Radioembolisation and portal vein embolization before resection of large hepatocellular carcinoma.
World J Gastroenterol
; 21(32): 9666-70, 2015 Aug 28.
Article
em En
| MEDLINE
| ID: mdl-26327775
ABSTRACT
Resectability of hepatocellular carcinoma in patients with chronic liver disease is dramatically limited by the need to preserve sufficient remnant liver in order to avoid postoperative liver insufficiency. Preoperative treatments aimed at downsizing the tumor and promoting hypertrophy of the future remnant liver may improve resectability and reduce operative morbidity. Here we report the case of a patient with a large hepatocellular carcinoma arising from chronic liver disease. Preoperative treatment, including tumor downsizing with transarterial radioembolization and induction of future remnant liver hypertrophy with right portal vein embolization, resulted in a 53% reduction in tumor volume and compensatory hypertrophy in the contralateral liver. The patient subsequently underwent extended right hepatectomy with no postoperative signs of liver decompensation. Pathological examination demonstrated a margin-free resection and major tumor response. This new therapeutic sequence, combining efficient tumor targeting and subsequent portal vein embolization, could improve the feasibility and safety of major liver resection for hepatocellular carcinoma in patients with liver injury.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Veia Porta
/
Carcinoma Hepatocelular
/
Compostos Radiofarmacêuticos
/
Terapia Neoadjuvante
/
Carga Tumoral
/
Embolização Terapêutica
/
Hepatectomia
/
Neoplasias Hepáticas
Limite:
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
World J Gastroenterol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Bélgica