According to the BCLC staging system, image-guided tumor ablation is recommended in patients with early-stage HCC (Bruix and Sherman, 2011). Percutaneous thermal ablation has proven to be as effective as resection in tumors < 5 cm and offers favorable results for tumors < 7 cm for patients without other treatment options. Cryoablation appears to offer similar tumor responses to RFA, but with increased complications. At institutions without thermal ablation technology, PEI remains an inexpensive way to treat tumors < 3 cm but offers less benefit than RFA(Davis, 2010). a- Radiofrequency ablation (RFA): RFA is a technology in the management of liver tumours. High-frequency alternating current (400-500KHz) is delivered through the electrodes, …show more content…
The main drawback of radiofrequency is its higher cost and the higher rate (up to 10%) of adverse events (pleural effusion – peritoneal bleeding).Procedure – related mortality ranges from 0% to 0.3% (Bruix and Sherman, 2005). This technique is best suited overall to small tumours (less than 3cm) deep within the hepatic parenchyma and away from the hepatic hilum (Bartlett et al., 2005). Complications with RFA: Complications may occur immediately or with a delay after a procedure, and may be related to the puncture, the entire procedure or to the patient’s disease and individual situation. Immediate complications can be metabolic, vascular and non-vascular, while delayed complications are determined by complex metabolic reactions, infections, biliary obstruction and tumor seeding. (De Baere et al. 2003). Or it may be divided into major and minor complications: Major complications: • Metabolic complications • Vascular complications • Infection • Liver failure • Non-Target Thermal
Currently, locoregional therapies play an important role in the treatment of patients awaiting LT. For patients listed within the (stage T2-HCC), a delay of LT over 6-12 months without bridging treatment is a well-recognized risk factor for tumor progression and dropout from the list or interval dissemination with post-transplant tumor recurrence. (Freeman RB et al., 2006).
Compare and contrast A Raisin in the Sun with Death of a Salesman and give examples.
AJCC stages I and II defines the disease without spread to large blood vessels or distant organs such as the liver or lungs with possibility of surgical resection of the tumor (Bond-Smith et al., 2012).
This was shown to be true as the most evident complication that was present in the 21 patients who participated in the trail was in fact infection (Yamamoto 410). The second complication that some patients experienced was that of ileus, a digestive disorder that usually occurs after surgery (Yamamoto 410). Another complication of DBS is the possibility of cancer. One patient from the 21 that participated in the DBS trial was diagnoses with cancer (Yamamoto 410). These are some of the complication that could result from an individual receiving DBS, but these compilations should not lessen the fact that DBS provides a greater chance of
Surgery is the oldest type of treatment for cancer. In its earlier use, surgery was not as successful as it is today. This was due to the difficulties involved with the anesthesias, excessive blood loss,
TIPS is a less invasive procedure done to the patient who has liver disease like cirrhosis. A connection is placed within the liver and extended to the portal vein. This helps to reduce pressure between the portal vein and circulatory system. When placing tips, the right jugular vein is normally accessed and a standard catheter is inserted through the vena cava to the right hepatic vein. A puncture from right hepatic vein through the liver to the portal vein is made using a needle, and a shunt is placed.
All except one patient had a complete excision of tumor. There were no major surgical complications.
Why would you want to use PDT? It has no long-term side effects. It’s less invasive than surgery. PDT only takes a little time, compared to other treatments. It can target the cancer very accurately. PDT can repeat many times at the same place if the cancer doesn’t go away, unlike radiation. There’s often little or no scarring after the place that has been treated heals. It usually costs less than other cancer treatments. However, PDT can only treat areas where light can reach, so it’s mainly used to treat problems on or just under the skin, or in organs that can be reached by light. Because light can’t travel very far through the body, PDT can’t be used to treat large cancers or cancers that have grown deeply into the skin or other organs.
The minority is defined by relative weakness of its social praxis, lack of the government representation, the unfairness of the judiciary towards it. The minority is a group of people who are signed out from the others in the society, receive unequal treatment and regard themselves as objects of collective discrimination (Akhtar, 2014). Even though the United States is multiethnic country and the number of minorities is growing, the treatment of minorities is still discriminatory.
This helps to locate the position of tumour and target the needle’s insertion into the liver under direct supervision.2 This method is allied with small risk of seeding of the needle tract with cancerous cells and it is commonly a harmless method, even in patients with haemangioma cyst.1 Laparoscopic Biopsy This is carried out at the point a patient is about to get an abdominal surgery. This allows the surgeon to examine the liver and take tissue sample as needed.3 Transvenous Biopsy An interventional radiologist may carry out Transvenous biopsy. 1This normally occurs when the patient has a major problem with clotting of the blood.
Theoretical advantages of induction CT include; better treatment compliance, ability to deliver full systemic doses of CT with possibility of tumor shrinking that facilitate more effective local treatment. The tumor shrinkage potentially improves tumor vascularity with eventually improving oxygenation and increase intratumoral concentration of cytotoxic drugs [8, 9].
According to a study made in 2004, T2D complications will lead to hospitalization at some stage, causing an increase in the direct and indirect medical expenditures. -For caring for the patient-2
In an effort to address the issue of radio frequency radiation exposure in this community, we will provide a background on the sources of radio frequency radiation as well as the known and suspected health effects. We will also proposed two epidemiological studies and discuss risk management and
Hepatocellular carcinoma (HCC) is one of the most common diseases, with an increasing incidence. With new and advanced surgical instrumentation and techniques, several curative therapies have become successful. The HCC patients are treated according to the stage of Liver tumor. For very early stage of HCC, the very first choice of therapy is liver resection but it is later being replaced by local ablative therapy which is useful as a bridging therapy toward liver transplantation and also as a replacement therapy for liver transplant when conditions are not feasible. However, liver transplantation provides better results in the HCC patients whose tumor meet the Milan criteria. The main obstacle towards the successful treatment is the HCC recurrence and at present there is no successful ways of treating and preventing HCC recurrence. For intermediate-stage HCC, the transarterial therapy is considered suitable. These surgical therapies not only provides suitable outcomes but also recovers the quality of life of HCC patients. Because of the complications of HCC, the surgical therapeutic approaches must be considered according to the tumor stage of each individual patient. The article presents an overview of treatment therapies for both early and advanced stage HCC based on the extensive review of the relevant literature.
According to Middleton, Teefey and Darcy,8 TIPS placement is successful in about 90% of patients, but does hold a complication rate of 10-16%. Research has shown that placement of TIPS as a secondary treatment for variceal bleeding has produced encouraging results. In 13 random clinical trials, including over 900 patients, recurrent variceal bleeding rates were 9-40%, which is superior to endoscopic treatments that have recurrent bleeding rates from 20-60%. This success rate has made TIPS procedures more utilized in the setting of variceal bleeding. Additionally, the same clinical trials indicate that ascites reduction after shunting ranges from 38-84%, which is favorable to large volume paracentesis that reported rates of 0-43%. “Compared with large-volume paracentesis, TIPS improved transplant-free survival and the incidence of recurrent ascites in cirrhotic patients with refractory ascites.”26 There is evidence of an increase in the development of HE in patients who undergo TIPS, whereas endoscopic treatment does not show an increase. Furthermore, HE is twice as likely to occur when paracentesis is performed. An important consideration is that the complication rate for hepatic encephalopathy does increase with TIPS usage whereas it doesn’t with endoscopic treatment and it is twice as likely to occur as when paracentesis is performed.28 Presently, TIPS is often used as a temporary solution for patients who are