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Abstract(s)
Introdução: O carcinoma hepatocelular é o sexto cancro mais comum do mundo, ocorrendo predominantemente em doentes com cirrose hepática. A trombose da veia porta é uma complicação comum do carcinoma hepatocelular, estando associada a um prognóstico mais reservado. Pretendeu-se, partindo de um caso clínico, realizar uma revisão da literatura sobre as opções terapêuticas do carcinoma hepatocelular associado a trombose da veia porta.
Material e Métodos: Pesquisa de artigos no motor de busca Pubmed, em língua inglesa, que incluíram uma análise de pelo menos dois dos seguintes termos: “carcinoma hepatocelular” AND “trombose da veia porta” AND “tratamento” AND “resseção cirúrgica” AND “sobrevida global”.
Resultados: A análise da literatura perscrutada revelou o tratamento sistémico sob a forma de sorafenib, a terapia recomendada para doentes com carcinoma hepatocelular com trombose da veia porta. Estão descritas outras opções terapêuticas que podem ser usadas em doentes selecionados, nomeadamente a quimioembolização transarterial, a radioembolização transarterial, a resseção cirúrgica e terapias combinadas.
Conclusões: Os estudos sugerem várias opções terapêuticas aplicáveis a doentes que não são candidatos cirúrgicos, incluindo sorafenib sistémico, quimioembolização transarterial e a radioembolização transarterial. A evidência atual demonstrou excelente segurança, tolerabilidade e aumento de sobrevida, nos doentes submetidos a radioembolização transarterial. No entanto, são necessários mais estudos de caráter prospetivo, aleatorizado e controlado que consubstanciem o referido.
Introduction: Hepatocellular carcinoma is the sixth most common cancer in the world, occurring predominantly in patients with cirrhosis. Portal vein thrombosis is a common complication of hepatocellular carcinoma, which leads with a poor prognosis. The main purpose was to review the literature on the treatment options of the patients with hepatocellular carcinoma and portal vein thrombosis, with special focus on the description of a real clinical case. Material and Methods: Pubmed search of several articles, written in English, which include an analysis of at least two of the following terms: "hepatocellular carcinoma", "portal vein thrombosis", "treatment", "surgical resection" and "overall survival". Results: The literature review revealed systemic treatment in the form of sorafenib, is the recommended therapy for hepatocellular carcinoma patients with portal vein thrombosis. Other options are described. It has been found therapies that may be used in selected patients, which are transarterial chemoembolization, transarterial radioembolization, surgical resection and combined therapies. Conclusions: Studies suggest several therapies applicable to patients who are not surgical candidates, including systemic sorafenib, transarterial chemoembolization and transarterial radioembolization. Current evidence has demonstrated excelente safety, tolerability and increased survival in patients undergoing transarterial radioembolization. However, further prospective, randomized, and controlled studies are needed to overcome the limitations of existing publications.
Introduction: Hepatocellular carcinoma is the sixth most common cancer in the world, occurring predominantly in patients with cirrhosis. Portal vein thrombosis is a common complication of hepatocellular carcinoma, which leads with a poor prognosis. The main purpose was to review the literature on the treatment options of the patients with hepatocellular carcinoma and portal vein thrombosis, with special focus on the description of a real clinical case. Material and Methods: Pubmed search of several articles, written in English, which include an analysis of at least two of the following terms: "hepatocellular carcinoma", "portal vein thrombosis", "treatment", "surgical resection" and "overall survival". Results: The literature review revealed systemic treatment in the form of sorafenib, is the recommended therapy for hepatocellular carcinoma patients with portal vein thrombosis. Other options are described. It has been found therapies that may be used in selected patients, which are transarterial chemoembolization, transarterial radioembolization, surgical resection and combined therapies. Conclusions: Studies suggest several therapies applicable to patients who are not surgical candidates, including systemic sorafenib, transarterial chemoembolization and transarterial radioembolization. Current evidence has demonstrated excelente safety, tolerability and increased survival in patients undergoing transarterial radioembolization. However, further prospective, randomized, and controlled studies are needed to overcome the limitations of existing publications.
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Keywords
Carcinoma Hepatocelular Fígado Tratamento Trombose da Veia Porta