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01-01-2017 | Original Scientific Report

Yttrium-90 Radioembolization for Hepatocellular Carcinoma Prior to Liver Transplantation

Authors: Giuseppe Maria Ettorre, Giovanni Battista Levi Sandri, Andrea Laurenzi, Marco Colasanti, Roberto Luca Meniconi, Raffaella Lionetti, Roberto Santoro, Pasquale Lepiane, Rosa Sciuto, Giuseppe Pizzi, Roberto Cianni, Rita Golfieri, Gianpiero D’Offizi, Adriano M. Pellicelli, Mario Antonini, Giovanni Vennarecci

Published in: World Journal of Surgery | Issue 1/2017

Abstract

Background

Liver transplantation (LT) is a well-established procedure for hepatocellular carcinoma (HCC) within the Milan criteria. Yttrium-90 microspheres radioembolization (Y90-RE) has shown to be an effective and safe treatment of primary liver tumors. We retrospectively evaluate the efficacy of the Y90-RE in patients with HCC prior to LT.

Methods

From January 2002 to December 2015, 365 patients were transplanted at the San Camillo Hospital Center. One hundred forty-three patients were transplanted for HCC, and in 22 cases the patients were treated with Y90-RE before LT.

Results

Three patients were treated with Y90-RE within the Milan criteria, and 19 patients were out of criteria before Y90-RE. Four patients had an increasing MELD score between Y90-RE and LT. On the other hand, alpha-fetoprotein decreases after Y90-RE treatment in all cases. No patient death was observed in Y90-RE procedure or at LT. In 78.9 % of cases, a successful downstaging was observed, and in 100 % of cases bridging was achieved. From Y90-RE treatment overall survival was 43.9 months. From LT, overall mean survival was 30.2 months with a free survival of 29.6 months. The overall survival after LT analysis between the patients treated with Y90-RE and patients without was not significant (p = 0.113). Free survival analysis was not significant (p = 0.897) between the two populations.

Conclusions

We successfully performed LT in patients after Y90-RE treatment both as bridging and downstaging for HCC and obtained a similar overall and free survival of LT for HCC within Milan criteria. Y90-RE becomes a real option to provide curative therapy for patients who traditionally are not considered eligible for surgery.

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Title: Yttrium-90 Radioembolization for Hepatocellular Carcinoma Prior to Liver Transplantation
Authors: Giuseppe Maria Ettorre
Giovanni Battista Levi Sandri
Andrea Laurenzi
Marco Colasanti
Roberto Luca Meniconi
Raffaella Lionetti
Roberto Santoro
Pasquale Lepiane
Rosa Sciuto
Giuseppe Pizzi
Roberto Cianni
Rita Golfieri
Gianpiero D’Offizi
Adriano M. Pellicelli
Mario Antonini
Giovanni Vennarecci
Publication date: 01-01-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 1/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3682-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Yttrium-90 Radioembolization for Hepatocellular Carcinoma Prior to Liver Transplantation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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