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Combined Regional Chemoembolization and Ablative Therapy for Hepatic Malignancies

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Tumor Ablation

Abstract

Hepatic malignancies are one of the most difficult therapeutic challenges in oncology. Cure usually is not possible because of the predilection for intrahepatic recurrence, despite complete resection or ablation of the initial tumor. Nonetheless, durable local control can be achieved through vigilant monitoring and aggressive multimodality therapy coordinated by a multidisciplinary team of specialists in medical, surgical, and interventional oncology. For tumors that tend not to metastasize aggressively beyond the liver, regional control may benefit quality of life and overall survival.

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References

  1. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996;334(11):693–699.

    Article  PubMed  CAS  Google Scholar 

  2. Pichlmayr R, Weimann A, Oldhafer KJ, et al. Role of liver transplantation for the treatment of unresectable liver cancer. World J Surg 1995;19(6):807–813.

    Article  PubMed  CAS  Google Scholar 

  3. Selby R, Kadry Z, Carr B, Tzakis A, Madariaga JR, Iwatsuki S. Liver transplantation for hepatocellular carcinoma. World J Surg 1995;19(1):53–58.

    Article  PubMed  CAS  Google Scholar 

  4. Spreaflco C, Marchiano A, Regalia E, et al. Chemoembolization of hepatocellular carcinoma in patients who undergo liver transplantation. Radiology 1994;192:687–690.

    Article  Google Scholar 

  5. Oldhafer KJ, Chavan A, Fruhauf NR, et al. Arterial chemoembolization before liver transplantation in patients with hepatocellular carcinoma: marked tumor necrosis, but no survival benefit? J Hepatol 1998;29:953–959.

    Article  PubMed  CAS  Google Scholar 

  6. Veltri A, Grosso M, Martina MC, et al. Effect of preoperative radiological treatment of hepatocellular carcinoma before liver transplantation: a retrospective study. Cardiovasc Intervent Radiol 1998;21:393–398.

    Article  PubMed  CAS  Google Scholar 

  7. Richard HM III, Silberzweig JE, Mitty HA, Lou WYW, Ahn J, Cooper JM. Hepatic arterial complications in liver transplant recipients treated with pretransplantation chemoembolization for hepatocellular carcinoma. Radiology 2000;214:775–779.

    Article  PubMed  Google Scholar 

  8. Lu C-D, Peng S-Y, Jiang X-C, Chiba Y, Tanigawa N. Preoperative transcatheter arterial chemoembolization and prognosis of patients with hepatocellular carcinomas: retrospective analysis of 120 cases. World J Surg 1999;23:293–300.

    Article  PubMed  CAS  Google Scholar 

  9. Di Carlo V, Ferrari G, Castoldi R, et al. Preoper ative chemoembolization of hepatocellular carcinoma in cirrhotic patients. Hepato-Gastroenterology 1998;45:1950–1954.

    PubMed  Google Scholar 

  10. Zhang Z, Liu Q, He J, Yang J, Yang G, Wu M. The effect of preoperative transcatheter hepatic arterial chemoembolization on disease-free survival after hepatectomy for hepatocellular carcinoma. Cancer 2000;89:2606–2612.

    Article  PubMed  CAS  Google Scholar 

  11. Paye F, Jagot P, Vilgrain V, Farges O, Borie D, Belghiti J. Preoperative chemoembolization of hepatocellular carcinoma. Arch Surg 1998;133:767–772.

    Article  PubMed  CAS  Google Scholar 

  12. Wu C-C, Ho Y-Z, Ho WL, Wu T-C, Liu T-J, P’eng F-K. Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma: a reappraisal. Br J Surg 1995;85:122–126.

    Article  Google Scholar 

  13. Tang Z-Y, Yu Y-Q, Zhou X-D, et al. Cytoreduction and sequential resection for surgically verified unresectable hepatocellular carcinoma: evaluation with analysis of 72 patients. World J Surg 1995;19:784–789.

    Article  PubMed  CAS  Google Scholar 

  14. Majno PE, Adam R, Bismuth H, et al. Influence of preoperative transarterial lipiodol chemoembolization on resection and transplantation for hepatocellular carcinoma in patients with cirrhosis. Ann Surg 1997;226(6):688–703.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  15. Sitzmann J. Conversion of unresectable liver cancer: an approach and follow-up study. World J Surg 1995;19:790–794.

    Article  PubMed  CAS  Google Scholar 

  16. Harada T, Matsuo K, Inoue T, Tamesue S, Inoue T, Nakamura H. Is preoperative hepatic arterial chemoembolization safe and effective for hepatocellular carcinoma? Ann Surg 1996;224(1):4–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  17. Yu Y-Q, Xu D-B, Zhou X-D, Lu J-Z, Tang Z-Y, Mack P. Experience with liver resection after hepatic arterial chemoembolization for hepatocellular carcinoma. Cancer 1993;71:62–65.

    Article  PubMed  CAS  Google Scholar 

  18. Poon R, Fan S-T, Wong J. Risk factors, prevention, and management of postoperative recurrence after resection of hepatocellular carcinoma. Ann Surg 2000;232(1):10–24.

    Article  Google Scholar 

  19. Adachi E, Matsumata T, Nishizaki T, Hashimoto H, Tsuneyoshi M, Sugimachi K. Effects of preoperative transcatheter arterial chemoembolization for hepatocellular carcinoma: the relationship between postoperative course and tumor necrosis. Cancer 1993;72:3593–3598.

    Article  PubMed  CAS  Google Scholar 

  20. Uchida M, Kohno H, Kubota H, et al. Role of preoperative transcatheter arterial oily chemoembolization for resectable hepatocellular carcinoma. World J Surg 1996;20:326–331.

    Article  PubMed  CAS  Google Scholar 

  21. Tanaka K, Nakamura S, Numata K, et al. Hepatocellular carcinoma: Treatment with percutaneous ethanol injection and transcatheter arterial embolization. Radiology 1992;185:457–460.

    Article  PubMed  CAS  Google Scholar 

  22. Matsui O, Kadoya M, Yoshikawa J, et al. Small hepatocellular carcinoma: treatment with subsegmental transcatheter arterial embolization. Radiology 1993;188:79–83.

    Article  PubMed  CAS  Google Scholar 

  23. Yamakado K, Nakatsuka A, Tanaka N, Matsumura K, Takase K, Takeda K. Long-term follow-up arterial chemoembolization combined with transportal ethanol injection used to treat hepatocellular carcinoma. JVIR 1999;10:641–647.

    Article  PubMed  CAS  Google Scholar 

  24. Bartolozzi C, Lencioni R, Caramella D, et al. Treatment of large HCC: Transcatheter arterial chemoembolization combined with percutaneous ethanol injection versus repeated transcatheter arterial chemoembolization. Radiology 1995;197:812–818.

    Article  PubMed  CAS  Google Scholar 

  25. Yamakado K, Hirano T, Kato N, et al. Hepatocellular carcinoma: treament with a combination of transcatheter arterial chemoembolization and transportal ethanol injection. Radiology 1994;193:75–80.

    Article  PubMed  CAS  Google Scholar 

  26. Seki T, Tamai T, Nakagawa T, et al. Combination therapy with transcatheter arterial chemoembolization and percutaneous microwave coagulation therapy for hepatocellular carcinoma. Cancer 2000;89(6):1245–1251.

    Article  PubMed  CAS  Google Scholar 

  27. Pacella C, Bizzarri G, Cecconi P, et al. Hepatocellular carcinoma: Long-term results of com bined treatment with laser thermal ablation and transcatheter arterial chemoembolization. Radiology 2001;219:669–678.

    Article  PubMed  CAS  Google Scholar 

  28. Rossi S, Garbagnati F, Lencioni R, et al. Percutaneous radio-frequency thermal ablation of nonresectable hepatocellular carcinoma after occlusion of tumor blood supply. Radiology 2000;217:119–126.

    Article  PubMed  CAS  Google Scholar 

  29. Bloomston M, Binitie O, Fraiji E, et al. Transcatheter arterial chemoembolization with or without radiofrequency ablation. I: The management of patients with advanced hepatic malignancy. Am Surg 2002;68:827–831.

    PubMed  Google Scholar 

  30. Registry of Hepatic Metastases. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of indications for resection. Surgery 1988;103(3):278–288.

    PubMed Central  Google Scholar 

  31. Wagner JS, Adson MA, Van Heerden JA, Adson MH, Ilstrup DM. The natural history of hepatic metastases from colorectal cancer: a comparison with resective treatment. Ann Surg 1984;199(5):502–508.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  32. Leichman CG, Jacobson JR, Modiano M, et al. Hepatic chemoembolization combined with systemic infusion of 5-fluorouracil and bolus leucovorin for patients with metastatic colorectal carcinoma. Cancer 1999;86(5):775–781.

    Article  PubMed  CAS  Google Scholar 

  33. Bavisotto LM, Patel NH, Althaus SJ, et al. Hepatic transcatheter arterial chemoembolization alternating with systemic protracted continuous infusion 5-fluorouracil for gastrointestinal malignancies metastatic to liver: a phase II trial of the Puget Sound Consortium (PSOC 1104). Clin Cancer Res 1999;5(1):95–109.

    PubMed  CAS  Google Scholar 

  34. Tono T, Hasuike Y, Ohzato H, Takatsuka Y, Kikkawa N. Limited but definite efficacy of prophylactic hepatic arterial infusion chemotherapy after curative resection of colorectal liver metastases. Cancer 2000;88(7):1549–1556.

    Article  PubMed  CAS  Google Scholar 

  35. Kemeny N, Huang Y, Cohen AM, et al. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 1999;341(27):2039–2048.

    Article  PubMed  CAS  Google Scholar 

  36. Lorenz M, Muller H-H, Schramm H, et al. Randomized trial of surgery versus surgery followed by adjuvant hepatic arterial infusion with 5-fluorouracil and folinic acid for liver metastases of colorectal cancer. Ann Surg 1998;228(6):756–762.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  37. Rose DM, Allegra DP, Bostick PJ, Foshag LJ, Bilchik AJ. Radiofrequency ablation: a novel primary and adjunctive ablative technique for hepatic malignancies. Am Surg 1999;65:1009–1014.

    PubMed  CAS  Google Scholar 

  38. Elias D, Debaere T, Muttillo I, Cavalcanti A, Coyle C, Roche A. Intraoperative use of radio-frequency treatment allows an increase in the rate of curative resection. J Surg Oncol 1998;67:190–191.

    Article  PubMed  CAS  Google Scholar 

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Soulen, M.C., Kernagis, L.Y. (2005). Combined Regional Chemoembolization and Ablative Therapy for Hepatic Malignancies. In: vanSonnenberg, E., McMullen, W.N., Solbiati, L., Livraghi, T., Müeller, P.R., Silverman, S.G. (eds) Tumor Ablation. Springer, New York, NY. https://doi.org/10.1007/0-387-28674-8_21

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  • DOI: https://doi.org/10.1007/0-387-28674-8_21

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-95539-1

  • Online ISBN: 978-0-387-28674-7

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