Chemoembolization for Hepatocellular Carcinoma via the Inferior Pancreaticoduodenal Artery in Patients with Celiac Artery Stenosis

1993 ◽  
Vol 34 (1) ◽  
pp. 20-25 ◽  
Author(s):  
M. Okazaki ◽  
H. Higashihara ◽  
H. Ono ◽  
F. Koganemaru ◽  
R. Fujimitsu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Fluid Collection ◽  
Survival Rates ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Proper Hepatic Artery ◽  
Pancreaticoduodenal Artery ◽  
Group A ◽  
Group B

Twenty-one patients with hepatocellular carcinoma (HCC) accompanied by extensive celiac artery stenosis or obstruction were treated by chemoembolization via the inferior pancreaticoduodenal artery (IPDA). The tip of the catheter was placed in the arteries in front of the confluence with the proper hepatic artery in 12 patients (group A: the proximal portion of the IPDA in 10, and common hepatic artery in 2), and in the proper hepatic artery or branches of it (group B) in 9 using a coaxial catheter system. Transient hyperamylasemia was observed in 10 of the 12 patients in group A and in 3 of the 9 patients in group B after chemoembolization. Splenic infarction developed in 8 patients in group A and in none in group B. Intrapancreatic fluid collection was present in 2 patients in group A following chemoembolization. No fatal complications were encountered. The 1-, 2-, and 3-year survival rates of the 10 patients in group A treated by only chemoembolization were 90, 57, and 23%, respectively (mean survival 780 days). The 1- and 2-year survival rates of 9 patients in group B were 85.8 and 85.8% (mean 879 days), respectively. Considering the severity of complications and the survival rates in groups A and B, chemoembolization by superselective catheterization into the hepatic artery via the IPDA is the treatment of choice. However, chemoembolization from the arteries in front of the confluence with the proper hepatic artery seems to be acceptable in cases of hypervascular HCC which fail to be superselectively catheterized.

Chemoembolization for Hepatocellular Carcinoma via the Inferior Pancreaticoduodenal Artery in Patients with Celiac Artery Stenosis

1993 ◽  
Vol 34 (1) ◽  
pp. 20-25
Author(s):  
M. Okazaki ◽  
H. Higashihara ◽  
H. Ono ◽  
F. Koganemaru ◽  
R. Fujimitsu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Pancreaticoduodenal Artery

Chemoembolization for Hepatocellular Carcinoma via the Inferior Pancreaticoduodenal Artery in Patients with Celiac Artery Stenosis

1993 ◽  
Vol 34 (1) ◽  
pp. 20-25 ◽  
Author(s):  
M. Okazaki ◽  
H. Higashihara ◽  
H. Ono ◽  
F. Koganemaru ◽  
R. Fujimitsu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Celiac Artery ◽  
Artery Stenosis ◽  
Pancreaticoduodenal Artery

Is Noncurative Hepatic Resection Justified for Advanced Hepatocellular Carcinoma?

2018 ◽  
Vol 84 (12) ◽  
pp. 1938-1944 ◽  
Author(s):  
Seikan Hai ◽  
Etsuro Hatano ◽  
Toshihiro Okada ◽  
Naoki Uyama ◽  
Kazuhiro Suzumura ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Resection ◽  
Clinical Course ◽  
Survival Rates ◽  
Advanced Hepatocellular Carcinoma ◽  
Remnant Liver ◽  
Advanced Hcc ◽  
Group A ◽  
Group B ◽  
Group D

It has been obscure whether or not noncurative hepatic resection (Hx) has a favorable impact on the clinical course in patients with advanced hepatocellular carcinoma (HCC). The aim of this study is to clarify the significance of noncurative Hx for advanced HCC. Among 666 consecutive patients undergoing Hx for HCC in our department, 79 patients underwent noncurative Hx. These patients were classified as Group A (presence of macrovascular invasion [MVI]; n = 29), Group B (residual tumors in the remnant liver; n = 37), Group C (residual tumors in the remnant liver with MVI; n = 7), or Group D (residual tumors in the remnant liver with distant metastasis [with or without MVI]; n = 6). The three-year survival rates were 49.6 per cent in Group A, 30.3 per cent in Group B, 14.3 per cent in Group C, and 0.0 per cent in Group D, respectively (Groups A and B vs Group D, P < 0.05). Moreover, the survival rate was significantly higher in patients with ≤3 tumors than in those with ≥4 tumors ( P < 0.05), when Group B was divided into subgroups according to the number of residual tumors in the remnant liver. In conclusion, noncurative Hx might be acceptable for advanced HCC with MVI or ≤3 residual tumors in the remnant liver.

Survival trends in unresectable hepatocellular carcinoma and the effect of DEB-TACE: SEER versus tertiary cancer center.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 308-308
Author(s):  
Minzhi Xing ◽  
Hasmukh J. Prajapati ◽  
Nima Kokabi ◽  
Juan C. Camacho ◽  
Bassel F. El-Rayes ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Supportive Care ◽  
Survival Rates ◽  
Best Supportive Care ◽  
Term Survival ◽  
Long Term Survival ◽  
Unresectable Hepatocellular Carcinoma ◽  
Group A ◽  
Group B

308 Background: Long-term survival in patients with advanced unresectable hepatocellular carcinoma (HCC) treated with drug-eluting bead transarterial chemoembolization (DEB-TACE) vs. best supportive care has not been investigated in large-scale population studies. Methods: Under IRB approval, our institute’s cancer registry was queried for patients with advanced unresectable HCC diagnosed from Sept 2005 to Dec 2010, treated with DEB-TACE. Eighteen registries of the U.S. Surveillance, Epidemiology and End Results (SEER) database were queried for patients with advanced HCC not amenable to surgery/radiation diagnosed in the same time period. Baseline characteristics, median overall survival (OS) from HCC diagnosis and median OS from first DEB-TACE were stratified by national/state cohorts. Survival analysis and 95% confidence intervals (CI) were calculated using Kaplan-Meier estimation. Results: A total of 231 patients who underwent DEB-TACE for unresectable HCC (Group A) and 20,897 patients with unresectable HCC who received neither radiation nor cancer-directed surgery (Group B) were included. Both groups were similar for mean age at diagnosis, gender, race, bilobar disease, portal vein thrombosis and mean largest tumor size (p>0.05). Median OS from HCC diagnosis was 21.8 months (Group A; 95% CI, 18.1-25.4) and 4.0 months (Group B; 95% CI, 3.9-4.1), p<0.001. Median OS from first DEB-TACE was 15.0 months (Group A; 95% CI, 9.6-20.4). Interval survival rates from HCC diagnosis for Group A vs. B were: 99% vs. 65% (1 month), 92% vs. 49% (3 months), 75% vs. 36% (6 months), 58% vs. 35% (1 year), 36% vs. 9% (2 years), and 20% vs. 4% (3 years). Conclusions: DEB-TACE in patients with unresectable HCC demonstrated significantly greater median OS and favorable long-term survival rates compared to best supportive care in a population-based study. [Table: see text]

scholarly journals The Clinical Outcome in Patients with Peritoneal Metastasis

2020 ◽  
pp. 1-3
Author(s):  
Spiliotis J ◽  
◽  
Farmakis D ◽  
Raptis A ◽  
Kopanakis N ◽  
...  
Keyword(s):  
Systemic Chemotherapy ◽  
Treatment Options ◽  
Survival Rates ◽  
Peritoneal Metastases ◽  
Mortality And Morbidity ◽  
Chemotherapy Group ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Group D

Cytroreductive surgery (CRS) and HIPEC are controversial effective treatment options for selected patients with peritoneal metastases. We retrospectively examined 4.500 patients with peritoneal metastases from different tumors from 2005 to 2020. Patients were divided in 4 groups, surgery plus HIPEC and then systemic chemotherapy: Group A n=730, Group B n=700, R0 surgery plus systemic chemotherapy, Group C n=870, palliative surgery plus systemic chemotherapy and Group D n=2.200, palliative care and best support. The postoperative outcomes, morbidity, mortality were compared between the 4 groups. The mean survival rates Group A=24,4+10,2m, Group B= 18,4+6,3m, Group C=12,3+5,7m, Group D=5,8+2,3m (p<0.05 between Gr A vr Gr B). There was no statistically significant difference in the 30-day mortality and morbidity. In conclusion CRS + HIPEC are feasible in 16% of our patients with peritoneal metastases and are associated with pro-longed survival.

Mechanical ventricular support using pulsatile Abiomed BVS 5000 and centrifugal Biomedicus-pump in postcardiotomy shock

1994 ◽  
Vol 17 (9) ◽  
pp. 492-498 ◽  
Author(s):  
K. Minami ◽  
H. Posival ◽  
A. El-Bynayosy ◽  
M.M. Körner ◽  
H. Schrofel ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Survival Rates ◽  
Valve Surgery ◽  
Ventricular Assist Devices ◽  
Ventricular Assist ◽  
Postcardiotomy Shock ◽  
Group A ◽  
Group B ◽  
Long Term Survivors

Since we started using ventricular assist devices (VAD) in July 1987 up to August 1993, 63 of 15,650 (0.4%) patients (pts) who underwent open heart sugery were supported postoperatively by VAD at out institution. Forty-three were male and 20 female, mean age 55.5 years. In 49 pts coronary artery bypass grafting (CABG), in 8 pts valve surgery, in 3 pts combined CABG and valve surgery and in 3 pts corrective procedures for congenital heart disease were performed. Perioperative myocardial infarction was the most frequent indication (73%). In 37 of the 63 pts (58.7%) a centrifugal (Biomedicus pump (group A) was used and in 26 pts (41.3%) a pulsatile Abiomed BVS 5000 (group B). Fourteen of 37 pts (38%) in group A were weaned from the VAD and all of them were discharged. Twenty-three pts were unable to be weaned and 19 of these pts died. The remaining 4 pts were transplanted successfully and subsequently 3 died and 1 was discharged. In all, 15 pts (39%) were long-term survivors. Sixteen of 26 pts (62%) in group B were weaned from VAD and 13 (50%) of them were discharged of whom 3 died. Ten patients were unable to be weaned and 7 of these died. The remaining 3 pts were transplanted successfully. In all, 16 pts (61.5%) were long-term survivors. The shorter the interval between beginning resuscitation and application of VAD the better the outcome. Younger age, VAD installation in OR, support time between 2 and 7 days and Abiomed pump, influence the survival rate positively. Because of higher recovery and survival rates in patients assisted by Abiomed compared to the Biomedicus pump, we recommend the Abiomed pump in postcardiotomy cardiac failure.

scholarly journals Changes in Background Liver Function in Patients with Hepatocellular Carcinoma over 30 Years: Comparison of Child-Pugh Classification and Albumin Bilirubin Grade

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 518-528 ◽  
Author(s):  
Takashi Kumada ◽  
Hidenori Toyoda ◽  
Toshifumi Tada ◽  
Satoshi Yasuda ◽  
Junko Tanaka
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Hepatic Function ◽  
Hepatic Reserve ◽  
Significant Survival ◽  
Detailed Evaluation ◽  
Group A ◽  
Group B ◽  
Survival Differences ◽  
Group D

Background: Background liver function in patients with hepatocellular carcinoma (HCC) has improved remarkably with advances in various treatments. Recently, the Child-Pugh classification (CPC) system has been recognized as limited in its ability to assess patients with good hepatic reserve. We compared the albumin-bilirubin (ALBI) grade, which is suitable for a more detailed evaluation of patients with good liver function, with CPC over a 30-year period. Methods: A total of 2,347 patients were analyzed. Patients were stratified by year of diagnosis into 6 groups: Group A (1990–1994, n = 376), Group B (1995–1999, n = 434), Group C (2000–2004, n = 438), Group D (2005–2009, n = 444), Group E (2010–2014, n = 392), and Group F (2015–2018, n = 263). We compared ALBI grade and CPC across the groups. Results: The prevalence of patients with CPC A at diagnosis increased throughout the study period, reaching nearly 80% in Groups E and F (p < 0.001). By contrast, the percentage of patients with ALBI grade 1 disease remained approximately 50% in Groups E and F (p < 0.001). Modified ALBI (mALBI) grade 2a corresponds to patients with CPC A who have poor hepatic function. There were significant survival differences between patients with mALBI grade 1 versus 2a, 1 versus 2b, and 2a versus 2b disease, respectively (p < 0.0001), in patients with CPC A. Conclusions: CPC is not suitable for assessing patients with recently diagnosed HCC and good remnant hepatic function. In such patients with HCC, the prognosis can be stratified by ALBI grade rather than CPC.

scholarly journals Superior Mesenteric-Portal Vein Resection in Patients With Pancreatic Adenocarcinoma Is Safe and May Increase Survival

2017 ◽  
Vol 102 (7-8) ◽  
pp. 356-361
Author(s):  
Wei-Ding Wu ◽  
Hong-Guo Yang ◽  
Jia Wu ◽  
Kai Jiang ◽  
Kun Guo ◽  
...  
Keyword(s):  
Portal Vein ◽  
Pancreatic Adenocarcinoma ◽  
Survival Rates ◽  
Vein Wall ◽  
Venous Resection ◽  
Group A ◽  
Tumor Involvement ◽  
Artery First ◽  
Vein Resection ◽  
Group B

Extension of pancreatic adenocarcinoma into adjacent vasculature often necessitates resection of the portal vein (PV) and or superior mesenteric vein (SMV) during pancreaticoduodenectomy (PD). Our study describes the surgical technique and results of PV/SMV resection in pancreatic adenocarcinoma patients. Between January 2008 and October 2013, 252 patients underwent PD for pancreatic malignancy. A total of 42 PV/SMV resections were performed (28 men, 14 women). Patients were categorized into 2 groups according to the degree of invasion into the portal vein wall: Group A (n = 16), extended compression of the portal vein wall by the surrounding carcinoma without true invasion, and Group B (n = 26), true invasion including intramural and transmural invasion. Morbidity of the 42 patients was 35%; there was no operative mortality, and overall 1-, 3-, and 5-year survival rates were 60%, 21%, and 12%, respectively. No differences in tumor size, margin positivity, nodal positivity, or survival rates were observed between groups. Resection of the PV/SMV is safe and does not increase morbidity or mortality. Tumor involvement of the PV/SMV is not associated with histopathologic signs that are predictive of a poor prognosis. The “artery first” approach should be considered as a means to facilitate safe venous resection and reconstruction.

Cyberknife stereotactic radiosurgery in patients with primary hepatocellular carcinoma

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4645-4645
Author(s):  
K. Kang ◽  
B. Choi ◽  
H. Jang ◽  
S. Bae ◽  
M. Ryu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Stereotactic Radiosurgery ◽  
Complete Response ◽  
Treated Group ◽  
Target Volume ◽  
Primary Treatment ◽  
Primary Hepatocellular Carcinoma ◽  
Ulcer Bleeding ◽  
Group A ◽  
Group B

4645 Background: Conventional radiotherapy has historically played a limited role in the primary treatment of hepatocellular carcinoma (HCC). This study evaluated the effect of Cyberknife stereotactic radiosurgery (SRS) with for both for small primary non-resectable HCC, and for advanced HCC with portal vein tumor thrombosis (PVTT). Methods: From March 2004 to March 2005, thirty one patients with HCC were treated Cyberknife SRS was used for 32 lesions in patients with SRS for primary HCC. There was performed in 22 patients (23 lesions) with targeting to the primary HCC was treated (Group A), and in 9 patients with targeting to the PVTT was treated (Group B). The total SRS doses treated were 30–39 Gy (median, 36 Gy) to the 70–85%, 3 fractions and the target volume was of 3.6–57.3 cc (median, 25.2 cc). Results: The median follow up was 10.5 months. A complete response (CR) was achieved in 10 lesions, a partial response (PR) in 13 lesions, stable disease was noted in 6 lesions, and disease progression in 3 lesions. The response rate (CR+PR) was 71.9% (group A: 82.6%, group B: 44.4%). The level of serum alpha-fetoprotein after the treatment was decreased significantly in 17 patients (54.8%) (group A: 54.5%, group B: 55.5%). Complications were observed in 15 patients, among them, greater than grade 3 complication was observed in two patients of group A (gastric ulcer bleeding (1), liver necrosis (1)). Conclusions: These results suggest that Cyberknife SRS could be considered as an effective and safe treatment for primary HCC. For PVTT, Cyberknife SRS as the only curative tool, and produced acceptable local control in this study. No significant financial relationships to disclose.

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