Arterial chemotherapy and transcatheter arterial embolization therapy for non-resectable hepatocellular carcinoma

Hirai, Kenji; Kawazoe, Y; Yamashita, Ken; Aoki, Yosuke; Fujimoto, Takafumi; Sakai, Terufumi; Matsumoto, Yasuo; Abe, Masahide; Tanikawa, Kyuichi

doi:10.1007/bf00647237

Cited by 39 publications

(34 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is evidence that TACE is the preferred method to arrest tumor bleeding [13,[28][29][30][31][32][33][34] . Besides, two-stage hepatectomy is advisable because it can prolong the survival of selected patients [35][36][37][38][39][40] . Figure 4 is the logarithm about how to approach the patients with spontaneous ruptured HCC [35][36][37][38][39][40] .…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Hung

Wu²,

Lee³

et al. 2008

WJG

View full text Add to dashboard Cite

INTRODUCTIONHepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. It is usually manifested in the 6th and 7th decades of life. Extrahepatic metastases are seen in 64% of patients with HCC. The most frequent sites of extrahepatic metastases are lung, abdominal lymph node and bone, but peritoneal dissemination is unusual [1,2] . The incidence of spontaneous rupture of HCC is about 8%-26% in Asia [3][4][5] and the mortality rate of HCC patients is 10% [6] . However, peritoneal metastasis of HCC after spontaneous rupture is seldom noted. Here, we report a case of intraperitoneal metastasis of HCC after spontaneous rupture 10 mo ago, which was treated with transarterial embolization. CASE REPORTA previously asymptomatic 72-year-old man had a history of chronic hepatitis C-related liver cirrhosis without regular follow-up. Sudden nausea and vomiting with watery diarrhea were noted on January 2006. Then he was sent to Yun-Lin Branch of National Taiwan University Hospital for help. Abdominal computer tomography (CT) scan showed a huge HCC that was suspicious of rupture. Under the request of his family, he was transferred to our hospital and transarterial embolization was performed on January 31, 2006. After discharge, he was regularly followed up at our Gastrointestinal (GI) Outpatient Department (OPD). Dull abdominal pain over the right upper quadrant area, accompanied with fullness sensation, was noted in November 2006. Besides, he also had body weight loss of about ten kilograms in one year. So he visited our hospital again. Abdominal CT scan revealed a peritoneal mass in the right upper quadrant peritoneal area and hepatoma recurrence was considered ( Figure 1). Transarterial embolization was arranged again, but failed. After consultation with the surgeon, he was admitted for surgical resection.Surgical intervention was arranged on January 24, 2007. Operative methods were segmental hepatectomy (S6 and partial S5), excision of extrahepatic tumor, and cholecystectomy. The operation showed a huge tumor (12 cm × 8 cm × 6 cm) over the right upper quadrant area just below liver parenchyma (Figure 2) with its blood supplied from the omentum. Besides, two small mass lesions (3 cm × 2 cm and 2 cm × 1 cm) were found over AbstractRupture of hepatocellular carcinoma (HCC) is a lifethreatening complication. Peritoneal metastasis of HCC after spontaneous rupture was seldom noted. We report a case of intraperitoneal metastasis of HCC after spontaneous rupture. A previously asymptomatic 72-yearold man was admitted due to dull abdominal pain with abdominal fullness. He had a history of HCC rupture 10 mo ago and transarterial embolization was performed at that time. Abdominal computer tomography (CT) scan showed a huge peritoneal mass over the right upper quadrant area. Surgical resection was arranged and subsequent microscopic examination confirmed a diagnosis of moderately-differentiated HCC.

show abstract

Section: Discussionmentioning

confidence: 99%

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Hung

Wu²,

Lee³

et al. 2008

WJG

View full text Add to dashboard Cite

show abstract

“…The variation in clinical presentations poses a challenge to clinicians in diagnosis and management. Various treatment options have been proposed, which include conservative treatment, 5 transarterial embolization (TAE), [6][7][8][9][10][11] different methods of operative hemostasis, 12,13 and emergency liver resection.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to the poor result of surgical treatment, TAE was enthusiastically attempted but most of the reported series were small and the selection criteria used were uncertain. [6][7][8][9][10][11] Okazaki et al 9 described a larger series of patients in which the 1-month mortality in patients with a total bilirubin level of less than 51.3 µmol/L (3.0 mg/dL) was 8.3% but was 86% in those with higher bilirubin levels. Chen et al 14 suggested immediate hepatectomy with an in-hospital mortality of 4.3% and a 5-year survival rate of 26.5%.…”

Section: Methodsmentioning

confidence: 99%

Spontaneous Rupture of Hepatocellular Carcinoma

Leung

Lau²,

Lai³

et al. 1999

Arch Surg

View full text Add to dashboard Cite

“…The overall probability of survival in the treated group was 64, 38, 27. and 27% at 1,2, 3, and 4 years, respective ly; that in the untreated group was 18, 6, and 5% at 1.2, and 3 years, respectively (p < 0.0001). A significant survial benefit of TACE was seen when compared with hepatic arterial chemotherapy [100,121 ] or systemic che motherapy [100]. Most reports are retrospective analyses, and comparisons between the numerous trials arc diffi cult to make because the disease is characterized by geo graphical variation in its natural history.…”

Section: Hepatocellular Carcinom a (Hcc)mentioning

confidence: 99%

Regional Chemotherapy of Gastro-Intestinal Cancer

Maurer¹,

Borner

Büchler³

1997

Dig Surg

View full text Add to dashboard Cite

Despite exciting progress in the understanding of advanced gastro-intestinal cancer, the prognosis of these diseases is still poor because of limited treatment options. Curative surgery is often not possible or worthwhile due to tumour spread. Systemic chemotherapy typically shows low response rates of short duration, and a potential palliative benefit is limited by systemic toxicity. This problem could be circumvented by local chemotherapy administration, and this review will summarize the actual role of regional intra-arterial chemotherapy in the treatment of advanced gastro-intestinal cancer. Due to its beneficial effect on survival and quality of life, hepatic artery infusion chemotherapy is a viable option for the treatment of non-resectable metastases confined to the liver from colorectal cancer. Regional chemotherapy for locally or regionally advanced or recurrent cancer of stomach, pancreas, or rectum must still be regarded as an experimental treatment with sometimes impressive pain relief. When systemic chemotherapy and radiotherapy have failed in non-resectable (recurrent) rectal cancer, regional chemotherapy via internal iliac arteries may provide satisfactory palliation. The response rates of intra-arterial chemotherapy in gastro-intestinal cancer are better than, or at least as good as, those of all other palliative treatment modalities. In terms of survival, besides one controlled trial showing better survival after liver infusion, the role of regional chemotherapy needs to be further evaluated.

show abstract

Arterial chemotherapy and transcatheter arterial embolization therapy for non-resectable hepatocellular carcinoma

Cited by 39 publications

References 10 publications

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Spontaneous Rupture of Hepatocellular Carcinoma

Regional Chemotherapy of Gastro-Intestinal Cancer

Contact Info

Product

Resources

About