Management of hepatocellular adenoma: comparison of resection, embolization and observation
| Autor: | Peter J. Allen, Ami M. Karkar, George I. Getrajdman, Stephen B. Solomon, T. Peter Kingham, Michael I. D' Angelica, Yuman Fong, Mithat Gonen, Laura H. Tang, William R. Jarnagin, Ronald P. DeMatteo, Camilo Correa-Gallego, Nilesh D. Kashikar |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adenoma medicine.medical_treatment Adenoma Liver Cell Resection Tertiary Care Centers Predictive Value of Tests medicine Hepatectomy Humans Embolization Watchful Waiting Retrospective Studies Chi-Square Distribution Hepatology business.industry Patient Selection Liver Neoplasms Gastroenterology Retrospective cohort study Original Articles Middle Aged Hepatocellular adenoma Hepatic tumour medicine.disease Embolization Therapeutic digestive system diseases Tumor Burden Surgery Treatment Outcome Predictive value of tests Female New York City sense organs Neoplasm Recurrence Local business Watchful waiting |
| Zdroj: | HPB. 15:235-243 |
| ISSN: | 1365-182X |
| Popis: | IntroductionHepatocellular adenoma (HA) is an uncommon benign hepatic tumour with the potential for malignant change or spontaneous haemorrhage. Resection has been the recommended treatment, but outcomes with other approaches are ill defined.MethodsDemographic and outcomes data were retrospectively collected on patients diagnosed with HA at a tertiary hepatobiliary centre from 1992–2011 whom underwent resection, bland embolization or observation.ResultsIn total, 52 patients with 100 adenomas were divided into single HA (n = 27), multiple HA (n = 18), and adenomatosis (n = 7) groups. Eighty‐seven per cent were female and 37% had a history of hormone use. Median sizes of resected, embolized and observed adenomas were 3.6 cm, 2.6 cm and 1.2 cm, respectively. Forty‐eight adenomas were resected as a result of suspicion of malignancy (39%) or large size (39%); 61% of these were solitary. Thirty‐seven were embolized for suspicion of malignancy (56%) or hsemorrhage (20%); 92% of these were multifocal. Two out of three resected adenomas with malignancy were ≥10 cm and recurred locally [4%, confidence interval (CI) 1–14%]. Ninety‐two per cent of the embolized adenomas were effectively treated; three persisted (8.1%, CI 2–22%). Most observed lesions did not change over time.conclusionsWhile solitary adenomas are often resected, multifocal HAs are frequently embolized. Small adenomas can safely be observed. Given low recurrence rates, select HAs can be considered for embolization. |
| Databáze: | OpenAIRE |
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