Patient Care

What Should Hospitalists Know about Transarterial Liver Tumor Therapies?

Bottom Line

Transarterial liver tumor therapies offer treatment options to patients who would otherwise have none. With these presented considerations in mind, the hospitalist will be prepared to address common issues when and if they arise.

Drs. Sandeep and Archana Laroia are clinical assistant professors in the department of radiology at the University of Iowa Hospitals and Clinics, Iowa City. Dr. Morales is a radiology resident at UIHC.

Key Points

  • The incidence of liver cancer, both primary and secondary, is rising in the United States due to higher incidence of chronic liver disease (hepatitis C, alcoholic cirrhosis, and NASH) and metastatic cancers.
  • Transarterial liver tumor therapies provide a less invasive, effective treatment option for patients who are not surgical candidates.
  • Postembolization syndrome is the most common side effect of liver tumor embolization and can be managed conservatively with antiemetics and pain medication.
  • Common complications of arterial puncture are similar to those seen with cardiac interventional procedures.

Additional Reading

  • Sangro B, Salem R, Kennedy A, Coldwell D, Wasan H. Radioembolization for hepatocellular carcinoma: a review of the evidence and treatment recommendations. Am J Clin Oncol. 2011;34(4):422-431.
  • Starley BQ, Calcagno CJ, Harrison SA. Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection. Hepatology. 2010;51(5):1820-1832.
  • Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol. 2001;12(3):321-326.

References

  1. Howlader N, Noone AM, Krapcho M, et al. SEER Cancer Statistics Review, 1975-2010, National Cancer Institute. Available at: http://seer.cancer.gov/archive/csr/1975_2010/. Accessed January 11, 2015.
  2. Llovet JM. Treatment of hepatocellular carcinoma. Curr Treat Options Gastroenterol. 2004;7(6):431-441.
  3. Sasson AR, Sigurdson ER. Surgical treatment of liver metastases. Semin Oncol. 2002;29(2):107-118.
  4. National Cancer Institute. Colon Cancer Treatment (PDQ). Available at: http://cancer.gov/cancertopics/pdq/treatment/colon/HealthProfessional. Accessed January 11, 2015.
  5. Merriweather N, Sulzbach-Hoke LM. Managing risk of complications at femoral vascular access sites in percutaneous coronary intervention. Crit Care Nurse. 2012;32(5):16-29.
  6. Sigstedt B, Lunderquist A. Complications of angiographic examinations. AJR Am J Roentgenol. 1978;130(3):455-460.
  7. Clark TW. Complications of hepatic chemoembolization. Semin Intervent Radiol. 2006;23(2):119-125.
  8. Webber GW, Jang J, Gustavson S, Olin JW. Contemporary management of postcatheterization pseudoaneurysms. Circulation. 2007;115(20):2666-2674.
  9. Tran DD, Andersen CA. Axillary sheath hematomas causing neurologic complications following arterial access. Ann Vasc Surg. 2011;25(5):697 e5-8.
  10. Hall R. Vascular injuries resulting from arterial puncture of catheterization. Br J Surg. 1971;58(7):513-516.
  11. Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol. 2001;12(3):321-326.
  12. Kawaoka T, Aikata H, Katamura Y, et al. Hypersensitivity reactions to transcatheter chemoembolization with cisplatin and Lipiodol suspension for unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2010;21(8):1219-1225.
  13. Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006;354(4):379-386.
  14. McCullough PA, Adam A, Becker CR, et al. Risk prediction of contrast-induced nephropathy. Am J Cardiol. 2006;98(6A):27K-36K.
Previous 1 2 3
Gastroenterology

Comment on this Article

Your email address will not be published. Required fields are marked *