PMID- 27878478
OWN - NLM
STAT- MEDLINE
DCOM- 20180223
LR  - 20180223
IS  - 1534-4681 (Electronic)
IS  - 1068-9265 (Linking)
VI  - 24
IP  - 4
DP  - 2017 Apr
TI  - Liver Resection After Selective Internal Radiation Therapy with Yttrium-90 is
      Safe and Feasible: A Bi-institutional Analysis.
PG  - 906-913
LID - 10.1245/s10434-016-5697-y [doi]
AB  - BACKGROUND: Treatment with yttrium-90 (Y90) microspheres has emerged as a viable 
      liver-directed therapy for patients with unresectable tumors and those outside
      transplantation criteria. A select number of patients demonstrate a favorable
      response and become candidates for surgical resection. METHODS: Patients who
      underwent selective internal radiation therapy (SIRT) with Y90 microspheres at
      two institutions were reviewed. Patients who underwent liver resection were
      included in the study. The data gathered included demographics, tumor
      characteristics, response to Y90, surgical details, perioperative outcomes, and
      survival. RESULTS: The inclusion criteria were met by 12 patients. The diagnoses 
      included metastatic disease from colorectal adenocarcinoma (n = 6),
      neuroendocrine tumor (n = 1), and ocular melanoma (n = 1) in addition to
      hepatocellular carcinoma (n = 4). The median time from liver disease diagnosis to
      Y90 treatment was 5.5 months (range 2-92 months). The median time from Y90
      treatment to surgery was 9.5 months (range 3-20 months). The surgical approach
      included right hepatectomy (n = 3), extended right hepatectomy (n = 5), extended 
      left hepatectomy (n = 1), segmentectomy with ablation (n = 2), and segmentectomy 
      with isolated liver perfusion (n = 1). The hospital stay was 7 days (range 4-31
      days), and 67% of the patients were discharged home. The readmission rate was
      42%. The 90-day morbidity and mortality rates were respectively 42 and 8%. At
      this writing, the median overall survival has not been reached at 25 months.
      CONCLUSION: Liver resection after Y90 SIRT is a challenging surgical procedure
      with high rates of perioperative morbidity and hospital readmission. However, for
      properly selected patients, potential exists for extending disease-free and
      overall survival in the current era of multimodal therapy for malignant liver
      disease.
FAU - Wright, G Paul
AU  - Wright GP
AD  - Division of Surgical Oncology, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA. wrightgp@upmc.edu.
FAU - Marsh, J Wallis
AU  - Marsh JW
AD  - Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery,
      University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
FAU - Varma, Manish K
AU  - Varma MK
AD  - Advanced Radiology Services PC, Grand Rapids, MI, USA.
FAU - Doherty, Michael G
AU  - Doherty MG
AD  - Advanced Radiology Services PC, Grand Rapids, MI, USA.
FAU - Bartlett, David L
AU  - Bartlett DL
AD  - Division of Surgical Oncology, University of Pittsburgh Medical Center,
      Pittsburgh, PA, USA.
FAU - Chung, Mathew H
AU  - Chung MH
AD  - Division of Surgical Oncology, Spectrum Health Medical Group, Grand Rapids, MI,
      USA.
AD  - Department of Surgery, Michigan State University College of Human Medicine, Grand
      Rapids, MI, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20161122
PL  - United States
TA  - Ann Surg Oncol
JT  - Annals of surgical oncology
JID - 9420840
RN  - 0 (Radiopharmaceuticals)
RN  - 0 (Yttrium Radioisotopes)
SB  - IM
MH  - Adenocarcinoma/secondary/*therapy
MH  - Adult
MH  - Aged
MH  - *Brachytherapy
MH  - Carcinoma, Hepatocellular/*therapy
MH  - Colorectal Neoplasms/*pathology
MH  - *Embolization, Therapeutic
MH  - Eye Neoplasms/pathology
MH  - *Hepatectomy/adverse effects
MH  - Humans
MH  - Length of Stay
MH  - Liver Neoplasms/diagnostic imaging/secondary/*therapy
MH  - Melanoma/secondary
MH  - Middle Aged
MH  - Neuroendocrine Tumors/secondary
MH  - Patient Readmission
MH  - Postoperative Complications/etiology
MH  - Radiopharmaceuticals/therapeutic use
MH  - Response Evaluation Criteria in Solid Tumors
MH  - Retrospective Studies
MH  - Tomography, X-Ray Computed
MH  - Yttrium Radioisotopes/therapeutic use
EDAT- 2016/11/24 06:00
MHDA- 2018/02/24 06:00
CRDT- 2016/11/24 06:00
PHST- 2016/07/01 00:00 [received]
PHST- 2016/11/24 06:00 [pubmed]
PHST- 2018/02/24 06:00 [medline]
PHST- 2016/11/24 06:00 [entrez]
AID - 10.1245/s10434-016-5697-y [doi]
AID - 10.1245/s10434-016-5697-y [pii]
PST - ppublish
SO  - Ann Surg Oncol. 2017 Apr;24(4):906-913. doi: 10.1245/s10434-016-5697-y. Epub 2016
      Nov 22.