Case Report: Cytoreductive Surgery and HIPEC Associated With Liver Electrochemotherapy in a Cholangiocarcinoma Patient With Peritoneal Carcinomatosis and Liver Metastasis Case Report
| Autor: | Costantino Mastronardi, Alessandro Palladino, Luca Ansaloni, Vanni Agnoletti, Mauro Stefano, Beatrice Benini, Paola Fugazzola, Marcello Bisulli, Federico Coccolini, Matteo Tomasoni, Enrico Prosperi, Emanuela Giampalma |
|---|---|
| Přispěvatelé: | Stefano M., Prosperi E., Fugazzola P., Benini B., Bisulli M., Coccolini F., Mastronardi C., Palladino A., Tomasoni M., Agnoletti V., Giampalma E., Ansaloni L. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Electrochemotherapy cholangiocarcinoma debulking electrochemotherapy heated intraperitoneal chemotherapy peritoneal metastases Tare weight medicine.medical_treatment lcsh:Surgery Hilum (biology) Case Report Metastasis 03 medical and health sciences 0302 clinical medicine Medicine Embolization business.industry lcsh:RD1-811 medicine.disease Debulking Primary tumor 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Hyperthermic intraperitoneal chemotherapy Radiology business |
| Zdroj: | Frontiers in Surgery, Vol 8 (2021) Frontiers in Surgery |
| Popis: | Introduction: Cholangiocarcinoma (CCA) is the second most common primary tumor of the liver, and the recurrence after hepatic resection (HR), the only curative therapy, is linked with a worse prognosis. Systemic chemotherapy (SC) and liver loco-regional treatments, like trans-arterial chemoembolization (TACE) or radio embolization (TARE), have been employed for the treatment of unresectable intrahepatic metastasis (IM) with benefit on overall survival (OS), but SC has a limited effect on peritoneal metastasis (PM). In the last years, novel treatments like electrochemotherapy (ECT) with bleomycine (BLM) for IM and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) for PM have been applied in small series but with encouraging results. We hereby describe the first synchronous application of ECT and CRS and HIPEC for the treatment of a patient with IM and PM from CCA.Case Description: A 47-year-old male patient with CCA underwent HR followed by adjuvant SC. After 14 months, for the occurrence of IM, the patient underwent a second HR and SC. Nonetheless, a new recurrence occurred and a third attempt of HR was proposed. Due to the intraoperative finding of unresectable IM with PM, no resective procedure was performed and the patient was referred to our center. CRS and HIPEC with cisplatin and mitomycin for PM and ECT with BLM on a bulky metastasis of the hepatic hilum were performed after 38 months from the first HR. The length of hospital stay was 19 days. At the computed tomography (CT) performed 11 days after treatment complete necrosis of the treated IM was detected.Results: CT scan after 3 and 6 months and magnetic resonance after 9 months were performed. Necrosis of the treated IM nor PM but progression of the residual liver lesions was observed. After 3 months, the patient received SC and underwent TACE after 8 months and TARE after 9 months for the residual liver metastases. At 14 months from CRS and HIPEC, the patient is alive, in good condition, and with stability of the disease.Conclusions: The association of ECT and CRS and HIPEC could be safe and effective for the treatment of unresectable recurrent intrahepatic CCA with PM. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|