Table 2 Therapeutic features of human alveolar echinococcosis cohort patients in Hungary(2003–2018)
case no. | 1 | 2 | 3 | 4 |
|---|---|---|---|---|
antiparasitic drug tx (duration in months) | – | ABZ (3) 10.2004–12.2004 | ABZ (162) continuously since 07.2005 | ABZ (12) 11.2008 – 01.2009 and 06.2016–03.2017 |
surgery | – | – | exploration –unresectable | exploration, fenestration, marsupialisation |
EPI | – | – | – | PTD (2x), ERCP |
follow-up period in months | 27 | 177 | 162 | 124 |
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) | CT (04.2005) – pseudocystic AE lesion in left lobe 49 mm, two more AE lesions in right lobe, 35 mm and 24 mm | US (09.2014) stabilization | MRI (12.2018) stabilization | US (12.2018) residual cavity in SIV 70 mm, giant biloma in porta hepatis |
PNM at final imaging | P1N0Mx | P1NxMx | P2N1Mx | P3N0Mx |
complications | elevated GGT (136), ALP (621), sebi (36,3) | – | – | central biliary obstruction, cholangitis, biloma, bile-leaking |
outcome | progression, AE unrelated death | stabilization | stabilization | progression |
case no. | 5 | 6 | 7 | 8 |
antiparasitic drug tx (duration in months) | – | ABZ (5) 02.2012–07.2012 | ABZ (67) continuously since 06.2013 | ABZ (24) postoperatively |
surgery | marsupialization, drainage | extended right hemihepatectomy | – | segmentectomy |
EPI | ERCP – biliary stent implantation, nasobiliary stent | – | – | – |
follow-up period in months | 9 | 84 | 69 | 51 |
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) | US (11.2011) residual cavity 45 mm, atrophy of right lobe | US (02.2018) no recurrence | MRI (10.2018) and US (10.2018), 109 mm | US (07.2018) no recurrence |
PNM at final imaging | P4N0Mx | P0N0Mx | P4N0Mx | P0N0M0 |
complications | central biliary obstruction, bile-leaking, bilio-peritoneal fistula, injury of bileducts during surgical manipulation, cachexia | postoperative peritonitis, haematoma, bile-leaking, Kehr-drainage | v. cava inferior compression | – |
outcome | progression, AE related death | no recurrence | stabilization | no recurrence |
case no. | 9 | 10 | 11 | 12 |
antiparasitic drug tx (duration in months) | ABZ (3) lowered dose intermittently in 2016, finally ceased | ABZ (30) continuously since 07.2016 | ABZ (21) postoperatively | ABZ (3) 09.2017–11.2017 |
surgery | – | – | segmentectomy | – |
EPI | – | – | – | – |
follow-up period in months | 36 | 30 | 20 | 18 |
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) | MRI (10.2018), CT (10.2018) no progression in liver, new pulmonary micronodules (09.2017) | MRI (11.2018) SIV 70 mm, progression | MRI (06.2018), US (10.2018) no recurrence | US (07.2018) AE lesion in left lobe 65 mm, AE lesion in right lobe 44 mm |
PNM at final imaging | P3N0Mx | P1N0Mx | P0N0Mx | P2N0Mx |
complications | ABZ hepatotoxicity and allergic reactions, undignified pulmonary microlesions | – | – | – |
outcome | stabilization | progression | no recurrence | progression |
case no. | 13 | 14 | 15 | 16 |
antiparasitic drug tx (duration in months) | ABZ (12) continuously since 01.2018 | ABZ (12) continuously since 01.2018 | ABZ (3) 06.2018–09.2018 | – |
surgery | – | right hemihepatectomy, exstirpation of d. choledochus and cholecystectomy, hepaticojejunostomia | explorative laparotomy | right hemihepatectomy, exstirpation of d. choledochus and cholecystectomy, hepaticojejunostomia |
EPI | – | ERCP | ERCP (2x), stent implantation (2x) | ERCP, stent implantation, PTD (2x) |
follow-up period in months | 13 | 12 | 5 | 1 |
radiomorphology on final control, largest diameter of AE lesion(s) in mm (date) | MRI (10.2018) AE lesion in SV 79 mm | CT (10.2018) no recurrence | US (05.2018) 120 mm AE lesion occupying left lobe, ascites, dilatated intrahepatic bileducts | – |
PNM at final imaging | P4N0Mx | P0N1Mx | P4N1Mx | P0N0Mx |
complications | thrombosis and parasitic infiltration of right v. portae, compression of d. hepaticus dexter | leukopenia, hairloss, haematoma in residual left lobe (32 mm) and undignified pulmonary microlesions | compression of d. hepaticus communis, peritonitis, cholangiogen sepsis | compression of d. hepaticus communis, abscessus hepatis, liver insufficiency, septic shock |
outcome | stabilization | no recurrence | progression, AE related death | progression, AE related death |