Treatment for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis: The Emerging Role for Radioembolization Using Yttrium-90Lau W.-Y.a · Sangro B.b · Chen P.-J.c · Cheng S.-Q.d · Chow P.e, f · Lee R.-C.g · Leung T.h · Han K.-H.i · Poon R.T.P.j
aFaculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, China; bLiver Unit, Clínica Universitaria de Navarra and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Pamplona, Spain; cHepatitis Research and Department of Internal Medicine, National Taiwan University and Hospital, Taipei, Taiwan, ROC; dEastern Hepatobiliary Surgery Hospital, The Second Military Medical University, Shanghai, China; eDepartment of General Surgery, Singapore General Hospital, and fOffice of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore, Singapore; gDepartment of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; hComprehensive Oncology Centre, Hong Kong Sanatorium and Hospital Hong Kong, Hong Kong, SAR, China; iDepartment of Internal Medicine, Yonsei Liver Cancer Special Clinic, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea; jDepartment of Surgery, The University of Hong Kong, Hong Kong, SAR, China
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background/Purpose: Patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) have an extremely poor prognosis and relatively few treatment options. Method: During a consensus meeting, experts met to examine the published data for HCC treatment strategies in patients with PVTT. Results: Many treatment guidelines consider the presence of PVTT a contraindication to partial hepatectomy or liver transplantation. Transarterial chemoembolization (TACE) is associated with an increased risk of ischemic necrosis of liver and of treatment-related death in patients with PVTT, and is, therefore, limited to a select group of patients with good hepatic function and adequate collateral circulation around the occluded portal vein. Systemic sorafenib results in survival benefit in patients regardless of the presence of PVTT. However, side effects are common, and there are no effects on time-to-symptom progression or quality of life. Transarterial radioembolization (TARE) with yttrium-90 microspheres is emerging as a valuable strategy. A wider range of patients with PVTT are suitable for this procedure compared to TACE. TARE is as effective as TACE in HCC and has quality-of-life advantages. Conclusion: In patients with HCC with PVTT, medical evidence suggests that TARE is a good choice of treatment.
© 2013 S. Karger AG, Basel
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.