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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2019

01-01-2019 | Hepatobiliary Tumors

Elective Regional Therapy Treatment for Hepatic Adenoma

Authors: Jack P. Silva, BS, Brittany Klooster, BS, Susan Tsai, MD MHS, Kathleen K. Christians, MD, Callisia N. Clarke, MD, Harveshp Mogal, MD, T. Clark Gamblin, MD

Published in: Annals of Surgical Oncology | Issue 1/2019

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Abstract

Background

Locoregional therapy treatments for hepatic adenoma (HA) are typically limited to selective hepatic arterial embolization (HAE) to control acute hemorrhage. This systematic review sought to report the utilization of HAE and ablation for non-emergent treatment of HA.

Methods

A PubMed query identified studies reporting ablation or embolization for HA patients. Abstracts were screened to exclude studies with only patients managed for acute hemorrhage. Outcomes of interest included rate of success, complications, and repeat procedures.

Results

Of 209 initial search results, 33 full-text publications were reviewed, and 10 were selected after applying the exclusion criteria. All were published from 2005 to 2016. A total of 105 patients were included, of which 66 patients with 138 adenomas underwent elective locoregional therapy treatment. The mean size of treated adenomas was 2.9 (range 0.8–8.3) cm. HAE was utilized in 25 patients with 58 adenomas, whereas 35 patients with 68 adenomas underwent radiofrequency ablation. Six patients with 12 adenomas received microwave ablation. Most patients were female (89/105), and adenomas were associated with oral contraceptive use or hormonal therapies in 49 of 105 patients. Success was reported in 115 of 138 first-time procedures, and repeat procedures were needed after 18 of 138. Mean follow-up time was 36.4 months, with two complications.

Conclusions

Reports of elective locoregional therapy for the treatment of HA are limited to case reports and small institutional series. In the select patients treated, outcomes are acceptable, with low rates of repeat procedures or complications. This systematic review warrants further discussion and broader consideration for the treatment of HA.
Appendix
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Metadata
Title
Elective Regional Therapy Treatment for Hepatic Adenoma
Authors
Jack P. Silva, BS
Brittany Klooster, BS
Susan Tsai, MD MHS
Kathleen K. Christians, MD
Callisia N. Clarke, MD
Harveshp Mogal, MD
T. Clark Gamblin, MD
Publication date
01-01-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 1/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6802-1

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