Author/Authors :
sandri, giovanni battista levi san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , ettorre, giuseppe maria san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , colasanti, marco san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , werra, edoardo de san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , mascianà, gianluca san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , ferraro, daniele san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , tortorelli, giovanni san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy , sciuto, rosa regina elena national cancer institute - istituti fisioterapici ospitalieri (ifo) - division of nuclear medicine, Rome, Italy , lucatelli, pierleone regina elena national cancer institute - istituti fisioterapici ospitalieri (ifo) - division of interventional radiology, Rome, Italy , pizzi, giuseppe regina elena national cancer institute - istituti fisioterapici ospitalieri (ifo) - division of interventional radiology, Rome, Italy , visco-comandini, ubaldo national institute for infectious disease “l. spallanzani” - division of hepatology and infectious disease, Rome, Italy , vennarecci, giovanni san camillo hospital rome - division of general surgery and liver transplantation, Rome, Italy
Abstract :
Background: Yttrium-90 microspheres radioembolization (Y90-RE) has shown to be an effective and safe treatment of primary liver tumors. According to the staging system of the Barcelona Clinic Liver Cancer (BCLC), patients with macrovascular invasion are staged as BCLC-C. This paper comprises a presentation of the results following application of the procedure. Methods: From January 2002 to December 2015, 367 patients were transplanted at the San Camillo Hospital Center. One hundred and forty-three patients were transplanted for hepatocellular carcinoma (HCC) and in 22 cases patients were treated with Y90-RE before liver transplantation (LT), of them 4 with macrovascular invasion were included in this study. Results: The four patients had a complete response for the thrombosis, and were included in the waiting list within the Milan criteria. Means interval time between Y90-RE and LT was 15.86 months. No patient death was observed at Y90-RE procedure or at LT. We obtain a free-survival of 39.1 (range, 6–76) months. In all four cases the complete thrombosis regression was observed. Conclusions: We reported a short series of patients transplanted after Y90-RE in patients with BCLC stage C. In our experience we achieved acceptable overall and disease-free survival. Eventually, Y90-RE seems to have a place in the downstaging strategy for LT candidates.
Keywords :
Yttrium , hepatocellular carcinoma (HCC) , liver transplantation (LT) , radioembolization , macrovascular invasion , downstaging , Barcelona Clinic Liver Cancer (BCLC)
