Please use this identifier to cite or link to this item:
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
Austin 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
Affiliation: HPB and Transplant Surgery, Clinica Universidad de Navarra, IDISNA, Pamplona, Navarra, Spain
Liver Unit, Clinica Universidad de Navarra, IDISNA, CIBEREHD, Pamplona, Navarra, Spain
Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
Institute of Transplantation, University of Newcastle Upon Tyne, Newcastle Upon Tyne, UK
Newcastle NHS Trust, Newcastle Upon Tyne, UK
Surgical Oncology, Methodist Dallas Medical Center, Dallas, TX, USA
Department of Surgery, Institut Jules Bordet, Université Libre de Bruxelles and Centre de Chirurgie Hépato-Biliaire de l'ULB, Brussels, Belgium
Radiology, University Hospitals Leuven, Louvain, Belgium
Hepatobiliary and Transplant Surgery, S. Orsola-Malpighi, University of Bologna, Bologna, Italy
Interventional Radiology, St Vincent's Hospital, Sydney, NSW, Australia
Department of Surgery, St George Hospital, University of New South Wales, Kogarah, NSW, Australia
HPB Surgery, Carolinas Medical Center, Charlotte, NC, USA
Surgical Oncology, National Cancer Center, Singapore, Singapore
Hepatobiliary Surgery, Wakefield Clinic, Wellington, New Zealand
Transplant Hepatology, Austin Health, Heidelberg, Victoria, Australia
Medical Oncology, Ospedale Santa Chiara, Pisa, Italy
Department of Surgery, Saint Francis Hospital, Tulsa, OK, USA
Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, Hong Kong
Klinikum Karlsruhe, Karlsruhe, Germany
Department of Abdominal Surgery, Hôpital Erasme, Université Libre de Bruxelles and Centre de Chirurgie Hépato-Biliaire de l'ULB, Brussels, Belgium
Hepatobiliary and Transplant Surgery, Sant'Orsola Hospital, University of Bologna, Bologna, Italy
Interventional Radiology, Clinica Universidad de Navarra, IDISNA, Pamplona, Navarra, Spain
Issue Date: 27-Jun-2017 2017-06-27
Publication information: 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
PubMed URL:
Type: Journal Article
Appears in Collections:Journal articles

Show full item record

Google ScholarTM


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.