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

Vogl, Thomas J.; Nour-Eldin, Nour-Eldin A.; Emad‐Eldin, Sally; Naguib, N; Trojan, Jörg; Ackermann, H.; Abdelaziz, Omar

doi:10.3748/wjg.v17.i10.1267

Cited by 27 publications

(19 citation statements)

References 31 publications

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“…Last, arterioportal shunts have been commonly observed in association with HCC, likely related to tumor vascular invasion [31, 32]. Vogl et al [33] reported a significantly increased rate of progression after TACE by MRI volumetric measurements compared with patients without arterioportal shunting.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of TACE in TIPS Patients: Comparison of Treatment Response to Chemoembolization for Hepatocellular Carcinoma in Patients With and Without a Transjugular Intrahepatic Portosystemic Shunt

Kuo

Kohi

Naeger

et al. 2013

Cardiovasc Intervent Radiol

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Purpose To compare treatment response after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in patients with and without a transjugular intrahepatic portosystemic shunt (TIPS). Materials and Methods A retrospective review of patients who underwent conventional TACE for HCC between January 2005 and December 2009 identified 10 patients with patent TIPS. From the same time period, 23 patients without TIPS were selected to control for comparable Model for End-Stage Liver Disease and Child–Pugh–Turcotte scores. The two groups showed similar distribution of Barcelona Clinic Liver Cancer and United Network of Organ Sharing stages. Target HCC lesions were evaluated according to the modified response evaluation criteria in solid tumors (mRECIST) guidelines. Transplantation rate, time to tumor progression, and overall survival (OS) were documented. Results After TACE, the rate of complete response was significantly greater in non-TIPS patients compared with TIPS patients (74 vs. 30 %, p = 0.03). Objective response rate (complete and partial response) trended greater in the non-TIPS group (83 vs. 50 %, p = 0.09). The liver transplantation rate was 80 and 74 % in the TIPS and non-TIPS groups, respectively (p = 1.0). Time to tumor progression was similar (p = 0.47) between the two groups. OS favored the non-TIPS group (p = 0.01) when censored for liver transplantation. Conclusion TACE is less effective in achieving complete or partial response using mRECIST criteria in TIPS patients compared with those without a TIPS. Nevertheless, similar clinical outcomes may be achieved, particularly in TIPS patients who are liver-transplantation candidates.

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Section: Discussionmentioning

confidence: 99%

Efficacy of TACE in TIPS Patients: Comparison of Treatment Response to Chemoembolization for Hepatocellular Carcinoma in Patients With and Without a Transjugular Intrahepatic Portosystemic Shunt

Kuo

Kohi

Naeger

et al. 2013

Cardiovasc Intervent Radiol

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“…Whether or not vascular resection of the portal vein bifurcation is necessary remains debated [70,71]. It has been shown that preoperative TACE could improve long-term outcome in patients with portal involvement [72,73].…”

Section: Assessment Of Liver Functionmentioning

confidence: 99%

HCC: current surgical treatment concepts

Cauchy

Fuks

Belghiti

2012

Langenbecks Arch Surg

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“…TARE with its microembolic properties has been favored for the treatment of HCC with PVTT. TACE can also be performed safely for palliative tumor control in patients with advanced HCC with portal vein thrombosis [ 97 ] .…”

Section: Treatment Options In Hccmentioning

confidence: 99%

Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring

2012

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Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Imaging is important for establishing a diagnosis of HCC. Several imaging modalities including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and angiography are used in evaluating patients with chronic liver disease and suspected HCC. CT, MRI and contrast-enhanced US have replaced biopsy for diagnosis of HCC. Dynamic multiphase contrast-enhanced CT or MRI is the current standard for imaging diagnosis of HCC. Functional imaging techniques such as perfusion CT and diffusion-weighted MRI provide additional information about tumor angiogenesis that may be useful for treatment. Techniques evaluating tissue mechanical properties such as magnetic resonance elastography, and acoustic radiation force impulse imaging are being explored for characterizing liver lesions. The role of PET in the evaluation of HCC is evolving with promise seen especially with the use of a hepatocyte-specific PET tracer. Imaging is also critical for assessment of treatment response and detection of recurrence following locoregional treatment. Knowledge of the post-treatment appearance of HCC is essential for correct interpretation. This review article provides an overview of the role of imaging in the diagnosis, staging and post-treatment follow-up of HCC.

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

Abstract: 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.

Cited by 27 publications

References 31 publications

Efficacy of TACE in TIPS Patients: Comparison of Treatment Response to Chemoembolization for Hepatocellular Carcinoma in Patients With and Without a Transjugular Intrahepatic Portosystemic Shunt

Efficacy of TACE in TIPS Patients: Comparison of Treatment Response to Chemoembolization for Hepatocellular Carcinoma in Patients With and Without a Transjugular Intrahepatic Portosystemic Shunt

HCC: current surgical treatment concepts

Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring

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