scholarly journals Radioembolization for recurrent hepatocellular carcinoma after surgical resection: safety and long-term outcomes

2017 ◽  
Vol 28 (2) ◽  
pp. S121
Author(s):  
R Ali ◽  
A Riaz ◽  
A Gabr ◽  
N Abouchaleh ◽  
O Uddin ◽  
...  
2019 ◽  
Author(s):  
Valtteri Kairaluoma ◽  
Mira Karjalainen ◽  
Juha Saarnio ◽  
Jarmo Niemelä ◽  
Heikki Huhta ◽  
...  

Abstract Background Hepatocellular carcinoma (HCC) is one leading cause of cancer mortality often presenting at inoperable stage. The aim of this study was to examine and compare surgically resected, locally ablated, angiologically treated and palliatively treated HCC patients’ short- and long-term outcomes in a single center over 35 year period. Methods All HCC diagnosed in Oulu University Hospital between 1983-2018 were identified from hospital records (n=273). Patients underwent hepatic resection (n=49), local ablation (RF, laser ablation or PEI; n=25), angiological treatments (TACE, TAE and SIRT; n=48) or palliative treatment (chemotherapy, best supportive care; n=151). Primary outcomes of the study were postoperative complications within 30 days after the operation, and short- (30- and 90-day) and long-term (1, 3 and 5-year) survival. Results were adjusted with sex, age, comorbidities, cirrhosis, Child-Pugh index points, ASA status, year of operation and stage. Results Surgically resected patients were younger than patients in other groups. Recurrence and local recidives occurred more often in local ablation group and in angiological treatment group (p<0.001). Surgical resection rate was 17.9%. Overall complication rates in surgical resection, local ablation and angiological group were 71.5%, 32.0% and 58.3%, (p<0.001). Major complications in respective groups occurred in 28.6%, 8.0% and 27.1%. Overall survival rates in surgical resection group were at 30 and 90 days, 1-, 3 and 5-years 95.9%, 95.9%, 85.1%, 59.0% and 51.2%. In local ablation group, respective overall survival rates were 100.0%, 100.0%, 86.1%, 43.1% and 18.8%, and in angiological group 95.8%, 93.6%, 56.1%, 26.3% and 6.6%. In cox regression model adjusted for confounding factors, local ablation and angiological treatment were significant risk factors for mortality. Prognosis was poor in palliatively treated patients. Conclusions Based on our study on Northern Finland population, the surgical resection of HCC seems to be the most effective treatment considering long-term survival and tumor recurrence after adjustment for confounding factors.


BMC Cancer ◽  
2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jongmoo Park ◽  
Jinhong Jung ◽  
Daegeun Kim ◽  
In-Hye Jung ◽  
Jin-hong Park ◽  
...  

2020 ◽  
Vol 73 ◽  
pp. S397-S398
Author(s):  
Yun Bin Lee ◽  
Jeonghoon Lee ◽  
Hyo Young Lee ◽  
Cheol-Hyung Lee ◽  
Minseok Albert Kim ◽  
...  

2012 ◽  
Vol 36 (11) ◽  
pp. 2684-2691 ◽  
Author(s):  
Hadrien Tranchart ◽  
Mircea Chirica ◽  
Ailton Sepulveda ◽  
Pierre-Philippe Massault ◽  
Filomena Conti ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
Yoji Kishi ◽  
Kiyoshi Hasegawa ◽  
Yasuhiko Sugawara ◽  
Norihiro Kokudo

Currently, surgical resection is the treatment strategy offering the best long-term outcomes in patients with hepatocellular carcinoma (HCC). Especially for advanced HCC, surgical resection is the only strategy that is potentially curative, and the indications for surgical resection have expanded concomitantly with the technical advances in hepatectomy. A major problem is the high recurrence rate even after curative resection, especially in the remnant liver. Although repeat hepatectomy may prolong survival, the suitability may be limited due to multiple tumor recurrence or background liver cirrhosis. Multimodality approaches combining other local ablation or systemic therapy may help improve the prognosis. On the other hand, minimally invasive, or laparoscopic, hepatectomy has become popular over the last decade. Although the short-term safety and feasibility has been established, the long-term outcomes have not yet been adequately evaluated. Liver transplantation for HCC is also a possible option. Given the current situation of donor shortage, however, other local treatments should be considered as the first choice as long as liver function is maintained. Non-transplant treatment as a bridge to transplantation also helps in decreasing the risk of tumor progression or death during the waiting period. The optimal timing for transplantation after HCC recurrence remains to be investigated.


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