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Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma
Preoperative radioembolization may improve the resectability of liver tumor by inducing tumor shrinkage, atrophy of the embolized liver and compensatory hypertrophy of non-embolized liver. We describe the case of a cirrhotic Child-Pugh A patient with a segment IV hepatocellular carcinoma requiring a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756728/ https://www.ncbi.nlm.nih.gov/pubmed/29359022 http://dx.doi.org/10.4254/wjh.v9.i36.1372 |
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author | Vouche, Michael Degrez, Thierry Bouazza, Fikri Delatte, Philippe Galdon, Maria Gomez Hendlisz, Alain Flamen, Patrick Donckier, Vincent |
author_facet | Vouche, Michael Degrez, Thierry Bouazza, Fikri Delatte, Philippe Galdon, Maria Gomez Hendlisz, Alain Flamen, Patrick Donckier, Vincent |
author_sort | Vouche, Michael |
collection | PubMed |
description | Preoperative radioembolization may improve the resectability of liver tumor by inducing tumor shrinkage, atrophy of the embolized liver and compensatory hypertrophy of non-embolized liver. We describe the case of a cirrhotic Child-Pugh A patient with a segment IV hepatocellular carcinoma requiring a left hepatectomy. Preoperative angiography demonstrated 2 separated left hepatic arteries, for segment IV and segments II-III. This anatomic variant allowed sequential radioembolizations, delivering high-dose (90)Yttrium (160 Gy) to the tumor, followed 28 d later by lower dose (120 Gy) to segments II-III. After 3 mo, significant tumor response and atrophy of the future resected liver were obtained, allowing uneventful left hepatectomy. This case illustrates that, when anatomic disposition permits it, sequential radioembolizations, delivering different (90)Yttrium doses to the tumor and the future resected liver, could represent a new strategy to prepare major hepatectomy in cirrhotic patients, allowing optimal tumoricidal effect while reducing the toxicity of the global procedure. |
format | Online Article Text |
id | pubmed-5756728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-57567282018-01-22 Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma Vouche, Michael Degrez, Thierry Bouazza, Fikri Delatte, Philippe Galdon, Maria Gomez Hendlisz, Alain Flamen, Patrick Donckier, Vincent World J Hepatol Case Report Preoperative radioembolization may improve the resectability of liver tumor by inducing tumor shrinkage, atrophy of the embolized liver and compensatory hypertrophy of non-embolized liver. We describe the case of a cirrhotic Child-Pugh A patient with a segment IV hepatocellular carcinoma requiring a left hepatectomy. Preoperative angiography demonstrated 2 separated left hepatic arteries, for segment IV and segments II-III. This anatomic variant allowed sequential radioembolizations, delivering high-dose (90)Yttrium (160 Gy) to the tumor, followed 28 d later by lower dose (120 Gy) to segments II-III. After 3 mo, significant tumor response and atrophy of the future resected liver were obtained, allowing uneventful left hepatectomy. This case illustrates that, when anatomic disposition permits it, sequential radioembolizations, delivering different (90)Yttrium doses to the tumor and the future resected liver, could represent a new strategy to prepare major hepatectomy in cirrhotic patients, allowing optimal tumoricidal effect while reducing the toxicity of the global procedure. Baishideng Publishing Group Inc 2017-12-28 2017-12-28 /pmc/articles/PMC5756728/ /pubmed/29359022 http://dx.doi.org/10.4254/wjh.v9.i36.1372 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Case Report Vouche, Michael Degrez, Thierry Bouazza, Fikri Delatte, Philippe Galdon, Maria Gomez Hendlisz, Alain Flamen, Patrick Donckier, Vincent Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title_full | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title_fullStr | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title_full_unstemmed | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title_short | Sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
title_sort | sequential tumor-directed and lobar radioembolization before major hepatectomy for hepatocellular carcinoma |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5756728/ https://www.ncbi.nlm.nih.gov/pubmed/29359022 http://dx.doi.org/10.4254/wjh.v9.i36.1372 |
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