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Hashimoto A, Tanaka T, Sho M, Nishiofuku H, Masada T, Sato T, Marugami N, Anai H, Sakaguchi H, Kanno M, Tamamoto T, Hasegawa M, Nakajima Y, Kichikawa K. Adjuvant Hepatic Arterial Infusion Chemotherapy After Resection for Pancreatic Cancer Using Coaxial Catheter-Port System Compared with Conventional System. Cardiovasc Intervent Radiol 2016; 39:831-9. [PMID: 26762632 DOI: 10.1007/s00270-016-1292-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/25/2015] [Indexed: 01/11/2023]
Abstract
PURPOSE Previous reports have shown the effectiveness of adjuvant hepatic arterial infusion chemotherapy (HAIC) in pancreatic cancer. However, percutaneous catheter placement is technically difficult after pancreatic surgery. The purpose of this study was to evaluate the feasibility and outcome of HAIC using a coaxial technique compared with conventional technique for postoperative pancreatic cancer. MATERIALS AND METHODS 93 consecutive patients who received percutaneous catheter-port system placement after pancreatectomy were enrolled. In 58 patients from March 2006 to August 2010 (Group A), a conventional technique with a 5-Fr indwelling catheter was used and in 35 patients from September 2010 to September 2012 (Group B), a coaxial technique with a 2.7-Fr coaxial catheter was used. RESULTS The overall technical success rates were 97.1 % in Group B and 86.2 % in Group A. In cases with arterial tortuousness and stenosis, the success rate was significantly higher in Group B (91.7 vs. 53.8 %; P = 0.046). Fluoroscopic and total procedure times were significantly shorter in Group B: 14.7 versus 26.7 min (P = 0.001) and 64.8 versus 80.7 min (P = 0.0051), respectively. No differences were seen in the complication rate. The 1 year liver metastasis rates were 9.9 % using the conventional system and 9.1 % using the coaxial system (P = 0.678). The overall median survival time was 44 months. There was no difference in the survival period between two systems (P = 0.312). CONCLUSIONS The coaxial technique is useful for catheter placement after pancreatectomy, achieving a high success rate and reducing fluoroscopic and procedure times, while maintaining the safety and efficacy for adjuvant HAIC in pancreatic cancer.
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Affiliation(s)
- Aya Hashimoto
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.,Department of Radiology, Nara City Hospital, Nara, Japan
| | - Toshihiro Tanaka
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan.
| | - Masayuki Sho
- Department of Surgery, Nara Medical University, Kashihara, Japan
| | - Hideyuki Nishiofuku
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Tetsuya Masada
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Takeshi Sato
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Nagaaki Marugami
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
| | - Hiroshi Anai
- Department of Radiology, Nara City Hospital, Nara, Japan
| | - Hiroshi Sakaguchi
- Department of Radiology, Nara Prefectural Western Medical Center, Sango, Japan
| | | | - Tetsuro Tamamoto
- Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
| | - Masatoshi Hasegawa
- Department of Radiation Oncology, Nara Medical University, Kashihara, Japan
| | | | - Kimihiko Kichikawa
- Department of Radiology, Nara Medical University, 840 Shijo-cho, Kashihara, 634-8522, Japan
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