Prior Biliary Tree Instrumentation Does Not Preclude Hepatic Arterial Therapy for Malignancy
| Autor: | Charles R. Scoggins, Robert C.G. Martin, Jason T. Bowling, Kelly M. McMasters, Nathan P. Reuter, Cliff Tatum |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
education.field_of_study medicine.drug_class business.industry Antibiotics Population Cancer General Medicine Malignancy medicine.disease Gastroenterology Surgery medicine.anatomical_structure Biliary tract Internal medicine parasitic diseases medicine Liver cancer business education Complication Artery |
| Zdroj: | The American Surgeon. 76:618-621 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/000313481007600626 |
| Popis: | Hepatic arterial therapy (HAT) has become an accepted alternative for patients with unresectable hepatic malignancies. HAT has an acceptable toxicity profile, yet its safety for use in patients who have undergone significant biliary manipulation is undocumented. A retrospective review identified 18 consecutive patients with unresectable hepatic malignancies who had undergone significant prior biliary tree manipulation. All patients received peri-HAT antibiotics. Clinicopathologic, treatment-related, and outcomes data were collected and analyzed. Eighteen patients who had HAT were analyzed; 72 per cent were men, the median age was 61 years, and 61 per cent had greater than 25 per cent hepatic parenchymal replacement by tumor. Seventy-eight per cent of patients had an indwelling biliary stent and 22 per cent had undergone a hepaticojejunostomy Twenty-two per cent of patients developed a complication, none of which were infectious, and there were no peri-HAT deaths. The majority of patients had evidence of either a partial response (55%) or stable disease (22%) upon follow-up. One patient had a complete response to HAT. The median survival was 27 months. Hepatic arterial therapy seems to be safe for patients with unresectable hepatic malignancies and a history of significant biliary instrumentation. There is no increased risk of infectious complications in this population after HAT |
| Databáze: | OpenAIRE |
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