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What Should Hospitalists Know about Transarterial Liver Tumor Therapies?

The Hospitalist. 2015 February;2015(02):
February 2, 2015 | The Hospitalist
Sandeep Laroia, MD ; Steven Morales, MD ; Archana Laroia, MD

Bottom Line

Transarterial liver tumor therapies offer treatment options to patients who would otherwise have none. With these presented considerations in mind, the hospitalist will be prepared to address common issues when and if they arise.

Drs. Sandeep and Archana Laroia are clinical assistant professors in the department of radiology at the University of Iowa Hospitals and Clinics, Iowa City. Dr. Morales is a radiology resident at UIHC.

Key Points

  • The incidence of liver cancer, both primary and secondary, is rising in the United States due to higher incidence of chronic liver disease (hepatitis C, alcoholic cirrhosis, and NASH) and metastatic cancers.
  • Transarterial liver tumor therapies provide a less invasive, effective treatment option for patients who are not surgical candidates.
  • Postembolization syndrome is the most common side effect of liver tumor embolization and can be managed conservatively with antiemetics and pain medication.
  • Common complications of arterial puncture are similar to those seen with cardiac interventional procedures.

Additional Reading

  • Sangro B, Salem R, Kennedy A, Coldwell D, Wasan H. Radioembolization for hepatocellular carcinoma: a review of the evidence and treatment recommendations. Am J Clin Oncol. 2011;34(4):422-431.
  • Starley BQ, Calcagno CJ, Harrison SA. Nonalcoholic fatty liver disease and hepatocellular carcinoma: a weighty connection. Hepatology. 2010;51(5):1820-1832.
  • Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol. 2001;12(3):321-326.

References

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  11. Leung DA, Goin JE, Sickles C, Raskay BJ, Soulen MC. Determinants of postembolization syndrome after hepatic chemoembolization. J Vasc Interv Radiol. 2001;12(3):321-326.
  12. Kawaoka T, Aikata H, Katamura Y, et al. Hypersensitivity reactions to transcatheter chemoembolization with cisplatin and Lipiodol suspension for unresectable hepatocellular carcinoma. J Vasc Interv Radiol. 2010;21(8):1219-1225.
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