A multidisciplinary approach to peritoneal metastasis from hepatocellular carcinoma: clinical features, management and outcomes

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art_FONSECA_A_multidisciplinary_approach_to_peritoneal_metastasis_from_hepatocellular_2022.PDF (173.85 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2022
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
TERMEDIA PUBLISHING HOUSE LTD
Autores
Citação
CLINICAL AND EXPERIMENTAL HEPATOLOGY, v.8, n.1, p.42-48, 2022
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Aim of the study: Hepatocellular carcinoma (HCC) is a lethal malignancy with heterogeneous behavior determined by liver function, clinical presentation and treatment response. Peritoneal metastasis (PM) from HCC is rare and management is challenging. We aim to report a cohort of patients with advanced HCC and describe demographic characteristics, treatment and outcomes of patients with PM. Material and methods: We analyzed data from a retrospective cohort of patients with HCC. Patients with PM were analyzed individually. Baseline characteristics, treatment strategy and median overall survival (OS) with 95% confidence interval (CI) were reported. Results: 238 patients with advanced HCC were evaluated. Eleven patients had PM: 7 patients were treated with systemic treatment and 4 were treated with upfront peritonectomy followed by systemic treatment at recurrence. These 4 patients had well-preserved liver function and low disease burden and were younger compared to the total cohort. The median time to recurrence after peritonectomy was 30.25 months (interquartile range [IQR]: 13.53-46.92): 3 of them presented peritoneal recurrence (2 with diffuse peritoneal spread and 1 with concomitant hepatic recurrence) and 1 presented pulmonary recurrence. Overall, patients with PM showed similar OS compared to patients with other metastatic sites (11.8 months; 95% CI: 1.5-19.8 vs. 8 months; 95% CI: 6.7-10, p = 0.901). Patients with PM treated with upfront surgery had a median OS of 60 months (95% CI: 16.7-not reached). Conclusions: Resection of PM from HCC may provide long-term survival in selected patients. A multidisciplinary approach is the optimal strategy for managing PM from HCC.
Palavras-chave
hepatocellular carcinoma, peritonectomy, liver cancer, prognosis, cancer treatment
URI
https://observatorio.fm.usp.br/handle/OPI/47126
Referências
  1. Bruix J, 2005, HEPATOLOGY, V42, P1208, DOI 10.1002/hep.20933
  2. Bruix J, 2019, NAT REV GASTRO HEPAT, V16, P617, DOI 10.1038/s41575-019-0179-x
  3. Chua TC, 2012, SURG ONCOL, V21, P95, DOI 10.1016/j.suronc.2011.01.005
  4. Finn RS, 2020, NEW ENGL J MED, V382, P1894, DOI 10.1056/NEJMoa1915745
  5. Forner A, 2012, LANCET, V379, P1245, DOI 10.1016/S0140-6736(11)61347-0
  6. Gordan JD, 2020, J CLIN ONCOL, V38, P4317, DOI 10.1200/JCO.20.02672
  7. Honore C, 2016, J VISC SURG, V153, P101, DOI 10.1016/j.jviscsurg.2015.11.010
  8. Jacquet P, 1996, Cancer Treat Res, V82, P359
  9. Kosaka A, 1999, SURG TODAY, V29, P453, DOI 10.1007/BF02483040
  10. Kudo M, 2018, LANCET, V391, P1163, DOI 10.1016/S0140-6736(18)30207-1
  11. Kwak MS, 2012, DIGEST DIS SCI, V57, P813, DOI 10.1007/s10620-011-1995-1
  12. Lin CC, 2009, J GASTROEN HEPATOL, V24, P815, DOI 10.1111/j.1440-1746.2009.05848.x
  13. Llovet JM, 2003, J HEPATOL, V38, pS136, DOI 10.1016/S0168-8278(02)00432-4
  14. Llovet JM, 2008, NEW ENGL J MED, V359, P378, DOI 10.1056/NEJMoa0708857
  15. Natsuizaka M, 2005, J GASTROEN HEPATOL, V20, P1781, DOI 10.1111/j.1440-1746.2005.03919.x
  16. Reig M, 2018, J HEPATOL, V69, P525, DOI 10.1016/j.jhep.2018.03.028
  17. Ren A, 2019, ASIAN J SURG, V42, P464, DOI 10.1016/j.asjsur.2018.09.006
  18. Sarveazad A, 2019, J RES MED SCI, V24, DOI 10.4103/jrms.JRMS_1017_18
  19. Stigliano R, 2007, CANCER TREAT REV, V33, P437, DOI 10.1016/j.ctrv.2007.04.001
  20. Tabrizian P, 2014, J SURG ONCOL, V110, P786, DOI 10.1002/jso.23739
  21. Uchino K, 2011, CANCER-AM CANCER SOC, V117, P4475, DOI 10.1002/cncr.25960
  22. Villanueva A, 2019, NEW ENGL J MED, V380, P1450, DOI 10.1056/NEJMra1713263
  23. Yeh CN, 2004, WORLD J SURG, V28, P382, DOI 10.1007/s00268-003-7319-7

Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/07
Artigos e Materiais de Revistas Científicas - LIM/37
Artigos e Materiais de Revistas Científicas - ODS/03
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