scholarly journals Multidisciplinary treatment of advanced hepatocellular carcinoma with severe arterioportal shunt: a case report

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110248
Author(s):  
Yao-chang Luo ◽  
Hai-lin Lu ◽  
Wen-ling Song ◽  
Fei-fei Xuan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multidisciplinary Approach ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Advanced Hepatocellular Carcinoma ◽  
Term Survival ◽  
Arterioportal Shunt ◽  
Advanced Stages ◽  
Interventional Radiology Procedures

Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality globally. In addition, most patients present in advanced stages with limited curative treatment options. Therefore, multidisciplinary treatment is often warranted. Here, we report a patient with HCC and severe arterioportal shunt (APS) who was treated with a multidisciplinary approach comprising interventional radiology procedures, apatinib and camrelizumab. After treatment, the intrahepatic mass was stable, and a notable decrease in the number and size of lung lesions was observed. The patient achieved a long-term survival of more than 2 years. These data suggest that multidisciplinary treatments may be effective in the treatment of advanced HCC with severe APS.

scholarly journals Multidisciplinary Treatment of Advanced Hepatocellular Carcinoma With Severe Arterioportal Shunt: A Case Report.

2021 ◽  
Author(s):  
yao-chang luo ◽  
hai-lin lu ◽  
wen-ling song ◽  
Fei-fei Xuan
Keyword(s):  
Hepatocellular Carcinoma ◽  
Target Therapy ◽  
Treatment Options ◽  
Multidisciplinary Treatment ◽  
Stable Condition ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterioportal Shunt ◽  
Long Time ◽  
Intrahepatic Portosystemic Shunt ◽  
Hepatic Lesions

Abstract Hepatocellular carcinoma (HCC) is the fourth most lethal malignancy globally. However, most patients present in advanced stages with limited curative treatment options. Therefore, multidisciplinary treatment is often warranted. Here we report a patient with HCC combined with severe arterioportal shunt (APS) who was treated with multidisciplinary approach, comprising interventional radiology procedures, apatinib and camrelizumab. A 31-year-old man who presented to our hospital because of hematemesis caused by HCC with a severe APS. The patient underwent multidisciplinary treatment including transjugular intrahepatic portosystemic shunt, transarterial chemoembolization of arterial branches feeding the shunt and hepatic lesions and subsequent molecular target therapy combined with immunotherapy. After treatment, stable condition of intrahepatic mass and a notable decrease in the number and size of the lung lesions were observed. The patient achieved a long-time survival of more than 2 years. This data suggests that multidisciplinary treatments may be efficacious in the treatment of advanced HCC with severe APS.

New advances in the diagnosis and management of hepatocellular carcinoma

BMJ ◽  
2020 ◽  
pp. m3544 ◽  
Author(s):  
Ju Dong Yang ◽  
Julie K Heimbach
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systemic Treatment ◽  
Early Stage ◽  
Treatment Options ◽  
Intermediate Stage ◽  
Phase Iii ◽  
Advanced Hepatocellular Carcinoma ◽  
Long Term Outcomes ◽  
Stage Disease

ABSTRACT Hepatocellular carcinoma is one of the leading causes of cancer related death in the world. Biannual surveillance for the disease in patients with cirrhosis and in high risk carriers of hepatitis B virus allows early stage cancer detection and treatment with good long term outcomes. Liver ultrasonography and serum α fetoprotein are the most commonly used surveillance tests. If suspicious results are found on the surveillance test, multiphasic computed tomography or magnetic resonance imaging should be undertaken to confirm the diagnosis of hepatocellular carcinoma. If radiologic tests show inconclusive results, liver biopsy or repeat imaging could be considered for confirmation of hepatocellular carcinoma. Management of the disease is complex. Patients should be evaluated by a multidisciplinary team, and the selection of treatment should consider factors such as tumor burden, severity of liver dysfunction, medical comorbidities, local expertise, and preference of patients. Early stage hepatocellular carcinoma is best managed by curative treatment, which includes resection, ablation, or transplantation. Patients with intermediate stage disease often receive locoregional treatment. Systemic treatment is reserved for patients with advanced disease. Several positive, phase III, randomized controlled trials have expanded the systemic treatment options for advanced hepatocellular carcinoma with promising long term outcomes, especially trials using combination treatments, which could also have eventual implications for the treatment of earlier stage disease.

Predictive factors for long-term survival in patients with advanced hepatocellular carcinoma treated with sorafenib

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Daniela Reis ◽  
Miguel Moura ◽  
Luís Carlos Freitas ◽  
Sofia Carvalhana ◽  
Paulo Jorge Nogueira ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Advanced Hepatocellular Carcinoma ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Downstaging Conversion Therapy in Patients With Initially Unresectable Advanced Hepatocellular Carcinoma: An Overview

2021 ◽  
Vol 11 ◽  
Author(s):  
Hui-Chuan Sun ◽  
Xiao-Dong Zhu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Options ◽  
Multimodality Treatment ◽  
Tumor Burden ◽  
Advanced Hepatocellular Carcinoma ◽  
Conversion Therapy ◽  
Term Survival ◽  
Reduce Tumor Burden ◽  
Stage Disease ◽  
Systemic Treatments

The high mortality rate associated with hepatocellular carcinoma (HCC) is partly due to the high proportion of patients who present with advanced stage disease at diagnosis, for whom there are limited treatment options. For selected patients with initially unresectable HCC, locoregional and/or systemic treatments can result in tumor downstaging and consequently provide opportunities for surgical intervention and the potential for long-term survival. Therefore, the key aim of ‘conversion therapy’ is to reduce tumor burden so that patients become amenable to surgical resection. Various therapies have been investigated as candidates for downstaging patients with potentially resectable HCC including transarterial chemoembolization, transarterial radioembolization with yttrium-90 microspheres, radiotherapy, systemic therapies and combination or multimodality treatment approaches. However, downstaging conversion therapy remains controversial and there are several challenges such as defining the criteria used to identify the population of patients who are ‘potentially resectable’, the criteria used to define successful downstaging, and the optimum treatment approach to maximize the success of downstaging therapy. In this review article, we summarize clinical experience and evidence of downstaging conversion treatment in patients identified as having ‘potentially resectable’ HCC.

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

scholarly journals Long-term survival with multiple metastasectomies for pulmonary osteosarcoma: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Satoshi Takamori ◽  
Hiroyuki Oizumi ◽  
Jun Suzuki ◽  
Katsuyuki Suzuki
Keyword(s):  
Case Report ◽  
Pulmonary Metastases ◽  
Multidisciplinary Treatment ◽  
Underlying Disease ◽  
Pulmonary Metastasectomy ◽  
Extensive Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Primary Surgery

Abstract Background Repeat pulmonary metastasectomy (PM) considerably improves the prognosis of patients with pulmonary metastases of osteosarcoma. Reports have demonstrated a significantly improved prognosis in patients who have undergone repeat metastasectomy for osteosarcoma; however, there have been no reports with more than six metastasectomies. Herein, we describe the long-term survival of a patient following resection of multiple tumors and other treatments for metastatic osteosarcoma. Case presentation A 28-year-old woman underwent extensive resection and postoperative adjuvant chemotherapy for right tibial sarcoma. Over the years, she developed repeated pulmonary metastases. First, 116 metastases were removed from the bilateral lungs. After that, multiple PMs of approximately 250 tumors and other treatments for deep metastatic lesions were performed. The patient died of the underlying disease 24 years after the primary surgery. Conclusions This case report demonstrates the long-term survival benefit of a multidisciplinary treatment centered on multiple metastasectomies.

Sign in / Sign up

Export Citation Format

Share Document