Bridging therapy effectiveness in the treatment of hepatocellular carcinoma prior to orthotopic liver transplantation

Journal of Gastrointestinal Oncology
Maria M RubinsteinJennifer W Chuy

Abstract

Orthotopic liver transplantation (OLT) is the most effective treatment for hepatocellular carcinoma (HCC) in patients with underlying cirrhosis and portal hypertension. Availability of OLT is limited by donor-organ shortages, which increase patient waiting time until OLT. A variety of bridging therapies (BT) have been used to halt tumor progression in patients on the OLT waiting list. Despite complete radiologic responses following BT, viable tumor is often present in explants. Treatment outcomes were evaluated in 50 patients who had a total of 125 BT for treatment of 93 nodules. Success of BT was assessed by radiologic response compared to histopathological examination of explanted livers. Pre-transplant treatments included: transcatheter arterial chemoembolization (TACE), alcohol ablation (ETOH), radiofrequency ablation (RFA), microwave ablation (MWA), selective internal radiation therapy (SIRT) and stereotactic body radiation therapy (SBRT). Fifty-nine (64%) nodules had a complete radiographic response to therapy; however, only 28 nodules (30%) had complete tumor necrosis (CTN) on explant examination. Ten nodules with CTN were treated with TACE alone. Seven of the 28 nodules with CTN were treated with TACE and RFA. Three of ...Continue Reading

Citations

Apr 5, 2019·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Jyh-Jou ChenShiow-Luan Tsay
Sep 10, 2020·Journal of Gastrointestinal Cancer·Ryan D HirschAmanda J Nicoll
Sep 22, 2018·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·J MittlerH Lang
Aug 28, 2019·Digestive Diseases and Sciences·David E Kaplan
Nov 17, 2019·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Sabine GerumFalk Roeder
Apr 14, 2020·Digestive Diseases and Sciences·Carlos Moctezuma-VelazquezRichard J Owen
Dec 29, 2020·Transplant International : Official Journal of the European Society for Organ Transplantation·Markus Bo SchoenbergMarkus Otto Guba
Oct 17, 2020·Annals of Surgery·Gonzalo SapisochinVincenzo Mazzaferro

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carcinoma, Hepatocellular

Hepatocellular Carcinoma is a malignant cancer in liver epithelial cells. Discover the latest research on Hepatocellular Carcinoma here.