- Email: [email protected]
CME Test Questions: December 2015
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Locoregional Therapy for Liver Transplantation
12. Shim JH, Park J-W, Kim JH, et al. Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. Cancer Sci 2008; 99:2037–2044. 13. Zhang W, Kim R, Quintini C, et al. Prognostic role of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma undergoing liver transplantation. Liver Transpl 2015; 21:101–111. 14. U.S. Department of Health & Human Services. Organ Procurement and Transplantation Network. Available at: http://optn.transplant.hrsa.gov/. Accessed August 1, 2015. 15. Fontana RJ, Hamidullah H, Nghiem H, et al. Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma: a safe and effective bridge to liver transplantation. Liver Transpl 2002; 8:1165–1174. 16. Lu DSK, Yu NC, Raman SS, et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology 2005; 41:1130–1137.
Sheth et al
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JVIR
17. Mazzaferro V, Battiston C, Perrone S, et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg 2004; 240:900–909. 18. Stampfl U, Bermejo JL, Sommer CM, et al. Efficacy and nontarget effects of transarterial chemoembolization in bridging of hepatocellular carcinoma patients to liver transplantation: a histopathologic study. J Vasc Interv Radiol 2014;25:1018–1026.e4. 19. Pompili M, Mirante VG, Rondinara G, et al. Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: assessment of efficacy at explant analysis and of safety for tumor recurrence. Liver Transpl 2005; 11:1117–1126. 20. Green TJ, Rochon PJ, Chang S, et al. Downstaging disease in patients with hepatocellular carcinoma outside of milan criteria: strategies using drug-eluting bead chemoembolization. J Vasc Interv Radiol 2013; 24: 1613–1622.
CME TEST QUESTIONS: DECEMBER 2015
Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIR Learning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username and password, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center, click on the “Publication” activity type for a listing of all available JVIR CME tests. Each test will be available online for 3 years from the month/date of publication. The CME questions in this issue are derived from the article “Role of Locoregional Therapy and Predictors for Dropout in Patients with Hepatocellular Carcinoma Listed for Liver Transplantation” by Sheth et al. In this study, the authors analyze the role of locoregional therapy (LRT) for hepatocellular carcinoma (HCC) in patients on the wait list for orthotopic liver transplantation (OLT). Factors that predicted dropout (removal) from the wait list were analyzed and reported by the authors. 1. Although dropout rates vary by region, the reported a. 0.5 (lower than that of patients who did not dropout rates are approximately undergo LRT) a. o 5% b. 1.0 (same as that of patients who did not b. 10–15% undergo LRT) c. 15–30% c. 1.15 (slightly higher than that of patients who did d. 4 40% not undergo LRT) d. 2.9 (significantly higher than that of patients who 2. On a multivariate analysis which of the following did not undergo LRT) factors was found to correlate with increased like4. In this study, subgroup analysis of patients who lihood of transplantation? underwent OLT, which factor (of those analyzed) a. Time on the waitlist predicted HCC recurrence in the transplanted liver? b. LRT for HCC while on the waitlist a. AFP 4 400ng/mL at the time of transplant c. Peak alpha fetoprotein (AFP) level b. Time on the waitlist d. Age of the patient at the time of presentation c. Objective response to initial LRT while 3. Based on this study, the odds of successfully remainawaiting OLT ing on the waitlist while awaiting transplantation in d. Use of thermal ablation (vs chemoembolization) patients who underwent LRT were for LRT while awaiting OLT
’
Locoregional Therapy for Liver Transplantation
12. Shim JH, Park J-W, Kim JH, et al. Association between increment of serum VEGF level and prognosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. Cancer Sci 2008; 99:2037–2044. 13. Zhang W, Kim R, Quintini C, et al. Prognostic role of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma undergoing liver transplantation. Liver Transpl 2015; 21:101–111. 14. U.S. Department of Health & Human Services. Organ Procurement and Transplantation Network. Available at: http://optn.transplant.hrsa.gov/. Accessed August 1, 2015. 15. Fontana RJ, Hamidullah H, Nghiem H, et al. Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma: a safe and effective bridge to liver transplantation. Liver Transpl 2002; 8:1165–1174. 16. Lu DSK, Yu NC, Raman SS, et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology 2005; 41:1130–1137.
Sheth et al
’
JVIR
17. Mazzaferro V, Battiston C, Perrone S, et al. Radiofrequency ablation of small hepatocellular carcinoma in cirrhotic patients awaiting liver transplantation: a prospective study. Ann Surg 2004; 240:900–909. 18. Stampfl U, Bermejo JL, Sommer CM, et al. Efficacy and nontarget effects of transarterial chemoembolization in bridging of hepatocellular carcinoma patients to liver transplantation: a histopathologic study. J Vasc Interv Radiol 2014;25:1018–1026.e4. 19. Pompili M, Mirante VG, Rondinara G, et al. Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: assessment of efficacy at explant analysis and of safety for tumor recurrence. Liver Transpl 2005; 11:1117–1126. 20. Green TJ, Rochon PJ, Chang S, et al. Downstaging disease in patients with hepatocellular carcinoma outside of milan criteria: strategies using drug-eluting bead chemoembolization. J Vasc Interv Radiol 2013; 24: 1613–1622.
CME TEST QUESTIONS: DECEMBER 2015
Examination available at http://learn.sirweb.org/. To take the online JVIR CME tests, please log into the SIR Learning Center with your SIR user name and password. Nonmembers: If you do not already have an SIR username and password, please click on “Create an Account” to gain access to the SIR Learning Center. Once in the Learning Center, click on the “Publication” activity type for a listing of all available JVIR CME tests. Each test will be available online for 3 years from the month/date of publication. The CME questions in this issue are derived from the article “Role of Locoregional Therapy and Predictors for Dropout in Patients with Hepatocellular Carcinoma Listed for Liver Transplantation” by Sheth et al. In this study, the authors analyze the role of locoregional therapy (LRT) for hepatocellular carcinoma (HCC) in patients on the wait list for orthotopic liver transplantation (OLT). Factors that predicted dropout (removal) from the wait list were analyzed and reported by the authors. 1. Although dropout rates vary by region, the reported a. 0.5 (lower than that of patients who did not dropout rates are approximately undergo LRT) a. o 5% b. 1.0 (same as that of patients who did not b. 10–15% undergo LRT) c. 15–30% c. 1.15 (slightly higher than that of patients who did d. 4 40% not undergo LRT) d. 2.9 (significantly higher than that of patients who 2. On a multivariate analysis which of the following did not undergo LRT) factors was found to correlate with increased like4. In this study, subgroup analysis of patients who lihood of transplantation? underwent OLT, which factor (of those analyzed) a. Time on the waitlist predicted HCC recurrence in the transplanted liver? b. LRT for HCC while on the waitlist a. AFP 4 400ng/mL at the time of transplant c. Peak alpha fetoprotein (AFP) level b. Time on the waitlist d. Age of the patient at the time of presentation c. Objective response to initial LRT while 3. Based on this study, the odds of successfully remainawaiting OLT ing on the waitlist while awaiting transplantation in d. Use of thermal ablation (vs chemoembolization) patients who underwent LRT were for LRT while awaiting OLT