간문맥혈전을 동반한 간암의 화학색전술 후 장기생존 1예
Long-term survival in a case of hepatocellular carcinoma with portal vein thrombosis treated with transarterial chemoembolization
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
본 저자들은 주간문맥 혈전이 동반된 간세포암종에서 경동맥화학색전술을 시행하여 재발이나 간부전 소견없이 장기간 생존한 예를 보았기에 문헌고찰과 함께 보고하는 바이며, 간문맥 혈전이 동반된 경우라도 간기능이 잘 보존되어 있고 문맥주위 측부혈관이 잘 발달되어 있으면 경동맥화학색전술을 통해 예후를 향상시킬 수 있음을 보여주는 예라고 하겠다.
Abstract
Hepatocellular carcinoma (HCC) is the third most common malignancy in Korea and the prognosis of patients with HCC is generally poor. Most patients with HCC have unresectable disease at presentation and only a small proportion of patients diagnosed early receive curative treatment. Transarterial chemoembolization (TACE) is a widely used palliative treatment for advanced HCC and its prognostic benefit has been proven in several studies. TACE is contraindicated for patients with portal vein tumor thrombosis (PVT) because it carries a potential risk of acute hepatic failure. Recently, however, a few studies have provided evidence of a survival benefit after TACE in patients with PVT if they have good hepatic reserve and collateral circulation around the portal trunk. We experienced a case of HCC with PVT, with long-term survival and no evidence of recurrence or hepatic failure after TACE, and present this case with a review of the relevant literature.
참고문헌 (14)
- Yamada R, "Hepatic artery embolization in 120 patients with unresectable hepatoma", Radiology, 148, pp.397~401 (1983)
- Allison DJ, "Therapeutic embolization of the hepatic artery: a review of 75 procedures", Lancet, 1, pp.595~599 (1985)
- Bismuth H, "Primary treatment of hepatocellular carcinoma by arterial chemoembolization", Am J Surg, 163, pp.387~394 (1992)
- Lautt WW, "Conceptual review of the hepatic vascular bed", Hepatology, 7, pp.952~963 (1987)
- Pentecost MJ, "Hepatic chemoembolization: safety with portal vein thrombosis", J Vasc Interv Radiol, 4, pp.347~351 (1993)
- Llovet JM, "Natural history of untreated nonsurgical hepatocellular carcinoma: rationale for the design and evaluation of therapeutic trials", Hepatology, 29, pp.62~67 (1999)
- Villa E, "Natural history of inoperable hepatocellular carcinoma: estrogen receptors' status in the tumor is the strongest prognostic factor for survival", Hepatology, 32, pp.233~238 (2000)
- Okazaki M, "Intraperitoneal hemorrhage from hepatocellular carcinoma: emergency chemoembolization or embolization", Radiology, 180(3), pp.647~651 (1991)
- Georgiades CS, "Safety and efficacy of transarterial chemoembolization in patients with unresectable hepatocellular carcinoma and portal vein thrombosis", J Vasc Interv Radiol, 16, pp.1653~1659 (2005)
- Chung JW, "Hepatocellular carcinoma and portal vein invasion: results of treatment with transcatheter oily chemoembolization", AJR Am J Roentgenol, 165, pp.315~321 (1995)
- Higashihara H, "Transcatheter arterial chemoembolization of hepatocellular carcinoma: a Japanese experience", Hepatogastroenterology, 49, pp.72~78 (2002)
- Hara H, "A long surviving hepatocellular carcinoma case (2 years 1 month) with tumor thrombus in the portal trunk treated by embolization", Rinsho Hoshasen, 34, pp.1641~1644 (1989)
- Yamamoto T, "A patient with hepatocellular carcinoma and portal vein thrombosis in 1st branch who was treated by transcatheter arterial embolization", Gan To Kagaku Ryoho, 28, pp.1718~1723 (2001)
- 명선정, "주간문맥 혈전을 동반한 침윤성 간세포암종의 성공적인 경동맥화학색전술 치료 1예", The Korean Journal of Hepatology, 12(2006), pp.107~111 (2006), 대한간학회