Transcatheter Arterial Chemoembolization for Hepatic Recurrence after Curative Resection of Pancreatic Adenocarcinoma
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Background/Aims: Despite curative resection, hepatic recurrences cause a significant reduction in survival in patients with primary pancreatic adenocarcinoma. Transcatheter arterial chemoembolization (TACE) has recently been used successfully to treat primary and secondary hepatic malignancy. Methods: Between 2003 and 2008, 15 patients underwent TACE because of hepatic recurrence after curative resection of a pancreatic adenocarcinoma. The tumor response was evaluated based on computed tomography scans after TACE. The overall duration of patient survival was measured. Results: After TACE, a radiographically evident response occurred in six patients whose tumors demonstrated a tumor blush on angiography. Four patients demonstrated stabilization of a hypovascular mass. The remaining five patients demonstrated continued progression of hypovascular hepatic lesions. The median survival periods from the time of diagnosis and from the time of initial TACE were 9.6and 7.5 months, respectively. Conclusions: TACE may represent a viable therapeutic modality in patients with hepatic recurrence after curative resection of pancreatic adenocarcinoma.
Abstract
Background/Aims: Despite curative resection, hepatic recurrences cause a significant reduction in survival in patients with primary pancreatic adenocarcinoma. Transcatheter arterial chemoembolization (TACE) has recently been used successfully to treat primary and secondary hepatic malignancy. Methods: Between 2003 and 2008, 15 patients underwent TACE because of hepatic recurrence after curative resection of a pancreatic adenocarcinoma. The tumor response was evaluated based on computed tomography scans after TACE. The overall duration of patient survival was measured. Results: After TACE, a radiographically evident response occurred in six patients whose tumors demonstrated a tumor blush on angiography. Four patients demonstrated stabilization of a hypovascular mass. The remaining five patients demonstrated continued progression of hypovascular hepatic lesions. The median survival periods from the time of diagnosis and from the time of initial TACE were 9.6and 7.5 months, respectively. Conclusions: TACE may represent a viable therapeutic modality in patients with hepatic recurrence after curative resection of pancreatic adenocarcinoma.
참고문헌 (29)
- Bramhall SR, "Treatment and survival in 13,560 patients with pancreatic cancer, and incidence of the disease,in the west midlands: an epidemiological study", Br J Surg, 82, pp.111~115 (1995)
- Jemal A, "Cancer statistics, 2007", CA Cancer J Clin, 57, pp.43~66 (2007)
- Nitecki SS, "Longterm survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving?", Ann Surg, 221, pp.59~66 (1995)
- Sener SF, "Pancreatic cancer: a report of treatment and survival trends for 100,313 patients diagnosed from 1985-1995, using the National Cancer Database", J Am Coll Surg, 189, pp.1~7 (1999)
- Sohn TA, "Resected adenocarcinoma of the pancreas-616 patients: results, outcomes, and prognostic indicators", J Gastrointest Surg, 4, pp.567~579 (2000)
- Griffin JF, "Patterns of failure after curative resection of pancreatic carcinoma", Cancer, 66, pp.56~61 (1990)
- Sperti C, "Recurrenceafter resection for ductal adenocarcinoma of the pancreas", World J Surg, 21, pp.195~200 (1997)
- Westerdahl J, "Recurrence of exocrine pancreatic cancer--local or hepatic?", Hepatogastroenterology, 40, pp.384~387 (1993)
- Burris HA 3rd, "Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer:a randomized trial", J Clin Oncol, 15, pp.2403~2413 (1997)
- Tepper J, "Carcinoma of the pancreas: reviewof MGH experience from 1963 to 1973. Analysis of surgical failure and implications for radiation therapy", Cancer, 37, pp.1519~1524 (1976)
- Brown DB, "Quality improve ment guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy", J Vasc Interv Radiol, 17(2 Pt 1), pp.225~232 (2006)
- Liapi E, "Transcatheter and ablative therapeutic approaches for solid malignancies", J Clin Oncol, 25, pp.978~986 (2007)
- Kim JH, "Transcatheter arterial chemoembolization vs. chemoinfusion for unresectable hepatocellular carcinoma in patients with major portal vein thrombosis", Aliment Pharmacol Ther, 29, pp.1291~1298 (2009)
- Ruutiainen AT, "Chemoembolization and bland embolization of neuroendocrine tumor metastases to the liver", J Vasc Interv Radiol, 18, pp.847~855 (2007)
- Rajan DK, "Sarcomas metastatic to the liver: response and survival after cisplatin, doxorubicin, mitomycin-C, Ethiodol, and polyvinyl alcohol chemoembolization", J Vasc Interv Radiol, 12, pp.187~193 (2001)
- Buijs M, "Assessment of metastatic breast cancer response to chemoembolization with contrast agent enhanced and diffusion-weighted MR imaging", J Vasc Interv Radiol, 18, pp.957~963 (2007)
- Park YS, "Primary hepatic angiosarcoma: imaging findings and palliative treatment with transcatheter arterial chemoembolization or embolization", Clin Radiol, 64, pp.779~785 (2009)
- Lencioni R, "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma", Semin Liver Dis, 30, pp.52~60 (2010)
- Richter A, "Lorenz D, Post S, Trede M. Long-term results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25-year experience", World J Surg, 27, pp.324~329 (2003)
- Matsuno S, "Pancreatic Cancer Registry in Japan: 20 years of experience", Pancreas, 28, pp.219~230 (2004)
- Cleary SP, "Prognostic factors in resected pancreatic adenocarcinoma: analysis of actual 5-year survivors", J Am Coll Surg, 198, pp.722~731 (2004)
- Hishinuma S, "Patterns of recurrence after curative resection of pancreatic cancer, based on autopsy findings", J Gastrointest Surg, 1p, pp.511~518 (2006)
- Katsumata K, "Liver metastasis of pancreatic cancer managed by intra-arterial infusion chemotherapy combined with degradable starch microspheres", Int J Clin Oncol, 8, pp.110~112 (2003)
- Kim JH, "Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma: clinical efficacy and factors influencing outcomes", Cancer, 113`, pp.1614~1622 (2008)
- Kim JH, "Nonresectable combined hepatocellular carcinoma and cholangiocarcinoma: analysis of the response and prognostic factors after transcatheter arterial chemoembolization", Radiology, 255, pp.270~277 (2010)
- Noda A, "Hypervascular liver metastasis from hypovascular ductal cell carcinoma of thepancreas", Intern Med, 40, pp.227~231 (2001)
- Murphy-Lavallee J, "Are metastases really hypovascular in the arterial phase? The perspective based on contrast-enhanced ultrasonography", J Ultrasound Med, 26, pp.1545~1556 (2007)
- Song SY, "Liver abscess after transcatheter oily chemoembolization for hepatic tumors: incidence, predisposing factors, and clinical outcome", J Vasc Interv Radio, 12, pp.313~320 (2001)
- Jakobs TF, "Hepatic yttrium-90 radioembolization of chemotherapy-refractory colorectal cancer liver metastases", J Vasc Interv Radiol, 19, pp.1187~1195 (2008)