDP-H (35–65 mg/m2) followed by targeting the HCC nodules by transarterial oily chemoembolization with miriplatin.ResultsA total of nine patients were enrolled in this study and no DLT was observed with any dose of DDP-H in all cases in whom 80 mg (median, 18–120) miriplatin was administered. An anti-tumour efficacy rating for partial response was obtained in one patient, while a total of four patients (among eight evaluated) showed stable disease response, leading to 62.5% of disease control rate. The pharmacokinetic results showed no further increase in plasma platinum concentration following miriplatin administration.ConclusionOur results suggest that a combination of DDP-H and miriplatin can be safely administered up to their respective MTD for treating HCC.Trial registrationThis study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR000003541).

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Adjuvant arterial infusion chemotherapy after resection of hepatocellular carcinoma with portal thrombosis: a pilot study

Abstract: This chemotherapeutic regimen achieved favorable results and may be useful as adjuvant chemotherapy in treating patients after curative resection of HCC with mPVTT.

Cited by 21 publications

References 30 publications

Clinicopathologic Characteristics and Surgical Outcomes of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Clinicopathologic Characteristics and Surgical Outcomes of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Surgical Strategy for Hepatocellular Carcinoma Patients with Portal/Hepatic Vein Tumor Thrombosis

Phase I study of miriplatin combined with transarterial chemotherapy using CDDP powder in patients with hepatocellular carcinoma

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