Transarterial chemoembolisation in the treatment of patients with metastatic colorectal cancer

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Abstract

Aim. To assess effectiveness of chemoembolization of hepatic artery (CEHA) in treatment of patients with metastatic colorectal cancer, and also to determine the optimal interval in combination of CEHA with other treatment methods.

Materials and Methods. The study includes analysis of the results of treatment of 30 patients with resectable metastases of colorectal cancer in the liver. The first group included 15 patients with resection made 1 week after CEHA. The second group consisted of 15 patients in whom resection operation was made 2 weeks after CENA with subsequent assessment of morphological changes in metastases.

Results. Therapeutic pathomorphism was recorded in 25/30 patients. In the first group, therapeutic pathomorphism was observed in 13/15 patients. In 11/13 patients, the 2nd degree of therapeutic pathomorphism was recorded. In 2/13 patients – the 1st degree. In the second group, therapeutic pathomorphism was observed in 12/15 patients. In all patients the 2nd degree of therapeutic pathomorphism was recorded. No significant differences in the degree of therapeutic pathomorphism were recorded on the 7th and 14th day after regional chemotherapy (p=0.436).

Conclusion. Hepatic artery chemoembolization is an effective method of treating patients with metastases of colorectal cancer in the liver. In use of chemoembolization of hepatic artery in combination with other surgical methods, the sevenday time interval is optimal.

About the authors

Alexey V. Shabunin

Russian Medical Academy of Continuous Professional Education

Email: dc.drozdov@gmail.com
ORCID iD: 0000-0002-4230-8033
SPIN-code: 8917-7732

Corresponding Member of Russian Academy of Sciences, MD, Grand PhD, Professor, Head of Surgery Department, Russian Medical Academy of Continuous Professional Education; Head of Botkin Hospital

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

Michael M. Tavobilov

Russian Medical Academy of Continuous Professional Education

Email: dc.drozdov@gmail.com
ORCID iD: 0000-0003-0335-1204
SPIN-code: 9554-5553

MD, PhD, Associate Professor of Surgery Department, Russian Medical Academy of Continuous Professional Education; Head of the Department of Liver and Pancreatic Surgery, Botkin Hospital

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

Oksana V. Paklina

Botkin Hospital

Email: dc.drozdov@gmail.com
ORCID iD: 0000-0001-6373-1888
SPIN-code: 4575-9762

MD, Grand PhD, Professor, Head of the Pathoanatomical Department

Russian Federation, Mosсow

Dmitriy N. Grekov

Russian Medical Academy of Continuous Professional Education

Email: dc.drozdov@gmail.com
ORCID iD: 0000-0001-8391-1210
SPIN-code: 6734-9727

MD, PhD, Associate Professor of Surgery Department

Russian Federation, 2/1, Barrikadnaya st., Moscow, 125993

Galia R. Setdikova

Botkin Hospital

Email: dc.drozdov@gmail.com
ORCID iD: 0000-0002-9524-3798
SPIN-code: 6551-0854

MD, PhD, Pathologist

Russian Federation, Mosсow

Pavel A. Drozdov

Botkin Hospital

Author for correspondence.
Email: dc.drozdov@gmail.com
ORCID iD: 0000-0001-8016-1610
SPIN-code: 8184-8918

Surgeon of the Department of Liver and Pancreatic Surgery

Russian Federation, Mosсow

References

  1. Petrenko KN, Polishchuk LO, Garmaeva SV, et al. Radiochastotnaya ablyaciya zlokachestvennyh novoobrazovanij pecheni. Sovremennoe sostoyanie voprosa (Obzor literatury). Rossijskij zhurnal gactroehnterologii, gepatologii, koloproktologii. 2007;2:108. (In Russ).
  2. Patyutko YuI, Sagajdak IV, Polyakov AN. Kombinirovannoe lechenie bol'nyh s metastazami kolorektal'nogo raka v pechen'. Hirurgiya. Zhurnal im. NI Pirogova. 2008; 7:204. (In Russ).
  3. Adam R, Bismuth H, Castaing D, et al. Repeat hepatectomy for colorectal liver metastases. Annals of Surgery. 1997;225(1):5162. doi:10. 1097/0000065819970100000006
  4. Dudarev VS. Maloinvazivnye tekhnologii v lechenii zlokachestvennyh opuholej pecheni. Onkologicheskij zhurnal. 2007;1(2):12644. (In Russ).
  5. Patyutko YuI. Hirurgicheskoe lechenie zlokachestvennyh opuholej pecheni. Moscow: Prakticheskaya medicina; 2005. (In Russ).
  6. Abdalla E, Vauthey J, Ellis L, et al. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Annals of Surgery. 2004;239(6):81825. doi: 10.1097/01.sla.0000128305.90650.71
  7. August DA, Sugarbaker PH, Schneider PD. Lymphatic dissemination of hepatic metastases. Implications for the follow‐up and treatment of patients with colorectal cancer. Cancer. 1985;55 (7):14904. doi: 10.1002/10970142(19850401) 55:7<1490 ::aidcncr2820550712>3.0.co;2n
  8. Agcaoglu O, Aliyev S, Karabulut K, et al. Complementary use of resection and radiofrequency ablation for the treatment of colorectal liver metastases: an analysis of 395 patients. World Journal of Surgery. 2013;37(6):13339. doi: 10.1007/s0026801319811
  9. Kim K, Yoon Y, Yu C, et al. Comparative analysis of radiofrequency ablation and surgical resection for colorectal liver metastases. Journal of the Korean Surgical Society. 2011; 81(1):2534. doi: 10.4174/jkss.2011. 81.1.25
  10. Solbiati L, Ahmed M, Cova L, et al. Small liver colorectal metastases treated with percutaneous radiofrequency ablation: local response rate and longterm survival with up to 10year followup. Radiology. 2012;265(3): 95868. doi: 10.1148/radiol.12111851
  11. Wood T, Rose D, Chung M, et al. Radiofrequency ablation of 231 unresectable hepatic tumors: indications, limitations, and complications. Annals of Surgical Oncology. 2000; 7(8):593600. doi: 10.1007/bf02725339
  12. Lin J, Wu W, Jiang X, et al. Clinical outcomes of radiofrequency ablation combined with transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma: a singlecenter experience. Chinese Journal of Oncology. 2013;35(2):1447. doi: 10.3760/cma. j.issn.02533766.2013.02.016
  13. Tanaka M, Ando E, Simose S, et al. Radiofrequency ablation combined with transarterial chemoembolization for intermediate hepatocellular carcinoma. Hepatology Research. 2014; 44(2):194200. doi:10.1111/ hepr.12100
  14. Duan X, Zhou G, Zheng C, et al. Heat shock protein 70 expression and effect of combined transcatheter arterial embolization and radiofrequency ablation in the rabbit VX2 liver tumour model. Clinical Radiology. 2014;69(2): 18693. doi: 10.1016/j.crad.2013. 08.020
  15. Duan X, Li T, Zhou G, et al. Transcatheter arterial embolization combined with radiofrequency ablation activates cD8+ Tcell infiltration surrounding residual tumors in the rabbit VX2 liver tumors. Onco Targets and Therapy. 2016;9:283544. doi:10.2147/ OTT.S95973
  16. Lu Z, Wen F, Guo Q, et al. Radiofrequency ablation plus chemoembolization versus radiofrequency ablation alone for hepatocellular carcinoma: a metaanalysis of randomizedcontrolled trials. European Journal of Gastroenterology & Hepatology. 2013;25(2): 18794. doi: 10.1097/MEG.0b013e32835a0a07
  17. Tang C, Shen J, Feng W, et al. Combination therapy of radiofrequency ablation and transarterial chemoembolization for unresectable hepatocellular carcinoma: a retrospective study. Medicine. 2016;95(20):375461. doi:10. 1097/MD.0000000000003754
  18. Li Z, Kang Z, Qian J, et al. Radiofrequency ablation with or without transcather arterial chemoembolization for management of hepatocellular carcinoma. Journal of Southern Medical University. 2007;27(11):174951.
  19. Song M, Bae S, Lee J, et al. Combination transarterial chemoembolization and radiofrequency ablation therapy for early hepatocellular carcinoma. The Korean Journal of Internal Medicine. 2016;31(2):24252. doi: 10.3904/kjim. 2015.112
  20. Zhang L, Yon X, Gan Y, et al. Radiofrequency ablation following firstline transarterial chemoembolization for patients with unresectable hepatocellular carcinoma beyond the Milan criteria. BMC Gastroenterology. 2014;14(1):118. doi:10.1186/ 1471230X1411
  21. Wang Z, Wang M, Duan F, et al. Transcatheter arterial chemoembolization followed by immediate radiofrequency ablation for large solitary hepatocellular carcinomas. World Journal of Gastroenterology. 2013;19(26): 41929. doi: 10.3748/wjg.v19. i26.4192

Supplementary files

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2. Fig. 1. Study protocol for determining the optimal time for the second stage of treatment

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3. Fig. 2. Intensity of pain syndrome according to VAS for 1-3 days after regional chemotherapy

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4. Fig. 3. AST level on the 1-5th day after HEPA

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5. Fig. 4. ALT level for 1-5 days after HEPA

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6. Fig. 5. Metastasis of adenocarcinoma of intestinal type with the presence of fields of fibrosis (A) and inflammatory infiltration (B). The second degree of therapeutic pathomorphosis (color: hematoxylin and eosin, x 400)

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7. Fig. 6. Metastasis of adenocarcinoma of intestinal type. Moderate therapeutic pathomorphosis (grade 1). Fibrosis of separately lying glands and the appearance of calcifications. (color: hematoxylin and eosin, x 400)

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Copyright (c) 2018 Shabunin A.V., Tavobilov M.M., Paklina O.V., Grekov D.N., Setdikova G.R., Drozdov P.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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