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Title: The Post-SIR-Spheres Surgery Study (P4S): retrospective analysis of safety following hepatic resection or transplantation in patients previously treated with selective internal radiation therapy with yttrium-90 resin microspheres
Authors: Pardo, Fernando;Sangro, Bruno;Lee, Rheun-Chuan;Manas, Derek;Jeyarajah, Rohan;Donckier, Vincent;Maleux, Geert;Pinna, Antonio D;Bester, Lourens;Morris, David L;Iannitti, David;Chow, Pierce K;Stubbs, Richard;Gow, Paul J;Masi, Gianluca;Fisher, Kevin T;Lau, Wan Y;Kouladouros, Konstantinos;Katsanos, Georgios;Ercolani, Giorgio;Rotellar, Fernando;Bilbao, José I;Schoen, Michael
Issue Date: 27-Jun-2017
EDate: 2017-06-27
Citation: Annals of Surgical Oncology 2017; 24(9): 2468-2473
Abstract: BACKGROUND: Reports show that selective internal radiation therapy (SIRT) may downsize inoperable liver tumors to resection or transplantation, or enable a bridge-to-transplant. A small-cohort study found that long-term survival in patients undergoing resection following SIRT appears possible but no robust studies on postsurgical safety outcomes exist. The Post-SIR-Spheres Surgery Study was an international, multicenter, retrospective study to assess safety outcomes of liver resection or transplantation following SIRT with yttrium-90 (Y-90) resin microspheres (SIR-Spheres®; Sirtex). METHODS: Data were captured retrospectively at participating SIRT centers, with Y-90 resin microspheres, surgery (resection or transplantation), and follow-up for all eligible patients. Primary endpoints were perioperative and 90-day postoperative morbidity and mortality. Standard statistical methods were used. RESULTS: The study included 100 patients [hepatocellular carcinoma: 49; metastatic colorectal cancer (mCRC): 30; cholangiocarcinoma, metastatic neuroendocrine tumor, other: 7 each]; 36% of patients had one or more lines of chemotherapy pre-SIRT. Sixty-three percent of patients had comorbidities, including hypertension (44%), diabetes (26%), and cardiopathy (16%). Post-SIRT, 71 patients were resected and 29 received a liver transplant. Grade 3+ peri/postoperative complications and any grade of liver failure were experienced by 24 and 7% of patients, respectively. Four patients died <90 days postsurgery; all were trisectionectomies (mCRC: 3; cholangiocarcinoma: 1) and typically had one or more previous chemotherapy lines and presurgical comorbidities. CONCLUSIONS: In 100 patients undergoing liver surgery after receiving SIRT, mortality and complication rates appeared acceptable given the risk profile of the recruited patients.
DOI: 10.1245/s10434-017-5950-z
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Type: Journal Article
Appears in Collections:Journal articles

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