1.Effect of neoadjuvant transarterial chemoembolization followed by resection versus upfront liver resection on the survival of single large hepatocellular carcinoma patients:A systematic review and meta-analysis
Indah JAMTANI ; Toar Jean MAURICE LALISANG ; Wawan MULYAWAN
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(3):325-336
Background:
s/Aims: The efficacy of neoadjuvant transarterial chemoembolization (N−TACE) in resectable hepatocellular carcinoma (HCC) remains open to debate. While N−TACE may reduce tumor size, its impact on long-term outcomes is inconclusive.
Methods:
This meta-analysis reviewed studies on N−TACE before surgical resection vs. liver resection (LR) single large hepatocellular carcinoma (SLHCC) up to March 2023 from four online databases.
Results:
Five studies with 1,556 patients were analyzed. No significant differences between N−TACE and LR groups were observed in 1-, 3-, or 5-year overall survival (OS) and disease-free survival (DFS). No significant differences were noted in intraoperative blood loss between groups. Subgroup analysis showed favorable 1-, 3-, and 5-year OS with combination chemotherapy N−TACE (combination group), and better 1-year OS in the LR group with single-agent chemotherapy N−TACE (single-agent group). Five-year DFS favored LR in the single-agent group, and N−TACE in the combination group.
Conclusions
Managing SLHCC requires intricate considerations, and the treatment strategies for this challenging subgroup of HCC need to be improved. The influence of N−TACE on long-term survival depends on the specific chemotherapy regimen employed, and its impact on intraoperative blood loss in SLHCC appears limited.
2.Effect of neoadjuvant transarterial chemoembolization followed by resection versus upfront liver resection on the survival of single large hepatocellular carcinoma patients:A systematic review and meta-analysis
Indah JAMTANI ; Toar Jean MAURICE LALISANG ; Wawan MULYAWAN
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(3):325-336
Background:
s/Aims: The efficacy of neoadjuvant transarterial chemoembolization (N−TACE) in resectable hepatocellular carcinoma (HCC) remains open to debate. While N−TACE may reduce tumor size, its impact on long-term outcomes is inconclusive.
Methods:
This meta-analysis reviewed studies on N−TACE before surgical resection vs. liver resection (LR) single large hepatocellular carcinoma (SLHCC) up to March 2023 from four online databases.
Results:
Five studies with 1,556 patients were analyzed. No significant differences between N−TACE and LR groups were observed in 1-, 3-, or 5-year overall survival (OS) and disease-free survival (DFS). No significant differences were noted in intraoperative blood loss between groups. Subgroup analysis showed favorable 1-, 3-, and 5-year OS with combination chemotherapy N−TACE (combination group), and better 1-year OS in the LR group with single-agent chemotherapy N−TACE (single-agent group). Five-year DFS favored LR in the single-agent group, and N−TACE in the combination group.
Conclusions
Managing SLHCC requires intricate considerations, and the treatment strategies for this challenging subgroup of HCC need to be improved. The influence of N−TACE on long-term survival depends on the specific chemotherapy regimen employed, and its impact on intraoperative blood loss in SLHCC appears limited.
3.Effect of neoadjuvant transarterial chemoembolization followed by resection versus upfront liver resection on the survival of single large hepatocellular carcinoma patients:A systematic review and meta-analysis
Indah JAMTANI ; Toar Jean MAURICE LALISANG ; Wawan MULYAWAN
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(3):325-336
Background:
s/Aims: The efficacy of neoadjuvant transarterial chemoembolization (N−TACE) in resectable hepatocellular carcinoma (HCC) remains open to debate. While N−TACE may reduce tumor size, its impact on long-term outcomes is inconclusive.
Methods:
This meta-analysis reviewed studies on N−TACE before surgical resection vs. liver resection (LR) single large hepatocellular carcinoma (SLHCC) up to March 2023 from four online databases.
Results:
Five studies with 1,556 patients were analyzed. No significant differences between N−TACE and LR groups were observed in 1-, 3-, or 5-year overall survival (OS) and disease-free survival (DFS). No significant differences were noted in intraoperative blood loss between groups. Subgroup analysis showed favorable 1-, 3-, and 5-year OS with combination chemotherapy N−TACE (combination group), and better 1-year OS in the LR group with single-agent chemotherapy N−TACE (single-agent group). Five-year DFS favored LR in the single-agent group, and N−TACE in the combination group.
Conclusions
Managing SLHCC requires intricate considerations, and the treatment strategies for this challenging subgroup of HCC need to be improved. The influence of N−TACE on long-term survival depends on the specific chemotherapy regimen employed, and its impact on intraoperative blood loss in SLHCC appears limited.
4.Frey’s Procedure for Chronic Pancreatitis in an Adolescent with Recurrent Upper Gastrointestinal Bleeding: A Case Report
Adianto NUGROHO ; Ariani Dewi WIDODO ; Indah JAMTANI ; Asri Dwi RACHMAWATI
Korean Journal of Pancreas and Biliary Tract 2022;27(4):164-167
Chronic fibroinflammatory pancreatitis causes irreparable damage to the pancreatic parenchyma. This frequently results in food restrictions, painkiller addiction, and serious quality of life impairment in children. We observed a 13-year-old girl who had previously been hospitalized multiple times and had undergone acute pancreatitis arrived with excruciating abdominal pain and recurrent hematemesis. A chronic intra-pseudocyst bleed and an ampulla of Vater hemorrhage were discovered during an upper gastrointestinal endoscopy. A 3×2×1 cm pancreatic head pseudocyst was discovered on the magnetic resonance cholangiopancreatography, however the computed tomography scan revealed a pancreatic head pseudocyst, pancreatic duct stones, and substantial peripancreatic inflammation. The multidisciplinary team determined that Frey’s surgery was the most efficient method to minimize her suffering. No complications occurred during the healing phase following surgery, and two years later, neither recurrence bleeding nor abdominal pain appeared. In summary, Frey’s method is a secure and efficient intervention when applied by a multidisciplinary team.
5.Effect of neoadjuvant transarterial chemoembolization followed by resection versus upfront liver resection on the survival of single large hepatocellular carcinoma patients:A systematic review and meta-analysis
Indah JAMTANI ; Toar Jean MAURICE LALISANG ; Wawan MULYAWAN
Annals of Hepato-Biliary-Pancreatic Surgery 2024;28(3):325-336
Background:
s/Aims: The efficacy of neoadjuvant transarterial chemoembolization (N−TACE) in resectable hepatocellular carcinoma (HCC) remains open to debate. While N−TACE may reduce tumor size, its impact on long-term outcomes is inconclusive.
Methods:
This meta-analysis reviewed studies on N−TACE before surgical resection vs. liver resection (LR) single large hepatocellular carcinoma (SLHCC) up to March 2023 from four online databases.
Results:
Five studies with 1,556 patients were analyzed. No significant differences between N−TACE and LR groups were observed in 1-, 3-, or 5-year overall survival (OS) and disease-free survival (DFS). No significant differences were noted in intraoperative blood loss between groups. Subgroup analysis showed favorable 1-, 3-, and 5-year OS with combination chemotherapy N−TACE (combination group), and better 1-year OS in the LR group with single-agent chemotherapy N−TACE (single-agent group). Five-year DFS favored LR in the single-agent group, and N−TACE in the combination group.
Conclusions
Managing SLHCC requires intricate considerations, and the treatment strategies for this challenging subgroup of HCC need to be improved. The influence of N−TACE on long-term survival depends on the specific chemotherapy regimen employed, and its impact on intraoperative blood loss in SLHCC appears limited.