Prior biliary tree instrumentation does not preclude hepatic arterial therapy for malignancy
Jason T Bowling1, Nathan P Reuter, Robert C G Martin
1Division of Surgical Oncology, Department of Surgery and the James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky, USA.
The American Surgeon
|June 30, 2010
Summary
Hepatic arterial therapy (HAT) is safe for unresectable liver cancer patients with prior biliary procedures. This study found no increased infectious complications or deaths, with most patients showing disease control or response.
Area of Science:
- Oncology
- Hepatology
- Interventional Radiology
Background:
- Hepatic arterial therapy (HAT) is an established treatment for unresectable hepatic malignancies.
- The safety of HAT in patients with prior significant biliary manipulation is not well-documented.
Purpose of the Study:
- To evaluate the safety and outcomes of HAT in patients with unresectable hepatic malignancies who have undergone significant prior biliary tree manipulation.
Main Methods:
- Retrospective review of 18 consecutive patients with unresectable hepatic malignancies and prior biliary manipulation.
- Analysis of clinicopathologic, treatment-related, and outcomes data, with all patients receiving peri-HAT antibiotics.
Main Results:
- 22% of patients experienced complications, none infectious; no peri-HAT deaths occurred.
- 55% showed partial response, 22% stable disease, and 1 complete response.
- Median survival was 27 months.
Conclusions:
- Hepatic arterial therapy (HAT) appears safe for patients with unresectable hepatic malignancies and a history of significant biliary instrumentation.
- There is no elevated risk of infectious complications in this patient population following HAT.
