دورية أكاديمية
Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation.
| العنوان: | Transarterial embolization is an acceptable bridging therapy to hepatocellular carcinoma prior to liver transplantation. |
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| المؤلفون: | Lazzarotto-da-Silva G; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Scaffaro LA; Department of Interventional Radiology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Farenzena M; Department of Interventional Radiology Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Prediger L; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Silva RK; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Feier FH; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Grezzana-Filho TJM; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Rodrigues PD; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., de Araujo A; Department of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Alvares-da-Silva MR; Department of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Marchiori RC; Department of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Kruel CRP; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil., Chedid MF; Department of Liver Transplant and Hepatobiliary Surgery Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-007, Brazil. mchedid@hcpa.edu.br. |
| المصدر: | World journal of transplantation [World J Transplant] 2024 Jun 18; Vol. 14 (2), pp. 90571. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101608356 Publication Model: Print Cited Medium: Print ISSN: 2220-3230 (Print) Linking ISSN: 22203230 NLM ISO Abbreviation: World J Transplant Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group Original Publication: Hong Kong : Baishideng Pub. Group Co., Ltd. |
| مستخلص: | 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 periods. Locoregional therapies (LRTs) are employed as bridging therapies in patients with HCC awaiting LT. Although 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 literature. Aim: To compare the outcomes of TACE and TAE in patients with HCC awaiting LT. Methods: All consecutive patients with HCC awaiting LT between 2011 and 2020 at a single center were included. All patients underwent LRT with either TACE or TAE. Some patients also underwent percutaneous ethanol injection (PEI), concomitantly or in different treatment sessions. The choice of LRT for each HCC nodule was determined by a multidisciplinary consensus. The primary outcome was waitlist dropout due to tumor progression, and the secondary outcome was the occurrence of adverse events. In the subset of patients who underwent LT, complete pathological response and post-transplant recurrence-free survival were also assessed. Results: 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 similar between the groups ( P log-rank test = 0.71). Conclusion: Dropout rates and posttransplant recurrence-free survival of TAE were similar to those of TACE in patients with HCC. Our study reinforces the hypothesis that TACE is not superior to TAE as a bridging therapy to LT in patients with HCC. Competing Interests: Conflict-of-interest statement: All authors declare no conflict of interest. (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.) |
| References: | Hepatogastroenterology. 1998 Aug;45 Suppl 3:1214-20. (PMID: 9730377) J Clin Oncol. 2016 Jun 10;34(17):2046-53. (PMID: 26834067) Am J Transplant. 2010 Jul;10(7):1643-8. (PMID: 20486906) Asian J Pharm Sci. 2020 Sep;15(5):646-660. (PMID: 33193866) Lancet Oncol. 2012 Jan;13(1):e11-22. (PMID: 22047762) Hepatology. 2015 May;61(5):1643-50. (PMID: 25644186) Langenbecks Arch Surg. 2023 Jan 14;408(1):26. (PMID: 36639606) Br J Cancer. 2013 Apr 2;108(6):1252-9. (PMID: 23449352) J Vasc Interv Radiol. 2016 Jan;27(1):39-45. (PMID: 26508449) Clin Liver Dis (Hoboken). 2021 Aug 05;17(6):409-413. (PMID: 34386205) Cancers (Basel). 2023 Jun 13;15(12):. (PMID: 37370776) Hepatology. 2000 Apr;31(4):864-71. (PMID: 10733541) Cardiovasc Intervent Radiol. 2010 Jun;33(3):541-51. (PMID: 19937027) Lancet. 2002 May 18;359(9319):1734-9. (PMID: 12049862) N Engl J Med. 2011 Sep 22;365(12):1118-27. (PMID: 21992124) Liver Transpl. 2014 May;20(5):536-43. (PMID: 24493271) J Vasc Interv Radiol. 2010 Mar;21(3):327-32. (PMID: 20097098) Lancet. 2003 Dec 6;362(9399):1907-17. (PMID: 14667750) United European Gastroenterol J. 2017 Jun;5(4):511-518. (PMID: 28588882) Liver Int. 2013 Jul;33(6):944-9. (PMID: 23530918) J Hepatol. 2022 Mar;76(3):681-693. (PMID: 34801630) Hepatology. 2018 Jan;67(1):381-400. (PMID: 28859222) N Engl J Med. 1996 Mar 14;334(11):693-9. (PMID: 8594428) Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) Liver Transpl. 2005 Sep;11(9):1117-26. (PMID: 16123960) Gastroenterol Res Pract. 2016;2016:9420274. (PMID: 26819615) |
| فهرسة مساهمة: | Keywords: Bridging; Hepatocellular carcinoma; Liver transplantation; Locoregional therapy; Transarterial chemoembolization; Transarterial embolization |
| تواريخ الأحداث: | Date Created: 20240701 Latest Revision: 20240702 |
| رمز التحديث: | 20240702 |
| مُعرف محوري في PubMed: | PMC11212594 |
| DOI: | 10.5500/wjt.v14.i2.90571 |
| PMID: | 38947974 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2220-3230 |
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| DOI: | 10.5500/wjt.v14.i2.90571 |