Liver Resection After Selective Internal Radiation Therapy with Yttrium-90 is Safe and Feasible: A Bi-institutional Analysis

Wright, G. Paul; Marsh, J. Wallis; Varma, Mala; Doherty, Michael G.; Bartlett, David L.; Chung, Mathew H.

doi:10.1245/s10434-016-5697-y

Cited by 35 publications

(35 citation statements)

References 18 publications

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“…This is in accordance with the results of different groups and our clinical findings . The lack of radiation injury, together with the described effect on tumor tissue, supports the idea that SIRT has a role in preoperative downsizing of liver malignancies …”

Section: Discussionsupporting

confidence: 93%

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Histopathological changes resulting from selective internal radiotherapy (SIRT)

Justinger

Gruden

Kouladouros

et al. 2018

Journal of Surgical Oncology

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Section: Discussionsupporting

confidence: 93%

“…8 The lack of radiation injury, together with the described effect on tumor tissue, supports the idea that SIRT has a role in preoperative downsizing of liver malignancies. 8,26,27…”

Section: Effect Of Sirt On Healthy Liver Tissuementioning

confidence: 99%

Histopathological changes resulting from selective internal radiotherapy (SIRT)

Justinger

Gruden

Kouladouros

et al. 2018

Journal of Surgical Oncology

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“…Follow-up imaging was planned at three monthly intervals post SIRT, but this did not occur in all patients. It is important to emphasize that similar to a previous study, SIRT was not intended a bridge to surgical resection at the time of treatment [12].…”

Section: Methodsmentioning

confidence: 67%

“…Despite promising results, SIRT is considered a salvage therapy. A small cohort of patients can however have a response to SIRT which renders them potential candidates for curative surgical resection [11,12]. The experience with hepatic resection post SIRT is limited with less than 100 published cases.…”

Section: Introductionmentioning

confidence: 99%

Liver Resection After Selective Internal Radiation Therapy with Yttrium-90: Safety and Outcomes

Mafeld

Littler

Hayhurst

et al. 2019

J Gastrointest Canc

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Introduction Selective internal radiotherapy (SIRT) with yttrium-90 (Y-90) is an intra-arterial therapy for hepatic malignancy in patients who are unsuitable for surgical resection. This treatment is considered palliative, although some patients can demonstrate a response that is adequate to facilitate surgical resection with curative intent. Methods All patients who underwent liver resection post SIRT were reviewed. Data gathered included patient demographics, tumor type, surgical details, and post-operative outcomes. Results Twelve patients underwent SIRT followed by liver resection (7 males and 5 females). Pathologies were hepatocellular carcinoma (n = 5), metastatic colorectal cancer (n = 5), and neuroendocrine tumor (n = 2). Lesional response (size, volume, and RECIST (response evaluation criteria in solid tumors)) was calculated and where appropriate functional liver remnant (FLR) is presented. Mean FLR increase was 264cm 3 (range − 123 to 909), and all cases demonstrated a partial response according to RECIST with a mean largest lesion volume reduction of 475cm 3 (range 14-1632). No post-SIRT complications were noted. Hepatectomy occurred at a mean of 322 days from SIRT treatment. Ninety-day morbidity was 67% (n = 6), complications postsurgery were analyzed according to the Clavien-Dindo classification scale; a total of 15 events occurred in 6 patients. Ninety-day mortality of 11% (n = 1). Conclusion In selected cases, liver resection is possible post SIRT. As this can represent a potentially curative option, it is important to reconsider resection in the follow-up of patients undergoing SIRT. Post-operative complications are noted following major and extended liver resection. Therefore, further studies are needed to improve patient selection.

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“…5 While a high morbidity procedure, the median overall survival was prolonged beyond 25 months in a cohort of select patients with initially unresectable liver metastases. Similarly, in a selected cohort of 511 patients, Di Giorgio et al demonstrate oncological safety and overall survival outcomes of 54 months in patients with advanced ovarian cancer.…”

mentioning

confidence: 99%