Tratamiento combinado coadyuvante para el carcinoma hepatocelular previo al trasplante hepático

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Resumen

El objetivo de este estudio fue reportar el efecto antitumoral de la terapia combinada para el carcinoma hepatocelular en pacientes en lista de espera para trasplante hepático. Estudiamos a 3 pacientes cirróticos con carcinoma hepatocelular superior a 3 cm e inferior a 8 cm, sometidos a embolización transarterial e inyección percutánea de etanol como terapia combinada coadyuvante mientras aguardaban en lista de espera para trasplante de hígado. La embolización transarterial fue incapaz de causar la necrosis total del tumor. Posteriormente, con inyección percutánea de etanol se consiguió necrosis tumoral total en los 3 pacientes. Todos ellos siguen en la actualidad en lista de espera sin señales de recidiva local del tumor 9, 10 y 13 meses después de los procedimientos. En conclusión, la terapia combinada coadyuvante con embolización transarterial e inyección percutánea de etanol puede aumentar la necrosis tumoral y puede ser un tratamiento útil previo al trasplante hepático. Se requieren estudios más amplios para confirmar el valor de esta terapia combinada.

The aim of this study was to report the antitumor effect of combination therapy of hepatocellular carcinoma in patients on the waiting list for liver transplantation. We studied 3 cirrhotic patients with hepatocellular carcinoma > 3 cm and < 8 cm who underwent transarterial embolization and percutaneous ethanol injection as combination coadjuvant therapy while on the waiting list for liver transplantation. Transarterial embolization failed to produce total necrosis of the tumor. In all 3 patients this was subsequently achieved with percutaneous ethanol injection. All the patients currently remain on the waiting list and show no signs of local tumor recurrence 9, 10 and 13 months after the procedures. In conclusion, combination adjuvant therapy with transarterial embolization and percutaneous ethanol injection can increase tumor necrosis and can be useful prior to liver transplantation. Further studies with a greater number of patients are required to confirm the value of this combination therapy.

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