Background:While preliminary reports on resection following downstaging using transarterial radioembolization(TARE)for intermediate or advanced hepatocellular carcinomas(HCCs)reported promising oncological outcomes,th...Background:While preliminary reports on resection following downstaging using transarterial radioembolization(TARE)for intermediate or advanced hepatocellular carcinomas(HCCs)reported promising oncological outcomes,there’s a notable gap in the literature concerning post operative morbidity.Contrary to post hepatectomy liver failure(PHLF),damages to the bile ducts and their potential consequences have been poorly evaluated.Thus,our aim was to explore postoperative complications in HCC patients undergoing liver resection after Y90 TARE,focusing particularly on biliary complications.Methods:Conducted from June 2015 to December 2022,this retrospective study involved 30 HCC patients undergoing liver resection post-TARE.Comprehensive data on surgical procedures,complications,and follow-up were collected.Logistic regression analyses were conducted,starting with univariate analysis followed by multivariate analysis,focusing on variables with a significance level below P<0.2.Results:The objective response rate(ORR)in the TARE-treated area was 97%at 3 months.Survival outcomes showed a median overall survival(OS)of 5.1 years and progression-free survival(PFS)of 3.5 years post-liver resection.The study found a 40%(12 out of 30 patients)rate of severe postoperative complications and a 7%(2 out of 30 patients)90-day mortality rate.After liver resection,grade B bile leaks occurred in 20%(6 out of 30)of patients,with a third experiencing recurrence.Biliary-specific mortality was 9%.After multivariate analysis,only the interval between TARE and surgery emerged a significant risk factor for biliary complications,showing increased odds of bile leaks if surgery occurred 3-6 months post-TARE compared to after 6 months.Conclusions:This study highlights the importance of timing between TARE and surgery,suggesting a waiting period of at least 6 months.Such timing not only enhances the radiation effects of TARE but also optimizes both future liver remnant growth and patient selection.展开更多
Thermodynamics and kinetics for the preparation of Sm2Fe17 alloys by reduction-diffusion （R-D） method in CaSm2O3-Fe System were investigated. With increasing reaction temperature, it is found that the reaction rate ...Thermodynamics and kinetics for the preparation of Sm2Fe17 alloys by reduction-diffusion （R-D） method in CaSm2O3-Fe System were investigated. With increasing reaction temperature, it is found that the reaction rate of R-D and the amount of Sm in the Sm2Fe17 alloy increase, and the increased amount at lower temperature is higher than that at higher temperature. Moreover, results from contracting core modal show that the peritectic reaction between Sm and Fe is a ratedetermined step in the whole R-D process. The apparent activation energy and the pre-exponential factor for this reaction are 73.74 kJ· mol^ -1 and 7.79 × 10^- 3 respectively.展开更多
Background:This article aims to present the single-institution outcomes of patients with Fibrolamellar Carcinoma(FLC)treated with liver-directed therapies(LDT).Methods:In this single-center retrospective study,all pat...Background:This article aims to present the single-institution outcomes of patients with Fibrolamellar Carcinoma(FLC)treated with liver-directed therapies(LDT).Methods:In this single-center retrospective study,all patients diagnosed with FLC who underwent LDT were identified.Between July 2012 and July 2023,six patients were identified.One patient was excluded due to bleeding.Demographic and clinical parameters were recorded.Complications within 30 days of the LDT were evaluated.Radiological treatment responses at 1,6,and 12 months were assessed per mRECIST.Results:A total offive patients,which included three females and two males,were reviewed.Three patients were treated with transarterial hepatic embolization(TAE;n=3),transarterial radioembolization(TARE;n=1),and combined TAE+radiofrequency ablation(n=1).The objective response rate at one month was 80%[CR=2(40%),PR=2(40%),and SD=1(20%)].At 12 months(n=4),two patients demonstrated CR(50%)and two demonstrated PR(50%).Overall survival from LDT atfive years was 50%.There was no 30-day mortality among this group of patients or any adverse event attributable to the LDT.Conclusion:TAE,TARE,and ablation are safe and effective therapeutic options for FLC.Based on this study and previously published case reports,ablation and TARE yielded the most favorable results.展开更多
文摘Background:While preliminary reports on resection following downstaging using transarterial radioembolization(TARE)for intermediate or advanced hepatocellular carcinomas(HCCs)reported promising oncological outcomes,there’s a notable gap in the literature concerning post operative morbidity.Contrary to post hepatectomy liver failure(PHLF),damages to the bile ducts and their potential consequences have been poorly evaluated.Thus,our aim was to explore postoperative complications in HCC patients undergoing liver resection after Y90 TARE,focusing particularly on biliary complications.Methods:Conducted from June 2015 to December 2022,this retrospective study involved 30 HCC patients undergoing liver resection post-TARE.Comprehensive data on surgical procedures,complications,and follow-up were collected.Logistic regression analyses were conducted,starting with univariate analysis followed by multivariate analysis,focusing on variables with a significance level below P<0.2.Results:The objective response rate(ORR)in the TARE-treated area was 97%at 3 months.Survival outcomes showed a median overall survival(OS)of 5.1 years and progression-free survival(PFS)of 3.5 years post-liver resection.The study found a 40%(12 out of 30 patients)rate of severe postoperative complications and a 7%(2 out of 30 patients)90-day mortality rate.After liver resection,grade B bile leaks occurred in 20%(6 out of 30)of patients,with a third experiencing recurrence.Biliary-specific mortality was 9%.After multivariate analysis,only the interval between TARE and surgery emerged a significant risk factor for biliary complications,showing increased odds of bile leaks if surgery occurred 3-6 months post-TARE compared to after 6 months.Conclusions:This study highlights the importance of timing between TARE and surgery,suggesting a waiting period of at least 6 months.Such timing not only enhances the radiation effects of TARE but also optimizes both future liver remnant growth and patient selection.
文摘Thermodynamics and kinetics for the preparation of Sm2Fe17 alloys by reduction-diffusion （R-D） method in CaSm2O3-Fe System were investigated. With increasing reaction temperature, it is found that the reaction rate of R-D and the amount of Sm in the Sm2Fe17 alloy increase, and the increased amount at lower temperature is higher than that at higher temperature. Moreover, results from contracting core modal show that the peritectic reaction between Sm and Fe is a ratedetermined step in the whole R-D process. The apparent activation energy and the pre-exponential factor for this reaction are 73.74 kJ· mol^ -1 and 7.79 × 10^- 3 respectively.
文摘Background:This article aims to present the single-institution outcomes of patients with Fibrolamellar Carcinoma(FLC)treated with liver-directed therapies(LDT).Methods:In this single-center retrospective study,all patients diagnosed with FLC who underwent LDT were identified.Between July 2012 and July 2023,six patients were identified.One patient was excluded due to bleeding.Demographic and clinical parameters were recorded.Complications within 30 days of the LDT were evaluated.Radiological treatment responses at 1,6,and 12 months were assessed per mRECIST.Results:A total offive patients,which included three females and two males,were reviewed.Three patients were treated with transarterial hepatic embolization(TAE;n=3),transarterial radioembolization(TARE;n=1),and combined TAE+radiofrequency ablation(n=1).The objective response rate at one month was 80%[CR=2(40%),PR=2(40%),and SD=1(20%)].At 12 months(n=4),two patients demonstrated CR(50%)and two demonstrated PR(50%).Overall survival from LDT atfive years was 50%.There was no 30-day mortality among this group of patients or any adverse event attributable to the LDT.Conclusion:TAE,TARE,and ablation are safe and effective therapeutic options for FLC.Based on this study and previously published case reports,ablation and TARE yielded the most favorable results.
