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经肝动脉化疗栓塞(TACE)治疗后的肝癌患者行手术切除的转化治疗:多学科工作组的建议。

Conversion to resection post radioembolization in patients with HCC: recommendations from a multidisciplinary working group.

机构信息

University of Utah, Salt Lake City, UT, USA.

Mount Sinai Hospital, New York, NY, USA.

出版信息

HPB (Oxford). 2022 Jul;24(7):1007-1018. doi: 10.1016/j.hpb.2021.12.013. Epub 2021 Dec 25.

Abstract

BACKGROUND

Transarterial radioembolization (TARE) with yttrium-90 (Y) glass microspheres is an efficacious option for converting appropriately selected patients with borderline-resectable hepatocellular carcinoma (HCC) to surgical candidacy.

METHODS

In 2018 and 2019, a diverse multidisciplinary group of surgical and interventional experts with experience using Y for downstaging and bridging to liver transplant convened to review peer-reviewed literature and personal experience in the use of Y to convert borderline resectable liver cancer patients to surgical candidacy. The working group included surgical oncologists specializing in liver cancer, liver transplant surgeons with experience in complex hepatobiliary surgery, and interventional radiologists with experience using Y.

RESULTS

This document presents expert recommendations based upon the group's experience and consensus.

CONCLUSIONS

By combining related evidence from the literature with expert experiences with TARE in surgical candidates, these recommendations aim to demonstrate the safety, efficacy, and feasibility of TARE in converting borderline-resectable patients to surgical options. The document also addresses the concerns about potential complications associated with TARE during the surgical intervention.

摘要

背景

经动脉放射性栓塞术(TARE)联合钇-90(Y)玻璃微球是一种有效的治疗方法,可将合适选择的边界可切除肝细胞癌(HCC)患者转化为手术适应证。

方法

在 2018 年和 2019 年,一组来自不同专业领域的多学科手术和介入专家(具有使用 Y 进行降期和桥接肝移植的经验)齐聚一堂,回顾了经动脉放射性栓塞术治疗边界可切除肝癌患者的相关文献和个人经验,以评估其将患者转化为手术适应证的效果。该工作组包括专门从事肝癌手术的外科肿瘤学家、具有复杂肝胆手术经验的肝移植外科医生,以及具有 Y 使用经验的介入放射科医生。

结果

本文件基于专家组的经验和共识提出了专家建议。

结论

通过将文献中的相关证据与手术候选患者中 TARE 的专家经验相结合,这些建议旨在证明 TARE 转化为手术选择的安全性、有效性和可行性。该文件还解决了与 TARE 相关的潜在并发症在手术干预期间的担忧。

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