Journal article
Intrahepatic arterial chemoembolization for hepatocellular carcinoma and metastatic neuroendocrine tumors in the era of liver transplantation
The American surgeon, Vol.62(9), pp.724-731
09/1996
PMID: 8751763
Abstract
Surgical resection has been the standard approach for primary and metastatic liver tumors. Long-term survival, however, is limited because of recurrence or hepatic decompensation. Failure of chemotherapeutic regimens or liver transplantation (OLT) to prevent recurrence has resulted in the need for multimodality therapies. We report our experience with preoperative hepatic arterial chemoembolization (CET) followed by OLT in highly select patients. Over a 33-month period, 23 of 41 patients (56%) referred with primary (n = 16) or metastatic neuroendocrine (n = 7) liver tumors met eligibility requirements. Despite mild, self-limited chemical hepatitis, CET was well tolerated in all but three elderly patients who succumbed to liver failure. Four of five patients ultimately received OLT. Three are alive and free of disease at a mean followup of 17 months, one died of recurrent hepatocellular carcinoma, and one (NET) remains well at 33 months with elevated glucagon levels but no measurable disease. All NET patients are alive with resolution of hormonal symptoms. Four of five noncirrhotic patients died of disease, and one has progressive tumor growth. Although OLT following CET achieves superior survival, its application is limited to a minority of patients with such tumors. Careful pretreatment staging and patient selection combined with caution in the use of CET in elderly cirrhotic patients is critical to the success of such therapies.
Details
- Title: Subtitle
- Intrahepatic arterial chemoembolization for hepatocellular carcinoma and metastatic neuroendocrine tumors in the era of liver transplantation
- Creators
- M Martin - Department of Surgery, University of Iowa, Iowa City, USAD TararaY M WuF UkahA FabregaC CorwinE LangF Mitros
- Resource Type
- Journal article
- Publication Details
- The American surgeon, Vol.62(9), pp.724-731
- PMID
- 8751763
- NLM abbreviation
- Am Surg
- ISSN
- 0003-1348
- eISSN
- 1555-9823
- Language
- English
- Date published
- 09/1996
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Occupational and Environmental Health; Pathology; Internal Medicine
- Record Identifier
- 9984094315102771
Metrics
22 Record Views