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Hepatic chemoembolization: safety with portal vein thrombosis
M J Pentecost1, J R Daniels, G P Teitelbaum
1Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Summary
Hepatic chemoembolization is a safe and effective treatment for unresectable liver tumors, even with portal vein thrombosis. This procedure demonstrated positive patient responses and no major complications.
Area of Science:
- Interventional Radiology
- Oncology
- Hepatology
Background:
- Unresectable hepatic malignancy poses significant treatment challenges.
- Portal vein thrombosis (PVT) is often considered a contraindication for liver interventions.
- Effective treatment options for liver tumors with PVT are limited.
Purpose of the Study:
- To evaluate the safety and efficacy of hepatic chemoembolization in patients with unresectable hepatic malignancy and PVT.
- To determine if PVT necessitates excluding patients from chemoembolization therapy.
Main Methods:
- Nine patients with unresectable liver tumors and PVT underwent hepatic chemoembolization.
- Treatment involved a chemoembolic agent mixture (collagen, mitomycin, doxorubicin, cisplatin).
- Embolization continued until complete cessation of hepatic artery flow.
Main Results:
- All chemoembolization procedures were technically successful.
- Eight out of nine patients showed a positive response to treatment.
- Two patients achieved long-term survival (>2 years); no hepatic infarction or insufficiency occurred.
Conclusions:
- Portal vein thrombosis should not be an absolute contraindication for hepatic chemoembolization.
- Hepatic chemoembolization can be safely performed in patients with PVT, provided adequate collateral circulation exists.
- This approach offers a viable treatment option for selected patients with advanced liver cancer.