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Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation

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World Journal of Transplantation 2024年第2期14卷 126-134页

作者： Gabriel Lazzarotto-da-Silva Leandro A Scaffaro Mauricio Farenzena Lucas Prediger Rafaela K Silva Flávia Heinz Feier Tomaz J M Grezzana-Filho Pablo D Rodrigues Alexandre de Araujo Mario Reis Alvares-da-Silva Roberta C Marchiori Cleber Rosito Pinto Kruel marcio fernandes chedid Department of Liver Transplant and Hepatobiliary Surgery Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Interventional Radiology Unit Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil Department of Gastroenterology and Hepatology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007Brazil

BACKGROUND Hepatocellular carcinoma(HCC)is an aggressive malignant neoplasm that requires liver transplantation(LT).Despite patients with HCC being prioritized by most organ allocation systems worldwide,they still have to wait for long *** therapies(LRTs)are employed as bridging therapies in patients with HCC awaiting *** largely used in the past,transarterial embolization(TAE)has been replaced by transarterial chemoembolization(TACE).However,the superiority of TACE over TAE has not been consistently shown in the *** To compare the outcomes of TACE and TAE in patients with HCC awaiting *** All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were *** patients underwent LRT with either TACE or *** patients also underwent percutaneous ethanol injection(PEI),concom-itantly or in different treatment *** choice of LRT for each HCC nodule was determined by a multidisciplinary *** primary outcome was waitlist dropout due to tumor progression,and the secondary outcome was the occurrence of adverse *** the subset of patients who underwent LT,complete pathological response and post-transplant recurrence-free survival were also *** Twelve(18.5%)patients in the TACE group(only TACE and TACE+PEI;n=65)and 3(7.9%)patients in the TAE group(only TAE and TAE+PEI;n=38)dropped out of the waitlist due to tumor progression(P log-rank test=0.29).Adverse events occurred in 8(12.3%)and 2(5.3%)patients in the TACE and TAE groups,respectively(P=0.316).Forty-eight(73.8%)of the 65 patients in the TACE group and 29(76.3%)of the 38 patients in the TAE group underwent LT(P=0.818).Among these patients,complete pathological response was detected in 7(14.6%)and 9(31%)patients in the TACE and TAE groups,respectively(P=0.145).Post-LT,HCC recurred in 9(18.8%)and 4(13.8%)patients in the TACE and TAE groups,respectively(P=0.756).Posttransplant recurrence-free survival was simila

关键词： Hepatocellular carcinoma Transarterial embolization Transarterial chemoembolization Liver transplantation Locoregional therapy Bridging

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Giant hepatic extra-gastrointestinal stromal tumor treated with cytoreductive surgery and adjuvant systemic therapy:A case report and review of literature

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World Journal of Gastrointestinal Surgery 2021年第3期13卷 315-322页

作者： Michel Ribeiro fernandes Caroline Lorenzoni Almeida Ghezzi Tomaz J M Grezzana-Filho Flávia Heinz Feier Ian Leipnitz Aljamir Duarte chedid Carlos Thadeu Schmidt Cerski marcio fernandes chedid Cléber RositoPinto Kruel Department of Gastrointestinal Surgery and Transplantation Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007RSBrazil Division of Radiology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-903RSBrazil Department of Pathology Hospital de Clínicas de Porto AlegrePorto Alegre 90035-007RSBrazil

BACKGROUND Primary extra-gastrointestinal stromal tumors(E-GIST)of the liver are *** clinical presentation may range from asymptomatic to bleeding or manifestations of mass *** surgery followed by adjuvant therapy with imatinib is the standard of ***,under specific circumstances,a cytoreductive approach may represent a therapeutic *** describe herein the case of an 84-year-old woman who presented with a tender,protruding epigastric *** computed tomography scan revealed a large,heterogeneous mass located across segments III,IV,V,and VIII of the *** initial approach was transarterial embolization of the tumor,which elicited no appreciable *** the large size and central location of the tumor and the advanced age of the patient,non-anatomic complete resection was *** to substantial intraoperative bleeding and hemodynamic instability,only a near-complete resection could be *** and immunohistochemical staining confirmed the diagnosis of primary E-GIST of the *** the risk/benefit ratio for therapeutic options,debulking surgery may represent a strategy to control pain and prolong *** SUMMARY Here,we present a case report of a patient diagnosed with E-GIST primary of the liver,which was indicated a cytoreductive surgery and adjuvant therapy with *** E-GIST primary of the liver is a rare conditional,the treatment is with systemic therapy and total resection ***,a cytoreductive surgery will be necessary when a complete resection is no possible.

关键词： Extra-gastrointestinal stromal tumor Primary gastrointestinal stromal tumor of the liver Cytoreductive surgery Debulking surgery Case report

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