scholarly journals Selective Arterial Embolization of Liver Metastases from Gastrinomas: A Single-Centre Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Anneke P. J. Jilesen ◽  
Heinz Josef Klümpen ◽  
Olivier R. C. Busch ◽  
T. M. van Gulik ◽  
Krijn P. van Lienden ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Treatment Strategies ◽  
Arterial Embolization ◽  
Individual Treatment ◽  
Single Centre Experience ◽  
Radiological Response ◽  
Liver Embolization ◽  
Postembolization Syndrome ◽  
Prospective Database

Background. Gastrinomas are rare functional neuroendocrine tumors causing the Zollinger-Ellison syndrome (ZES). At presentation, up to 25% of gastrinomas are metastasized, predominantly to the liver. Embolization of liver metastases might reduce symptoms of ZES although a postembolization syndrome can occur. In this study, the results of embolization are presented, and the literature results are described. Methods. From a prospective database of pancreatic neuroendocrine tumors, all patients with liver metastatic gastrinomas were selected if treated with arterial embolization. Primary outcome parameters were symptom reduction, complications, and response rate. The literature search was performed with these items. Results. Three patients were identified; two presented with synchronous liver metastases. All the three patients had symptoms of ZES before embolization. Postembolization syndrome occurred in two patients. Six months after embolization, all the 3 patients had a clinical and complete radiological response; a biochemical response was seen in 2/3 patients. From the literature, only a small number of gastrinoma patients treated with liver embolization for liver metastases were found, and similar results were described. Conclusion. Selective liver embolization is an effective and safe therapy for the treatment of liver metastatic gastrinomas in the reduction of ZES. Individual treatment strategies must be made for the optimal success rate.

scholarly journals Hepatic Arterial Embolization for the Treatment of Metastatic Neuroendocrine Tumors

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Eric Lee ◽  
H. Leon Pachter ◽  
Umut Sarpel
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Survival Rates ◽  
Arterial Embolization ◽  
Progression Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Hepatic Arterial Embolization

Neuroendocrine tumors (NETs) have a high predilection for metastasizing to the liver and can cause severe debilitating symptoms adversely affecting quality of life. Although surgery remains the treatment of choice, many liver metastases are inoperable at presentation. Hepatic arterial embolization procedures take advantage of the arterial supply of NET metastases. The goals of these therapies are twofold: to increase overall survival by stabilizing tumor growth, and to reduce the morbidity in symptomatic patients. Patients treated with hepatic arterial embolization demonstrate longer progression-free survival and have 5-year survival rates of nearly 30%. The safety of repeat embolizations has also been proven in the setting of recurrent symptoms or progression of the disease. Despite not being curative, hepatic arterial embolization should be used in the management of NETs with liver metastases. Long-term survival is not uncommon, making aggressive palliation of symptoms an important component of treatment.

scholarly journals Hepatic Arterial Embolization Versus Chemoembolization in Patients With Liver Metastases of a Digestive Neuroendocrine Tumors

2011 ◽  
Vol 140 (5) ◽  
pp. S-875
Author(s):  
Frédérique Maire ◽  
Catherine Lombard-Bohas ◽  
Dermot O'Toole ◽  
Marie-Pierre Vullierme ◽  
Vinciane Rebours ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Arterial Embolization ◽  
Hepatic Arterial Embolization

Tumor necrosis of primary malignancy affects survival and outcome in patients with liver metastases from neuroendocrine tumors

2018 ◽  
Vol 56 (01) ◽  
pp. E2-E89
Author(s):  
G Atanasov ◽  
I Tsvetkova ◽  
S Benjamin ◽  
A Andreou ◽  
F Klein ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Tumor Necrosis ◽  
Primary Malignancy

scholarly journals Political Culture and Treatment Strategies in the Nordic Countries

1996 ◽  
Vol 13 (5-6) ◽  
pp. 240-252
Author(s):  
Jan E. Grindheim
Keyword(s):  
Cultural Theory ◽  
Nordic Country ◽  
Methadone Treatment ◽  
Group Analysis ◽  
Treatment Strategies ◽  
Nordic Countries ◽  
Individual Treatment ◽  
Heroin Addicts ◽  
Set Up ◽  
Strong Control

Taking as a point of departure Mary Douglas' grid-group analysis, elaborated on by Aaron Wildavsky in his cultural theory, the article explores the variations in the development of methadone treatment programmes in the Nordic countries from the mid-1960's to the mid-1990's. In Sweden, the first Nordic country to start an organized treatment of heroin addicts with methadone in 1966, the strategy has been characterized by many rules and strong control. In Denmark, methadone treatment was introduced in the late 1960's, and it has been characterized by few rules and weak control. In Norway, methadone treatment was banned in 1979, after some years of occasional experiments. But the spread of HIV among intravenous heroin addicts altered the attitudes and a small and highly regulated program was set up in the beginnings of the 1990's. In Finland, the attitude has been reserved, primarily due to the small population of heroin addicts. The organized treatment in the 1970's was limited, and still is, as it was set up again in 1995. In spite of the differences, however, there are two main patterns of harmonization that should be noticed. Firstly, as a result of HIV, regulated programmes have been developed in all four countries in the 1990's. Secondly, the prevailing abstinence-oriented philosophy has been questioned and supplemented by harm-reducing measures. Today, there is a stronger tendency to treat drug addicts as clients in the Nordic welfare state, entitled to individual treatment in the countries' general health and welfare systems.

scholarly journals Selective Arterial Embolization of Renal Angiomyolipomas with a N-Butyl Cyanoacrylate-Lipiodol Mixture: Efficacy, Safety, Short- and Mid-Term Outcomes

2021 ◽  
Vol 10 (18) ◽  
pp. 4062
Author(s):  
François-Victor Prigent ◽  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
Julie Pellegrinelli ◽  
Nicolas Falvo ◽  
...  
Keyword(s):  
Arterial Embolization ◽  
Volume Reduction ◽  
Renal Angiomyolipoma ◽  
Cyanoacrylate Glue ◽  
Selective Arterial Embolization ◽  
Before And After ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Postembolization Syndrome

Selective arterial embolization (SAE) for renal angiomyolipoma (rAML) is effective to treat or prevent bleeding. We report our experience using a cyanoacrylate–Lipiodol mixture. We performed a single-center retrospective review of all rAMLs embolized with cyanoacrylate glue between July 2014 and June 2020. Demographics, tuberous sclerosis complex (TSC) status, clinical presentation, angiography features, and follow-up data were recorded. Pre- and post-procedure rAML sizes and volumes were estimated from computed tomography (CT) or magnetic resonance imaging (MRI) studies. Kidney function was assessed before and after the procedure. We identified 24 patients (22 females and 2 males, mean age 51 years) treated for 27 AMLs, either prophylactically (n = 20) or as an emergency (n = 4). Technical success was achieved for 25/27 AMLs; two patients, each with a single AML, required nephrectomy and repeated embolization, respectively. Major complications occurred in three patients and minor complications such as postembolization syndrome in 15 patients. AML volume reduction after embolization was 55.1% after a mean follow-up of 15 months (range, 1–72 months). Factors associated with greater volume reduction were a smaller percentage of fat (p = 0.001), larger initial rAML volume (p = 0.014), and longer follow-up (p = 0.0001). The mean creatinine level did not change after SAE. Embolization of rAMLs with a mixture of cyanoacrylate and Lipiodol is feasible, safe, and effective in significantly decreasing tumor volume.

scholarly journals Expression of the phosphorylated variant of the AKT1-kinase (p-AKT1) in well-differentiated pancreatic neuroendocrine tumors: immunohistochemical evaluation

2018 ◽  
Vol 46 (4) ◽  
pp. 314-322
Author(s):  
V. V. Delektorskaya ◽  
O. N. Solov'eva ◽  
G. Yu. Chemeris ◽  
Yu. I. Patyutko
Keyword(s):  
Liver Metastases ◽  
Neuroendocrine Tumors ◽  
Treatment Effectiveness ◽  
Disease Free Survival ◽  
Immunohistochemical Analysis ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ki 67 ◽  
New Treatment ◽  
Well Differentiated ◽  
High Level

Background:Well-differentiated pancreatic neuroendocrine tumors (pNETs) represent a group of rare epithelial neoplasms with a highly variable clinical course. AKT1 is one of the most frequently activated protein kinases in pNETs, which promotes the tumor growth and is of interest as a prognostic factor and a target for new treatment approaches.Aim:To study the expression of the phosphorylated variant of AKT1-kinase (p-AKT1) in primary pNETs and their liver metastases and to correlate the results with various clinical and pathological parameters and the disease prognosis.Materials and methods:P-AKT1 expression was studied by the immunohistochemical analysis of the primary lesions and liver metastases in 52 pNETs patients.Results:A high level of cytoplasmic and/or nuclear immunoreactivity was detected in 24/52 of the primary pNETs (46.2%) and in 16/27 of their liver metastases (59.3%). p-AKT1 expression was observed in 3 (21.4%) of NET grade (G) 1, in 14 (46.7%) of NET G2, and in 7 (87.5%) of NET G3. p-AKT1 expression was more frequently identified in pNET G3 category and increased during the tumor progression in metachronous liver metastases, as compared to the corresponding primary tumor. In addition, p-AKT1 positivity was significantly associated with an increase of grade from G1 to G3 (p = 0.004), the Ki-67 index (p = 0.029), the pTNM stage (p = 0.0008), perineural invasion (p = 0.031) and a decrease in disease-free survival (p = 0.05).Conclusion:The results suggest that p-АКТ1 plays an important role in the pathogenesis of pNETs and may be an additional criterion for assessment of the prognosis and treatment effectiveness in this type of tumors.

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