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[PMID]:29277819
[Au] Autor:Kuramoto K; Beppu T; Nitta H; Imai K; Masuda T; Miyata T; Koga Y; Kitano Y; Kaida T; Nakagawa S; Okabe H; Hayashi H; Hashimoto D; Yamashita YI; Chikamoto A; Kikuchi K; Baba H
[Ad] Endereço:Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
[Ti] Título:Hepatic Resection Followed by Hepatic Arterial Infusion Chemotherapy for Hepatocellular Carcinoma with Intrahepatic Dissemination.
[So] Source:Anticancer Res;38(1):525-531, 2018 01.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIM: To investigate the utility of adjuvant hepatic arterial infusion chemotherapy (HAIC) following hepatectomy for patients with hepatocellular carcinoma (HCC) with intrahepatic dissemination (IHD) after local ablation therapy. PATIENTS AND METHODS: Twelve patients with HCC with IHD were divided into two groups: HAIC group (n=6) underwent hepatectomy followed by HAIC; and the non-HAIC group (n=6) underwent hepatectomy alone. HAIC with cisplatin and 5-fluorouracil was started within a month and was continued for a month: Results: At the first local ablation, tumors close to the major portal vein and insufficient ablation were recognized in eight (67.7%) and six (58.3%) of the patients, respectively. In the HAIC group, the 1-, 3-, and 5-year disease-free and overall survival rates were 50.0%, 16.7%, and 16.7%, and 83.3%, 83.3% and 62.5%, respectively. Three patients in the HAIC group remain alive after 10 years of follow-up. CONCLUSION: Hepatic resection with short-term postoperative HAIC may provide excellent outcomes in patients with HCC and IHD.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma Hepatocelular/tratamento farmacológico
Carcinoma Hepatocelular/cirurgia
Hepatectomia/métodos
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas/cirurgia
[Mh] Termos MeSH secundário: Idoso
Antimetabólitos Antineoplásicos/uso terapêutico
Carcinoma Hepatocelular/patologia
Cisplatino/uso terapêutico
Terapia Combinada/métodos
Intervalo Livre de Doença
Feminino
Fluoruracila/uso terapêutico
Artéria Hepática
Seres Humanos
Infusões Intra-Arteriais
Fígado/patologia
Neoplasias Hepáticas/patologia
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimetabolites, Antineoplastic); Q20Q21Q62J (Cisplatin); U3P01618RT (Fluorouracil)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171227
[St] Status:MEDLINE


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[PMID]:29078890
[Au] Autor:Kim M; Fisher DT; Powers CA; Gabriel EM; Korman AM; Sexton S; Gudkov AV; Skitzki JJ
[Ad] Endereço:Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York; Department of Immunology, Roswell Park Cancer Institute, Buffalo, New York.
[Ti] Título:Novel mouse models of hepatic artery infusion.
[So] Source:J Surg Res;219:25-32, 2017 Nov.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The liver has unique anatomy in that most blood flow to normal hepatocytes is derived from the portal venous system, whereas liver tumors obtain their nutrient blood supply exclusively from the hepatic artery. The focused arterial delivery of anticancer agents to liver tumors has been performed for decades; however, preclinical models to standardize drug regimens and examine novel agents have been lacking. The purpose of this study was to establish preclinical hepatic artery infusion (HAI) models in a mouse and to evaluate the safety and delivery capability of the models. MATERIAL AND METHODS: C57BL/6 and BALB/c mice were used to develop models of HAI via the hepatic artery (HA), superior pancreaticoduodenal artery (SPDA), or lienogastric artery (LGA). Success rates, distribution of perfusion, and associated morbidity and mortality were analyzed between groups. RESULTS: All three models were feasible and reproducible in mice, and there was no statistical difference on body weight change between models. The HA model had a 13.3% mortality from acute liver failure, and the SPDA model demonstrated duodenal and pancreatic toxicity. SPDA and LGA routes had the highest success rates (96.7% and 91.4%, respectively) with low mortality, better drug delivery, and preserved physiologic liver function compared with the HA model. CONCLUSIONS: The optimal route of HAI was mouse breed specific; SPDA access in BALB/c mice, and the LGA access in C57BL/6 mice. The described techniques serve as a reproducible platform for the identification and characterization of therapeutics for diverse metastatic liver tumors.
[Mh] Termos MeSH primário: Antineoplásicos/administração & dosagem
Neoplasias do Colo/patologia
Fluoruracila/administração & dosagem
Artéria Hepática
Neoplasias Hepáticas Experimentais/secundário
Neoplasias Hepáticas/secundário
[Mh] Termos MeSH secundário: Animais
Antineoplásicos/uso terapêutico
Linhagem Celular Tumoral
Feminino
Fluoruracila/uso terapêutico
Infusões Intra-Arteriais
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas Experimentais/tratamento farmacológico
Camundongos
Camundongos Endogâmicos BALB C
Camundongos Endogâmicos C57BL
Reprodutibilidade dos Testes
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); U3P01618RT (Fluorouracil)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171029
[St] Status:MEDLINE


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[PMID]:29029718
[Au] Autor:Sista AK; Moriarty JM
[Ad] Endereço:Division of Interventional Radiology, Langone School of Medicine, New York University, New York, NY.
[Ti] Título:The Future of Catheter-Directed Therapy: Data Gaps, Unmet Needs, and Future Trials.
[So] Source:Tech Vasc Interv Radiol;20(3):224-226, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This article will focus on 3 avenues for future research: (1) addressing the lack of short- and long-term clinical outcome research on catheter-directed therapy; (2) determining the safety and efficacy of novel thrombus removal devices; and (3) translating our knowledge of the pathobiology and pathophysiology of pulmonary embolism into novel diagnostic and therapeutic strategies.
[Mh] Termos MeSH primário: Cateterismo de Swan-Ganz/tendências
Cateteres/tendências
Ensaios Clínicos como Assunto/métodos
Fibrinolíticos/administração & dosagem
Lacunas da Prática Profissional/tendências
Embolia Pulmonar/terapia
Projetos de Pesquisa/tendências
Terapia Trombolítica/tendências
[Mh] Termos MeSH secundário: Cateterismo de Swan-Ganz/efeitos adversos
Cateterismo de Swan-Ganz/instrumentação
Difusão de Inovações
Desenho de Equipamento
Fibrinolíticos/efeitos adversos
Previsões
Seres Humanos
Infusões Intra-Arteriais
Embolia Pulmonar/diagnóstico
Embolia Pulmonar/fisiopatologia
Fatores de Risco
Terapia Trombolítica/efeitos adversos
Terapia Trombolítica/instrumentação
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


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[PMID]:29029714
[Au] Autor:Kesselman A; Kuo WT
[Ad] Endereço:Division of Vascular and Interventional Radiology, Stanford University Medical Center, Stanford, CA.
[Ti] Título:Catheter-Directed Therapy for Acute Submassive Pulmonary Embolism: Summary of Current Evidence and Protocols.
[So] Source:Tech Vasc Interv Radiol;20(3):193-196, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Treatment of acute submassive pulmonary embolism (PE) with thrombolytic therapy remains an area of controversy. For patients who fail or who have contraindications to systemic thrombolysis, catheter-directed therapy (CDT) may be offered depending on the patient's condition and the available institutional resources to perform CDT. Although various CDT techniques and protocols exist, the most studied method is low-dose catheter-directed thrombolytic infusion without mechanical thrombectomy. This article reviews current protocols and data on the use of CDT for acute submassive pulmonary embolism.
[Mh] Termos MeSH primário: Cateterismo de Swan-Ganz/instrumentação
Cateteres
Protocolos Clínicos
Medicina Baseada em Evidências
Fibrinolíticos/administração & dosagem
Embolia Pulmonar/tratamento farmacológico
Terapia Trombolítica/instrumentação
[Mh] Termos MeSH secundário: Doença Aguda
Cateterismo de Swan-Ganz/efeitos adversos
Desenho de Equipamento
Fibrinolíticos/efeitos adversos
Seres Humanos
Infusões Intra-Arteriais
Embolia Pulmonar/diagnóstico por imagem
Embolia Pulmonar/fisiopatologia
Fatores de Risco
Terapia Trombolítica/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Fibrinolytic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


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[PMID]:28906322
[Au] Autor:Fischer C; Petriccione M; Vitolano S; Guarini E; Davis ME; Dunkel IJ
[Ad] Endereço:Departments of *Pediatrics †Nursing, Memorial Sloan Kettering Cancer Center ‡Department of Pediatrics, Weill Cornell Medical College, New York, NY.
[Ti] Título:The Effect of Ophthalmic Artery Chemosurgery on Immune Function in Retinoblastoma Patients: A Single Institution Retrospective Analysis.
[So] Source:J Pediatr Hematol Oncol;39(7):555-559, 2017 Oct.
[Is] ISSN:1536-3678
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ophthalmic artery chemosurgery (OAC) is associated with grade 3 and 4 neutropenia, however the effect on T-cell number and function is unknown. The purpose of this retrospective review was to confirm that patients treated with OAC do not develop immunosuppression warranting Pneumocystis pneumonia prophylaxis. PROCEDURE: IRB approval was obtained for a single center retrospective review of immune function tests in retinoblastoma patients who received OAC. RESULTS: Twenty-three patients received ≥3 cycles of OAC and had immune function testing (absolute CD4 count) performed at a median of 34 days postcompletion of therapy (range, 15 to 63 d). Only 1 patient had a low absolute CD4 count of 189 cells/µL (normal, 359 to 1570 cells/µL) 2 and a half months after IV carboplatin and 28 days after their third dose of OAC. This patient was found to have coexisting hypogammaglobulinemia. Repeat immune function testing normalized through continued OAC treatment. CONCLUSIONS: Clinically significant immune suppression appears rare following OAC alone, but patients previously treated with IV chemotherapy may be immunosuppressed and may benefit from pneumocystis pneumonia prophylaxis until the CD4 count recovers.
[Mh] Termos MeSH primário: Neoplasias Oculares/imunologia
Artéria Oftálmica/efeitos dos fármacos
Retinoblastoma/imunologia
[Mh] Termos MeSH secundário: Contagem de Linfócito CD4
Carboplatina/uso terapêutico
Criança
Pré-Escolar
Neoplasias Oculares/terapia
Seres Humanos
Tolerância Imunológica/efeitos dos fármacos
Imunidade/efeitos dos fármacos
Lactente
Infusões Intra-Arteriais/efeitos adversos
Neutropenia/induzido quimicamente
Retinoblastoma/terapia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
BG3F62OND5 (Carboplatin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171028
[Lr] Data última revisão:
171028
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000968


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[PMID]:28817838
[Au] Autor:Lévi F; Karaboué A; Saffroy R; Desterke C; Boige V; Smith D; Hebbar M; Innominato P; Taieb J; Carvalho C; Guimbaud R; Focan C; Bouchahda M; Adam R; Ducreux M; Milano G; Lemoine A
[Ad] Endereço:INSERM, UMRS 935 Team 'Cancer Chronotherapy and Postoperative Liver Function', Campus CNRS, 7 rue Guy Môquet, and UMRS 1193 'Physiopathology and treatment of Liver diseases', Paul Brousse Hospital, 14 avenue Paul-Vaillant-Couturier, 94800 Villejuif, France.
[Ti] Título:Pharmacogenetic determinants of outcomes on triplet hepatic artery infusion and intravenous cetuximab for liver metastases from colorectal cancer (European trial OPTILIV, NCT00852228).
[So] Source:Br J Cancer;117(7):965-973, 2017 Sep 26.
[Is] ISSN:1532-1827
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The hepatic artery infusion (HAI) of irinotecan, oxaliplatin and 5-fluorouracil with intravenous cetuximab achieved outstanding efficacy in previously treated patients with initially unresectable liver metastases from colorectal cancer. This planned study aimed at the identification of pharmacogenetic predictors of outcomes. METHODS: Circulating mononuclear cells were analysed for 207 single-nucleotide polymorphisms (SNPs) from 34 pharmacology genes. Single-nucleotide polymorphisms passing stringent Hardy-Weinberg equilibrium test were tested for their association with outcomes in 52 patients (male/female, 36/16; WHO PS, 0-1). RESULTS: VKORC1 SNPs (rs9923231 and rs9934438) were associated with early and objective responses, and survival. For rs9923231, T/T achieved more early responses than C/T (50% vs 5%, P=0.029) and greatest 4-year survival (46% vs 0%, P=0.006). N-acetyltransferase-2 (rs1041983 and rs1801280) were associated with up to seven-fold more macroscopically complete hepatectomies. Progression-free survival was largest in ABCB1 rs1045642 T/T (P=0.026) and rs2032582 T/T (P=0.035). Associations were found between toxicities and gene variants (P<0.05), including neutropenia with ABCB1 (rs1045642) and SLC0B3 (rs4149117 and rs7311358); and diarrhoea with CYP2C9 (rs1057910), CYP2C19 (rs3758581), UGT1A6 (rs4124874) and SLC22A1 (rs72552763). CONCLUSION: VKORC1, NAT2 and ABCB1 variants predicted for HAI efficacy. Pharmacogenetics could guide the personalisation of liver-targeted medico-surgical therapies.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Arilamina N-Acetiltransferase/genética
Neoplasias Colorretais/genética
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas/genética
Vitamina K Epóxido Redutases/genética
[Mh] Termos MeSH secundário: Subfamília B de Transportador de Cassetes de Ligação de ATP/genética
Administração Intravenosa
Adulto
Idoso
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Camptotecina/administração & dosagem
Camptotecina/análogos & derivados
Proteínas da Membrana Plasmática de Transporte de Catecolaminas/genética
Cetuximab/administração & dosagem
Neoplasias Colorretais/patologia
Citocromo P-450 CYP2C19/genética
Citocromo P-450 CYP2C9/genética
Diarreia/induzido quimicamente
Diarreia/genética
Intervalo Livre de Doença
Feminino
Fluoruracila/administração & dosagem
Glucuronosiltransferase/genética
Hepatectomia
Artéria Hepática
Seres Humanos
Infusões Intra-Arteriais
Neoplasias Hepáticas/secundário
Neoplasias Hepáticas/cirurgia
Masculino
Meia-Idade
Neutropenia/induzido quimicamente
Neutropenia/genética
Compostos Organoplatínicos/administração & dosagem
Farmacogenética
Polimorfismo de Nucleotídeo Único
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (ABCB1 protein, human); 0 (ATP Binding Cassette Transporter, Sub-Family B); 0 (Catecholamine Plasma Membrane Transport Proteins); 0 (Organoplatinum Compounds); 0 (Slc22a1 protein, mouse); 04ZR38536J (oxaliplatin); 7673326042 (irinotecan); EC 1.14.13.- (CYP2C9 protein, human); EC 1.14.13.- (Cytochrome P-450 CYP2C9); EC 1.14.14.1 (Cytochrome P-450 CYP2C19); EC 1.17.4.4 (VKORC1 protein, human); EC 1.17.4.4 (Vitamin K Epoxide Reductases); EC 2.3.1.5 (Arylamine N-Acetyltransferase); EC 2.3.1.5 (NAT2 protein, human); EC 2.4.1.- (UDP-glucuronosyltransferase, UGT1A6); EC 2.4.1.17 (Glucuronosyltransferase); PQX0D8J21J (Cetuximab); U3P01618RT (Fluorouracil); XT3Z54Z28A (Camptothecin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1038/bjc.2017.278


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[PMID]:28754718
[Au] Autor:Barlow SC; Doviak H; Jacobs J; Freeburg LA; Perreault PE; Zellars KN; Moreau K; Villacreses CF; Smith S; Khakoo AY; Lee T; Spinale FG
[Ad] Endereço:Cardiovascular Translational Research Center, University of South Carolina School of Medicine and the William Jennings Bryan Dorn Veterans Affairs Medical Center, Columbia, South Carolina; and.
[Ti] Título:Intracoronary delivery of recombinant TIMP-3 after myocardial infarction: effects on myocardial remodeling and function.
[So] Source:Am J Physiol Heart Circ Physiol;313(4):H690-H699, 2017 Oct 01.
[Is] ISSN:1522-1539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ischemia-reperfusion (IR) and myocardial infarction (MI) cause adverse left ventricular (LV) remodeling and heart failure and are facilitated by an imbalance in matrix metalloproteinase (MMP) activation and the endogenous tissue inhibitors of metalloproteinase (TIMPs). We have identified that myocardial injections of recombinant TIMP-3 (rTIMP-3; human full length) can interrupt post-MI remodeling. However, whether and to what degree intracoronary delivery of rTIMP-3 post-IR is feasible and effective remained to be established. Pigs (25 kg) underwent coronary catheterization and balloon occlusion of the left anterior descending coronary artery (LAD) for 90 min whereby at the final 4 min, rTIMP-3 (30 mg, = 9) or saline was infused in the distal LAD. LV echocardiography was performed at 3-28 days post-IR, and LV ejection fraction (EF) and LV end-diastolic volume were measured. LV EF fell and LV end-diastolic volume increased from baseline (pre-IR) values (66 ± 1% and 40 ± 1 ml, respectively, means ± standard deviation) in both groups; however, the extent of LV dilation was reduced in the rTIMP-3 group by 40% at 28 days post-IR ( < 0.05) and the fall in LV EF was attenuated. Despite equivalent plasma troponin levels (14 ± 3 ng/ml), computed MI size at 28 days was reduced by over 45% in the rTIMP-3 group ( < 0.05), indicating that rTIMP-3 treatment abrogated MI expansion post-IR. Plasma NH -terminal pro-brain natriuretic peptide levels, an index of heart failure progression, were reduced by 25% in the rTIMP-3 group compared with MI saline values ( < 0.05). Although the imbalance between MMPs and TIMPs has been recognized as a contributory factor for post-MI remodeling, therapeutic strategies targeting this imbalance have not been forthcoming. This study is the first to demonstrate that a relevant delivery approach (intracoronary) using rTIMP can alter the course of post-MI remodeling. Myocardial ischemia and reperfusion injury remain significant causes of morbidity and mortality whereby alterations in the balance between matrix metalloproteinase and tissue inhibitor of metalloproteinase have been identified as contributory biological mechanisms. This novel translational study advances the concept of targeted delivery of recombinant proteins to modify adverse myocardial remodeling in ischemia-reperfusion injury.
[Mh] Termos MeSH primário: Infarto do Miocárdio
Traumatismo por Reperfusão
Inibidor Tecidual de Metaloproteinase-3/farmacologia
Disfunção Ventricular Esquerda/diagnóstico por imagem
Função Ventricular Esquerda/efeitos dos fármacos
Remodelação Ventricular/efeitos dos fármacos
[Mh] Termos MeSH secundário: Animais
Vasos Coronários
Ecocardiografia
Infusões Intra-Arteriais
Peptídeo Natriurético Encefálico/sangue
Peptídeo Natriurético Encefálico/efeitos dos fármacos
Fragmentos de Peptídeos/sangue
Fragmentos de Peptídeos/efeitos dos fármacos
Proteínas Recombinantes/farmacologia
Volume Sistólico/efeitos dos fármacos
Suínos
Troponina/sangue
Troponina/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Peptide Fragments); 0 (Recombinant Proteins); 0 (Tissue Inhibitor of Metalloproteinase-3); 0 (Troponin); 0 (pro-brain natriuretic peptide (1-76)); 114471-18-0 (Natriuretic Peptide, Brain)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170730
[St] Status:MEDLINE
[do] DOI:10.1152/ajpheart.00114.2017


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[PMID]:28705491
[Au] Autor:Kasai Y; Hatano E; Seo S; Taura K; Yasuchika K; Okajima H; Kaido T; Uemoto S
[Ad] Endereço:Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
[Ti] Título:Proposal of selection criteria for operative resection of hepatocellular carcinoma with inferior vena cava tumor thrombus incorporating hepatic arterial infusion chemotherapy.
[So] Source:Surgery;162(4):742-751, 2017 Oct.
[Is] ISSN:1532-7361
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Because operative resection of hepatocellular carcinoma with inferior vena cava tumor thrombus has been associated with a substantial risk of recurrence and postoperative morbidity, adequate patient selection for resection is necessary. Our aim was to propose selection criteria for resection of hepatocellular carcinoma with inferior vena cava tumor thrombus. METHODS: Long-term outcomes were analyzed retrospectively in 39 operative cases of hepatocellular carcinoma with inferior vena cava tumor thrombus (1996-2015). Since 2003, preoperative hepatic arterial infusion chemotherapy instead of immediate resection has been performed in patients with advanced inferior vena cava tumor thrombus, defined as those patients with suspected extrahepatic metastasis, who will need extracorporeal circulation, or who have marginal liver function and/or multiple bilobar tumors. Indication for resection has been based on the tumor response to hepatic arterial infusion chemotherapy thereafter. RESULTS: The median survival time for all patients was 15.2 months. Multivariate analysis revealed that preoperative hepatic arterial infusion chemotherapy (hazard ratio: 0.30), use of extracorporeal circulation (3.12), and extrahepatic metastasis (2.67) were independent prognostic factors for overall survival. Among patients with initially advanced inferior vena cava tumor thrombus, preoperative hepatic arterial infusion chemotherapy was associated with a much more favorable prognosis compared with no hepatic arterial infusion chemotherapy (median survival time: unreached vs 8.3 months, P = .007). Overall survival was significantly worse in patients with uncontrolled, advanced inferior vena cava tumor thrombus than in those without advanced inferior vena cava tumor thrombus or with advanced inferior vena cava tumor thrombus controlled by preoperative hepatic arterial infusion chemotherapy (median survival time: 10.4 vs 26.1 months, P = .039). CONCLUSION: An effective response to hepatic arterial infusion chemotherapy and subsequent operative resection salvaged patients with initially advanced inferior vena cava tumor thrombus. Our results suggest that operative resection should be indicated only in patients without advanced inferior vena cava tumor thrombus or with advanced inferior vena cava tumor thrombus controlled by preoperative hepatic arterial infusion chemotherapy.
[Mh] Termos MeSH primário: Antineoplásicos/administração & dosagem
Carcinoma Hepatocelular/terapia
Hepatectomia
Neoplasias Hepáticas/terapia
Veia Cava Inferior
Trombose Venosa/terapia
[Mh] Termos MeSH secundário: Idoso
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/secundário
Quimioterapia Adjuvante
Feminino
Seres Humanos
Infusões Intra-Arteriais
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/patologia
Masculino
Meia-Idade
Terapia Neoadjuvante
Seleção de Pacientes
Estudos Retrospectivos
Resultado do Tratamento
Trombose Venosa/etiologia
Trombose Venosa/mortalidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE


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[PMID]:28669140
[Au] Autor:Kim DY
[Ad] Endereço:Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
[Ti] Título:Can metronomic chemotherapy be an alternative to sorafenib in advanced hepatocellular carcinoma?
[So] Source:Clin Mol Hepatol;23(2):123-124, 2017 06.
[Is] ISSN:2287-285X
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Mh] Termos MeSH primário: Carcinoma Hepatocelular
Compostos de Fenilureia
[Mh] Termos MeSH secundário: Protocolos de Quimioterapia Combinada Antineoplásica
Seres Humanos
Infusões Intra-Arteriais
Neoplasias Hepáticas
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Nm] Nome de substância:
0 (Phenylurea Compounds)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170703
[St] Status:MEDLINE
[do] DOI:10.3350/cmh.2017.0107


  10 / 9208 MEDLINE  
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[PMID]:28651849
[Au] Autor:Rigattieri S; Biondi Zoccai G; Sciahbasi A; Di Russo C; Cera M; Patrizi R; Fedele S; Berni A; Pugliese FR
[Ad] Endereço:Interventional Cardiology, Sandro Pertini Hospital, Azienda Sanitaria Locale Roma 2, Rome, Italy. Electronic address: stefanorigattieri@yahoo.it.
[Ti] Título:Meta-Analysis of Head-to-Head Comparison of Intracoronary Versus Intravenous Adenosine for the Assessment of Fractional Flow Reserve.
[So] Source:Am J Cardiol;120(4):563-568, 2017 Aug 15.
[Is] ISSN:1879-1913
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intravenous (IV) infusion of adenosine represents the gold standard for measuring fractional flow reserve (FFR). However, IV adenosine is more expensive and time-consuming compared with intracoronary (IC) boluses of adenosine. We conducted a meta-analysis of studies comparing IC with IV adenosine for FFR assessment in the same coronary lesions. We searched for studies comparing IC with IV adenosine and reporting absolute FFR values or rate of abnormal FFR for both routes. Prespecified subgroup analysis was performed to appraise studies using low-dose (<100 µg) or high-dose IC adenosine (≥100 µg). We retrieved 11 studies amounting to 587 patients and 621 lesions. Six studies evaluated low-dose IC boluses (15 to 80 µg) and 5 studies high-dose boluses (120 to 600 µg). Absolute FFR values were slightly, yet significantly lower with IV adenosine compared with IC adenosine (mean difference 0.02, 95% confidence interval [CI] 0.00 to 0.03, p = 0.02). This difference, however, did not translate into a significant difference in the rate of abnormal FFR between IC and IV adenosine (hazard ratio 0.93, 95% CI 0.76 to 1.13, p = 0.57); moreover, no statistically significant difference was observed between low-dose and high-dose IC adenosine subgroups. Adverse events were less frequent with IC adenosine compared with IV adenosine (risk ratio 0.17, 95% CI 0.07 to 0.43, p <0.001). In conclusion, IC administration of adenosine, although inducing a slightly lower amount of hyperemia compared with IV infusion of adenosine, yields a similar diagnostic accuracy in identifying hemodynamically significant coronary stenosis and is better tolerated by the patients.
[Mh] Termos MeSH primário: Adenosina/administração & dosagem
Doença da Artéria Coronariana/diagnóstico
Circulação Coronária/efeitos dos fármacos
Vasos Coronários/fisiopatologia
Reserva Fracionada de Fluxo Miocárdico/fisiologia
Vasodilatação/fisiologia
[Mh] Termos MeSH secundário: Angiografia Coronária
Doença da Artéria Coronariana/fisiopatologia
Vasos Coronários/diagnóstico por imagem
Vasos Coronários/efeitos dos fármacos
Relação Dose-Resposta a Droga
Infusões Intra-Arteriais
Infusões Intravenosas
Índice de Gravidade de Doença
Vasodilatação/efeitos dos fármacos
Vasodilatadores/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Vasodilator Agents); K72T3FS567 (Adenosine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170628
[St] Status:MEDLINE



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