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

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

doi:10.1245/s10434-017-5950-z

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

Publication Date

2017-06-27

Author(s)

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

Type of document

Journal Article

OrcId

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.1245/s10434-017-5950-z

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.

Link

link

Citation

Annals of Surgical Oncology 2017; 24(9): 2468-2473

Jornal Title

Annals of Surgical Oncology

Austin Health

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