ABSTRACT
The transarterial chemoembolization (TACE) is a firstline therapeutic option for advanced hepatocellular carcinoma (HCC). Their indications are clearly defined by learned societies but the challenge is to determine the optimal number of TACE sessions that will benefit patients before switching to other therapies. For this reason, the Assessment for Retreatment with Transarterial chemoembolization (ART) score has been developed. The objective of our work is to show the prognostic value of the ART score before the second TACE. METHODS: This is a retrospective and prospective study of patients with hepatocellular carcinoma on cirrhosis liver who received a TACE between January 2012 to July 2019. The diagnosis of HCC was made according to the non-invasive criteria of EASL with the use of histology for doubtful cases. The ART score was calculated after the first chemoembolization. Patients were divided into 2groups: group A with an ART score between 0 and 1.5 and group B with a score =2.5. RESULTS: During the study period, 58 patients with HCC on cirrhosis liver received a TACE: 55.17% had an ART score between 0 - 1.5 before the second session and 44.8% had an ART score =2,5. Both groups were comparable regarding age, circumstances of discovery and Child's score. The size of the HCC as well as the value of the AFP was further increased in the group B. We observed a significant difference in the radiological response, the Child score and aspartate transaminase rate between the two groups after the first TACE. The overall survival rate at 3 years was 81% in group A versus 19% in group B. CONCLUSION: The ART score has an independent prognostic value and should be taken into account in the therapeutic strategy before the second TACE.
Subject(s)
Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Carcinoma, Hepatocellular/therapy , Child , Humans , Liver Neoplasms/therapy , Prognosis , Prospective Studies , Retrospective Studies , Treatment OutcomeABSTRACT
Parotid metastasis from carcinoma of the breast is very rare, only a few cases have been reported in the literature. We here report the case of a 43-year old patient treated for right breast cancer in whom left parotid metastasis (confirmed histologically) occurred two years after the end of the treatment.
Subject(s)
Breast Neoplasms/pathology , Parotid Gland/pathology , Parotid Neoplasms/diagnosis , Adult , Female , Humans , Parotid Neoplasms/pathology , Parotid Neoplasms/secondaryABSTRACT
The neuropathic osteoarthropathy are ectopic ossifications, developed near the joints, secondary to a process of neo-osteogenesis in the case of central neurological lesions and rarely peripheral lesions. We report the case of two patients aged of 7 years and 35 years, for whom the CT scan allowed us to make the positive diagnosis, and an accurate preoperative assessment, by studying the seat, the vessels and nerves, allowing an adapted and precocious management. We propose an update of neuropathic osteoarthropathy based on data from the literature.
