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Endovascular treatment of superior vena cava syndrome.

https://arctichealth.org/en/permalink/ahliterature132591
Source
Int Angiol. 2011 Oct;30(5):458-61
Publication Type
Article
Date
Oct-2011
Author
S. Duvnjak
P. Andersen
Author Affiliation
Department of Radiology, Odense University Hospital, Odense, Denmark. stevo.duvnjak@ouh.regionsyddanmark.dk
Source
Int Angiol. 2011 Oct;30(5):458-61
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angioplasty, Balloon - adverse effects - instrumentation
Carcinoma, Small Cell - complications
Denmark
Female
Humans
Male
Middle Aged
Palliative Care
Phlebography - methods
Quality of Life
Stents
Superior Vena Cava Syndrome - etiology - radiography - therapy
Thoracic Neoplasms - complications
Thrombosis - etiology
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Abstract
The aim of this study was to report our experience with palliative stent treatment of superior vena cava syndrome.
Between January 2008 and December 2009, 30 patients (mean age 60.7 years) were treated with stents because of stenosed superior vena cava. All patients presented clinically with superior vena cava syndrome and according caval stenosis confirmed by computed tomography. The causes of stenoses were non-small cell carcinoma in 22 patients and small cell carcinoma in 8 patients.
In all patients the stents were placed as intended in all patients there was an immediate clinical improvement with considerable reduction in the edema of upper extremities and head. There was, however, continous dyspnea in five patients (17%) and two patients (7%) had persistent visible collateral venous circulations on the upper chest. There were no stent associated complications. All patients were followed clinically till death and the median follow-up period was 2.8 months (15-420 days). During follow-up three cases of stent thrombosis (one complete and two partial thrombosis) were observed.
Palliative care with stent implantation for superior vena cava syndrome is a minimal invasive and safe procedure with good clinical effect giving the patients a significant better quality of their residual life.
PubMed ID
21804485 View in PubMed
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The use of music in facilitating emotional expression in the terminally ill.

https://arctichealth.org/en/permalink/ahliterature178803
Source
Am J Hosp Palliat Care. 2004 Jul-Aug;21(4):255-60
Publication Type
Article
Author
Amy Clements-Cortes
Author Affiliation
Baycrest Centre for Geriatric Care, Department of Therapeutic Recreation, Toronto, Ontario, Canada.
Source
Am J Hosp Palliat Care. 2004 Jul-Aug;21(4):255-60
Language
English
Publication Type
Article
Keywords
Aged
Anxiety - therapy
Depression - therapy
Female
Health Services for the Aged - standards
Hospice Care - methods
Humans
Music Therapy - methods - standards
Neoplasms - complications - psychology
Nursing Homes - standards
Ontario
Palliative Care - methods
Program Evaluation
Schizophrenia - therapy
Social Isolation - psychology
Time Factors
Treatment Outcome
Abstract
The expression and discussion of feelings of loss and grief can be very difficult for terminally ill patients. Expressing their emotions can help these patients experience a more relaxed and comfortable state. This paper discusses the role of music therapy in palliative care and the function music plays in accessing emotion. It also describes techniques used in assisting clients to express their thoughts and feelings. Case examples of three in-patient palliative care clients at Baycrest Centre for Geriatric Care are presented. The goals set for these patients were to decrease depressive symptoms and social isolation, increase communication and self-expression, stimulate reminiscence and life review, and enhance relaxation. The clients were all successful in reaching their individual goals.
PubMed ID
15315187 View in PubMed
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Facilitators of and barriers to advance care planning in adult congenital heart disease.

https://arctichealth.org/en/permalink/ahliterature117629
Source
Congenit Heart Dis. 2013 Jul-Aug;8(4):281-8
Publication Type
Article
Author
Matthias Greutmann
Daniel Tobler
Jack M Colman
Mehtap Greutmann-Yantiri
S Lawrence Librach
Adrienne H Kovacs
Author Affiliation
Division of Cardiology, University Hospital of Zurich, Zurich, Switzerland.
Source
Congenit Heart Dis. 2013 Jul-Aug;8(4):281-8
Language
English
Publication Type
Article
Keywords
Adult
Advance Care Planning
Age Factors
Attitude of Health Personnel
Attitude to Death
Canada
Communication
Cross-Sectional Studies
Female
Health Care Surveys
Health Knowledge, Attitudes, Practice
Heart Defects, Congenital - psychology - therapy
Humans
Life expectancy
Male
Middle Aged
Palliative Care
Patients - psychology
Physician-Patient Relations
Prognosis
Terminal Care
Time Factors
Trust
Young Adult
Abstract
Most adults with congenital heart disease (CHD) are interested in discussing matters related to advance care planning (ACP) early in the disease course, yet few such conversations actually occur. We aimed to evaluate factors that impact these discussions between patients and adult CHD providers.
Two hundred adult CHD outpatients completed a survey that included factors that might impact ACP discussions with their doctors. In parallel, forty-eight providers within the Canadian Adult Congenital Heart Network completed a similar online survey. Responses were compared between the groups.
Most providers (85%) worried that they were unable to reliably estimate life expectancy and believed that patients were not ready for end-of-life discussions if their estimated life expectancies were beyond 5 years (63%) or beyond 10 years (79%). In contrast, only 24% of patients, independent of disease complexity, thought they were not ready to talk about ACP. Most providers (83%) reported that greater certainty about patients' prognoses would help them discuss ACP. Patients thought that such discussions were best facilitated when they had trust in their doctors (85%) and believed their doctors are good at taking care of patients with CHD (78%).
Despite the fact that challenges to prognostication exist, discussions about ACP should not be reserved for patients with a severely reduced life expectancy. Most patients want these discussions regardless of the complexity of their disease. The trusting and close patient-doctor relationship in adult CHD, often evolving over many years, may provide an excellent platform from which to initiate such discussions.
PubMed ID
23279997 View in PubMed
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Variation in the use of palliative radiotherapy at end of life: examining demographic, clinical, health service, and geographic factors in a population-based study.

https://arctichealth.org/en/permalink/ahliterature140153
Source
Palliat Med. 2011 Mar;25(2):101-10
Publication Type
Article
Date
Mar-2011
Author
M Ruth Lavergne
Grace M Johnston
Jun Gao
Trevor Jb Dummer
Dorianne E Rheaume
Author Affiliation
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada. ruth.lavergne@gmail.com
Source
Palliat Med. 2011 Mar;25(2):101-10
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Delivery of Health Care - standards
Demography
Female
Health Services Accessibility
Health Services Needs and Demand - utilization
Humans
Logistic Models
Male
Middle Aged
Neoplasms - mortality - radiotherapy
Nova Scotia
Palliative Care - utilization
Quality of Life
Residence Characteristics
Rural Health
Socioeconomic Factors
Terminal Care - utilization
Time Factors
Abstract
Palliative radiotherapy (PRT) can improve quality of life for people dying of cancer. Variation in the delivery of PRT by factors unrelated to need may indicate that not all patients who may benefit from PRT receive it. In this study, 13,494 adults who died of cancer between 2000 and 2005 in Nova Scotia, Canada, were linked to radiotherapy records. Multivariate logistic regression was used to examine the relationships among demographic, clinical, service, and geographic variables, and PRT consultation and treatment. Among the decedents, 4188 (31.0%) received PRT consultation and 3032 (22.3%) treatment. PRT declined with increased travel time and community deprivation. Females, older persons, and nursing home residents also had lower PRT rates. Variations were observed by cancer site and previous oncology care. Variations in PRT use should be discussed with referring physicians, and improved means of access to PRT considered. Benchmarks for optimal rates of PRT are needed.
Notes
Cites: Int J Radiat Oncol Biol Phys. 2007 Nov 15;69(4):1001-717689029
Cites: Support Care Cancer. 2007 Sep;15(9):1015-2117277924
Cites: Clin Oncol (R Coll Radiol). 2008 Jun;20(5):327-3618276125
Cites: Clin Oncol (R Coll Radiol). 2008 Sep;20(7):506-1218524556
Cites: Med Care. 2008 Dec;46(12):1203-1119300309
Cites: Radiother Oncol. 1999 Aug;52(2):111-2110577696
Cites: Int J Radiat Oncol Biol Phys. 2000 Nov 1;48(4):1025-3311072159
Cites: Chronic Dis Can. 2000;21(3):104-1311082346
Cites: J Clin Oncol. 2001 Jan 1;19(1):137-4411134206
Cites: J Clin Oncol. 2001 Jul 15;19(14):3323-3211454879
Cites: Eur J Cancer. 2001 Oct;37 Suppl 7:S279-8811888001
Cites: J Clin Oncol. 2002 Mar 15;20(6):1584-9211896108
Cites: Am J Hosp Palliat Care. 2002 May-Jun;19(3):166-7012026039
Cites: Palliat Med. 2002 May;16(3):255-612047004
Cites: CMAJ. 2003 Feb 4;168(3):265-7012566330
Cites: Radiother Oncol. 2003 May;67(2):221-312812854
Cites: Palliat Med. 2003 Jul;17(5):433-4412882262
Cites: Australas Radiol. 2003 Sep;47(3):274-812890248
Cites: Soc Sci Med. 2003 Dec;57(11):2055-6314512237
Cites: Clin Oncol (R Coll Radiol). 2003 Sep;15(6):345-5214524489
Cites: J Clin Oncol. 2004 Sep 1;22(17):3581-615337808
Cites: J Public Health Med. 1991 Nov;13(4):318-261764290
Cites: J Palliat Care. 1995 Spring;11(1):19-267538572
Cites: Curr Probl Cancer. 1997 May-Jun;21(3):129-839202888
Cites: Int J Radiat Oncol Biol Phys. 2004 Dec 1;60(5):1373-815590167
Cites: Radiother Oncol. 2006 Jan;78(1):101-616330118
Cites: Palliat Med. 2006 Jun;20(4):439-4516875115
Cites: Age Ageing. 2006 Sep;35(5):469-7616751635
Cites: J Clin Oncol. 2007 Apr 10;25(11):1423-3617416863
Cites: Cancer J. 2007 Mar-Apr;13(2):130-717476142
Cites: Acta Oncol. 2007;46(5):659-6317562442
Cites: Soc Sci Med. 2008 Feb;66(3):675-9018036712
PubMed ID
20937613 View in PubMed
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Unresectable pancreatic adenocarcinoma: do we know who survives?

https://arctichealth.org/en/permalink/ahliterature140344
Source
HPB (Oxford). 2010 Oct;12(8):561-6
Publication Type
Article
Date
Oct-2010
Author
Mohammad H Jamal
Suhail A Doi
Eve Simoneau
Jad Abou Khalil
Mazen Hassanain
Prosanto Chaudhury
Jean Tchervenkov
Peter Metrakos
Jeffrey S Barkun
Author Affiliation
Department of Surgery, McGill University Health Center, Montreal, QC, Canada.
Source
HPB (Oxford). 2010 Oct;12(8):561-6
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - complications - mortality - pathology - therapy
Adult
Aged
Aged, 80 and over
Female
Humans
Jaundice - mortality
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Odds Ratio
Pain - mortality
Palliative Care
Pancreatic Neoplasms - complications - mortality - pathology - therapy
Proportional Hazards Models
Quebec - epidemiology
Registries
Reproducibility of Results
Retrospective Studies
Risk assessment
Risk factors
Smoking - mortality
Survival Rate
Time Factors
Treatment Outcome
Weight Loss
Abstract
This study attempts to define clinical predictors of survival in patients with unresectable pancreatic adenocarcinoma (UPA).
A retrospective study of 94 consecutive patients diagnosed with UPA from 2001 to 2006 was performed. Using data for these patients, a symptom score was devised through a forward stepwise Cox proportional hazards model based on four weighted criteria: weight loss of >10% of body weight; pain; jaundice, and smoking. The symptom score was subsequently validated in a distinct cohort of 32 patients diagnosed with UPA in 2007.
In the original cohort, the overall median survival was 9.0 months (95% confidence interval [CI] 7.6-10.4). This altered to 10.3 months (95% CI 6.1-14.5) in patients with locally advanced disease, and 6.6 months (95% CI 4.2-9.0) in patients with distant metastasis. Median survival was 14.6 months (95% CI 13.1-16.1) in patients with a low symptom (LS) score and 6.3 months (95% CI 4.1-8.5) in patients with a high symptom (HS) score. A total of 73% of LS score patients survived beyond 9 months, compared with only 38% of HS score patients (P
Notes
Cites: Gastrointest Endosc. 2002 Dec;56(6):835-4112447294
Cites: Gastrointest Endosc. 2002 Mar;55(3):366-7011868010
Cites: Ann Surg. 1994 Jan;219(1):18-247507656
Cites: Lancet. 1994 Dec 17;344(8938):1655-607996958
Cites: Cancer. 1996 Aug 1;78(3 Suppl):605-148681299
Cites: Ann Surg Oncol. 1996 Sep;3(5):470-58876889
Cites: J Clin Oncol. 1997 Jun;15(6):2403-139196156
Cites: Hepatogastroenterology. 1998 May-Jun;45(21):833-99684143
Cites: Am J Gastroenterol. 1999 May;94(5):1271-810235206
Cites: J Am Coll Surg. 1999 Jul;189(1):1-710401733
Cites: World J Surg. 2005 Apr;29(4):519-2315770375
Cites: Curr Opin Gastroenterol. 2005 Sep;21(5):601-516093777
Cites: Clin Nutr. 2005 Dec;24(6):998-100416140426
Cites: Am J Gastroenterol. 2006 Apr;101(4):735-4216635221
Cites: Cancer. 2006 Dec 1;107(11):2589-9617083124
Cites: JOP. 2007;8(2):240-5317356251
Cites: Pancreas. 2007 Apr;34(3):335-917414056
Cites: Dig Dis. 2007;25(3):285-817827959
Cites: J Clin Gastroenterol. 2008 Jan;42(1):86-9118097296
Cites: J Gastrointest Surg. 2008 Jan;12(1):91-10017786524
Cites: Am J Surg. 2008 Feb;195(2):221-818154768
Cites: Ann Surg Oncol. 2008 Nov;15(11):3138-4618787902
Cites: Dig Surg. 2009;26(1):75-919169034
Cites: Ann Surg Oncol. 2010 Jan;17(1):194-20519856029
Cites: Eur J Cancer. 2004 Mar;40(4):549-5814962722
PubMed ID
20887324 View in PubMed
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Measurement challenges of informal caregiving: a novel measurement method applied to a cohort of palliative care patients.

https://arctichealth.org/en/permalink/ahliterature140367
Source
Soc Sci Med. 2010 Nov;71(10):1890-5
Publication Type
Article
Date
Nov-2010
Author
Serge Dumont
Philip Jacobs
Véronique Turcotte
Donna Anderson
François Harel
Author Affiliation
Laval University, School of Social Work, Pavillon Charles-De Koninck, Québec, Québec, Canada. serge.dumont@svs.ulaval.ca
Source
Soc Sci Med. 2010 Nov;71(10):1890-5
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Aged
Canada
Caregivers - statistics & numerical data
Female
Home Nursing
Humans
Male
Middle Aged
Palliative Care
Prospective Studies
Questionnaires
Time Factors
Workload
Abstract
Informal caregiving is a complex concept, and inconsistencies are found in the literature regarding how to measure it. The differences in tasks included in the definition of caregiving, as well as the different methods used to measure caregiving time may explain the huge variations in results found in the literature. The current paper aimed to lay out the challenges of how to calculate the time spent by informal caregivers on providing care and assistance to an ill person at home. It also proposes a method for measuring informal caregiving time, which attempts to distinguish between "normal" activities and "caregiving" activities. The proposed measurement method is then applied to a cohort of informal caregivers of palliative care patients. The illustration study revealed that this method brought advantages comparatively to other methods, and that persisting challenges remain in measuring informal caregiving time. We conclude that, the estimate of time spent caregiving for palliative care patients may be useful in guiding support programs for the families taking care of a loved one at home during the palliative phase of care.
PubMed ID
20884103 View in PubMed
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Risk of injury associated with opioid use in older adults.

https://arctichealth.org/en/permalink/ahliterature140558
Source
J Am Geriatr Soc. 2010 Sep;58(9):1664-70
Publication Type
Article
Date
Sep-2010
Author
David Buckeridge
Allen Huang
James Hanley
Armel Kelome
Kristen Reidel
Aman Verma
Nancy Winslade
Robyn Tamblyn
Author Affiliation
Department of Epidemiology and Biostatistics, McGill University, Montreal Quebec, Canada.
Source
J Am Geriatr Soc. 2010 Sep;58(9):1664-70
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Aged
Analgesics, Opioid - administration & dosage - adverse effects
Conscious Sedation - adverse effects
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Incidence
Male
Palliative Care - methods
Prognosis
Proportional Hazards Models
Quebec - epidemiology
Retrospective Studies
Risk factors
Time Factors
Wounds and Injuries - epidemiology - etiology
Abstract
To estimate the dose-related risk of injuries in older adults associated with the use of low-, medium-, and high-potency opioids.
Historical population-based cohort study: 2001 to 2003.
Quebec, Canada's, universal healthcare system.
Four hundred three thousand three hundred thirty-nine adults aged 65 and older.
Population-based health databases were used to measure preexisting risk factors for injuries in 2001/02 and drug use and injuries during follow-up (2003). Type and dose of opioids were measured as time-dependent variables, as were other drugs that may increase the risk of injury from sedating side-effects or hypotension. The risk of injury per one adult dose increase in opioid dose was estimated using multivariate Cox proportional hazards models.
During the follow-up year, 50.7% of the study population were prescribed drugs with sedating side effects, 15.3% were prescribed an opioid, 20.7% were concurrently using more than one sedating medication, and 3.7% were treated for an injury, fractures (55.1%) being the most common. After adjusting for concurrent drug use and baseline risk factors, low- (hazard ratio (HR)=1.36, 95% confidence interval (CI)=1.33-1.39) and intermediate-potency (HR=1.05, 95% CI=1.02-1.07) opioids were associated with the risk of injury. Use of codeine combinations was associated with the highest risk of injury, a 127% greater risk (HR=2.27, 95% CI=2.21-2.34) per one adult dose increase. (The mean World Health Organization standardized dose in the study population was 1.71 ± 0.85 adult doses.)
Opioids increase the risk of injury in older adults, particularly codeine combinations.
PubMed ID
20863326 View in PubMed
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Rectal cancer: the influence of type of operation on local recurrence and survival.

https://arctichealth.org/en/permalink/ahliterature22529
Source
Eur J Surg. 1996 Aug;162(8):643-8
Publication Type
Article
Date
Aug-1996
Author
T. Bjerkeset
T H Edna
Author Affiliation
Department of Surgery, Innherred Hospital, Levanger, Norway.
Source
Eur J Surg. 1996 Aug;162(8):643-8
Date
Aug-1996
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - mortality - radiotherapy - surgery
Aged
Female
Follow-Up Studies
Humans
Incidence
Male
Neoplasm Recurrence, Local - epidemiology
Palliative Care
Prospective Studies
Radiotherapy, Adjuvant
Rectal Neoplasms - mortality - radiotherapy - surgery
Survival Rate
Time Factors
Abstract
OBJECTIVE: To assess the results of standardised total mesorectal excision of rectal cancer with particular reference to local recurrence and survival. DESIGN: Prospective open study. SETTING: Central hospital, Norway. MAIN OUTCOME MEASURES: Local recurrence, survival. RESULTS: The resectability rate was 90% (107/118), of whom 81 (76%) underwent curative resection. The overall local recurrence rate in patients who underwent primary resection was 9% with an overall five-year survival rate of 53%. In patients who had had curative operations the local recurrence rate was 4% (3/81), with an overall five year survival of 65% and a cancer specific survival of 85%. None of the patients who had palliative treatment survived five years. In 12 patients whose tumours were thought to be unresectable but who were operated on, of whom nine were given additional radiotherapy (46 Gy), 5 (42%) developed local recurrences and the five year cancer free survival was 25%. CONCLUSION: Total mesorectal excision and strict adherence to the surgical principles of anatomical dissection in the pelvis and washing out of the rectal stump before anastomosis reduce local recurrences to a minimum. In patients with locally advanced, fixed cancers, preoperative irradiation with more than 46 Gy must precede operation to achieve local control.
PubMed ID
8891623 View in PubMed
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Long-term outcome of palliative treatment with self-expanding metal stents for malignant obstructions of the GI tract.

https://arctichealth.org/en/permalink/ahliterature120036
Source
Scand J Gastroenterol. 2012 Dec;47(12):1505-14
Publication Type
Article
Date
Dec-2012
Author
Lene Larssen
Asle W Medhus
Hartwig Körner
Tom Glomsaker
Taran Søberg
Dagfinn Gleditsch
Øistein Hovde
Jan K Tholfsen
Knut Skreden
Arild Nesbakken
Truls Hauge
Author Affiliation
Department of Gastroenterology, Oslo University Hospital, Ullevål, Oslo, Norway. lene.larssen@medisin.uio.no
Source
Scand J Gastroenterol. 2012 Dec;47(12):1505-14
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cholestasis - etiology - surgery
Disease Progression
Endoscopy, Gastrointestinal
Esophageal Stenosis - etiology - surgery
Female
Follow-Up Studies
Humans
Intestinal Obstruction - etiology - surgery
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasms - complications - surgery
Norway
Palliative Care
Patient Readmission
Prosthesis Failure
Reoperation
Statistics, nonparametric
Stents
Time Factors
Abstract
Self-expanding metal stents (SEMS) are commonly used in the palliative treatment of malignant gastrointestinal (GI) obstructions with favorable short-term outcome. Data on long-term outcome are scarce, however.
To evaluate long-term outcome after palliative stent treatment of malignant GI obstruction.
Between October 2006 and April 2008, nine Norwegian hospitals included patients treated with SEMS for malignant esophageal, gastroduodenal, biliary, and colonic obstructions. Patients were followed for at least 6 months with respect to stent patency, reinterventions, and readmissions.
Stent placement was technically successful in 229 of 231 (99%) and clinically successful after 1 week in 220 of 229 (96%) patients. Long-term follow-up was available for 219 patients. Of those, 72 (33%) needed reinterventions. Stent occlusions or migrations (92%) were the most common reasons. Esophageal stents required reinterventions most frequently (41%), and had a significantly (p = 0.02) shorter patency (median 152 days) compared to other locations (gastroduodenal, 256 days; colon, 276 days; biliary, 460 days). Eighty percent of reinterventions were repeated endoscopic procedures that successfully restored patency. Readmissions were required for 156 (72%) patients. Progression of the underlying cancer was the most common reason, whereas 24% were readmitted due to stent complications.
Long-term outcome after palliative treatment with SEMS for malignant GI and biliary obstruction shows that 70% had a patent stent until death, and that most reobstructions could be solved endoscopically. Hospital readmissions were mainly related to progression of the underlying cancer disease.
PubMed ID
23046494 View in PubMed
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[Loco-regional therapy for liver malignancy in Iceland].

https://arctichealth.org/en/permalink/ahliterature123913
Source
Laeknabladid. 2012 Jun;98(6):334-40
Publication Type
Article
Date
Jun-2012
Author
Thorarinn Arni Bjarnason
Haraldur Bjarnason
Ottar Mar Bergmann
Hjalti Mar Thorisson
Author Affiliation
Laeknadelid Haskola Islands.
Source
Laeknabladid. 2012 Jun;98(6):334-40
Date
Jun-2012
Language
Icelandic
Geographic Location
Iceland
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - blood supply - drug therapy - mortality - pathology - radiography
Catheter Ablation
Chemoembolization, Therapeutic - adverse effects
Chemotherapy, Adjuvant
Female
Hepatectomy
Hepatic Artery - radiography
Humans
Iceland
Liver Neoplasms - blood supply - drug therapy - mortality - pathology - radiography
Liver Transplantation
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Palliative Care
Radiography, Interventional
Survival Analysis
Time Factors
Treatment Outcome
Abstract
Transarterial chemoembolization (TACE) is a loco-regional therapy performed to treat tumors in the liver. The branch of the hepatic artery supplying the tumor is catheterized and a mixture of iodized oil, chemotherapeutic agents and PVA embolic materials infused. TACE is a palliative treatment of unresectable cancer in the liver but can also be employed as adjunctive therapy to liver resection and/or radiofrequency ablation. The procedure can in certain instances downstage the disease and provide a bridge to liver transplantation. The aim of this study was to evaluate outcome in patients that have undergone loco-regional therapy in Iceland and the frequency and severity of complications related to the procedure.
All Icelandic patients that had undergone TACE, transarterial chemotherapy or bland embolization of liver tumors between 1 May 2007 and 1 March 2011 were included in the study.
Eighteen TACE, six transarterial chemotherapy treatments and two bland embolizations were performed on nine patients with hepatocellular carcinoma (HCC), and three patients with carcinoid metastases in the liver. Mean-survival of patients with HCC was 15.2 months. Survival of patients with carcinoid metastases was between 61 and 180 months. Complete response was achieved twice and partial response four times. The disease remained stable after eleven procedures but progressed after three procedures. Minor complications were diagnosed in 6 of 26 procedures and one major complication. No patient suffered from liver failure due to the procedure. Of the 9 HCC patients, 1 patient was on the liver transplant list before TACE and later underwent successful transplantation. Additionally, 3 of the remaining 8 patients were downstaged and put on to the transplant list.
PubMed ID
22647444 View in PubMed
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78 records – page 1 of 8.