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Hepatopulmonary Shunting: A Prognostic Indicator of Survival in Patients with Metastatic Colorectal Adenocarcinoma Treated with 90Y Radioembolization.
Narsinh, Kazim H; Van Buskirk, Mark; Kennedy, Andrew S; Suhail, Mohammed; Alsaikhan, Naif; Hoh, Carl K; Thurston, Kenneth; Minocha, Jeet; Ball, David S; Cohen, Steven J; Cohn, Michael; Coldwell, Douglas M; Drooz, Alain; Ehrenwald, Eduardo; Kanani, Samir; Nutting, Charles W; Moeslein, Fred M; Savin, Michael A; Schirm, Sabine; Putnam, Samuel G; Sharma, Navesh K; Wang, Eric A; Rose, Steven C.
Afiliação
  • Narsinh KH; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Van Buskirk M; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Kennedy AS; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Suhail M; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Alsaikhan N; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Hoh CK; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Thurston K; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Minocha J; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Ball DS; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Cohen SJ; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Cohn M; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Coldwell DM; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Drooz A; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Ehrenwald E; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Kanani S; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Nutting CW; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Moeslein FM; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Savin MA; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Schirm S; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Putnam SG; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Sharma NK; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Wang EA; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
  • Rose SC; From the Dept of Radiology, Univ of California San Diego School of Medicine, 200 W. Arbor Dr 8756, San Diego, CA 92103-8756 (K.H.N., M.S., N.A., C.K.H., J.M., S.C.R.); Data Reduction, Chester, NJ (M.V.B.); Sarah Cannon Research Inst, Nashville, Tenn (A.S.K.); Sirtex Medical, West Grove, Pa (K.T.); F
Radiology ; 282(1): 281-288, 2017 Jan.
Article em En | MEDLINE | ID: mdl-27440733
ABSTRACT
Purpose To determine if high lung shunt fraction (LSF) is an independent prognostic indicator of poor survival in patients who undergo yttrium 90 radioembolization for unresectable liver-dominant metastatic colorectal cancer. Materials and Methods Retrospective data were analyzed from 606 patients (62% men; mean age, 62 years) who underwent radioembolization to treat liver metastases from colorectal adenocarcinoma between July 2002 and December 2011 at 11 U.S. centers. Institutional review board exemptions were granted prior to the collection of data at each site. Overall survival was estimated by using Kaplan-Meier survival and univariate Cox proportional hazards models to examine the effect of LSF on survival and to compare this to other potential prognostic indicators. Multivariate analysis was also performed to determine whether LSF is an independent risk factor for poor survival. Results LSF higher than 10% was predictive of significantly decreased survival (median, 6.9 months vs 10.0 months; hazard ratio, 1.60; P < .001) and demonstrated a mild but significant correlation to serum carcinoembryonic antigen levels and tumor-to-liver volume ratio (Pearson correlation coefficients, 0.105 and 0.113, respectively; P < .05). A progressive decrease in survival was observed as LSF increased from less than 5% to more than 20% (P < .05). LSF did not correlate with the presence of extrahepatic metastases or prior administration of bevacizumab. Conclusion Increased LSF is an independent prognostic indicator of worse survival in patients undergoing radioembolization for liver-dominant metastatic colorectal adenocarcinoma. High LSF correlates poorly to other potential markers of tumor size, such as tumor-to-liver volume ratio or serum carcinoembryonic antigen level, and does not correlate to the presence of extrahepatic metastases. © RSNA, 2016 Online supplemental material is available for this article.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Radioisótopos de Ítrio / Neoplasias Colorretais / Adenocarcinoma / Fístula Arteriovenosa / Embolização Terapêutica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Radioisótopos de Ítrio / Neoplasias Colorretais / Adenocarcinoma / Fístula Arteriovenosa / Embolização Terapêutica Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article