Table of Contents
1
UI - 11148565
AU - O'Reilly EM; Stuart KE; Sanz-Altamira PM; Schwartz GK; Steger CM;
TI -
Raeburn L; Kemeny NE; Kelsen DP; Saltz LB
A phase II study of irinotecan in patients with advanced hepatocellular
carcinoma.
SO - Cancer 2001 Jan 1;91(1):101-5
AD - Department of Medicine, Solid Tumor Division, GI Oncology Service,
Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
oreillye@mskcc.org
BACKGROUND: Advanced hepatocellular carcinoma has a poor prognosis. In a
Phase II clinical trial, two academic centers assessed irinotecan, a
topoisomerase-1 inhibitor with broad spectrum clinical activity, in
patients who had advanced hepatocellular cancer. METHODS: Patients who
had had up to one prior chemotherapy regimen were eligible.
Bidimensionally measurable disease, a good performance status, and
adequate major organ function were required. At a starting dose of 125
mg/m2, irinotecan was administered weekly for 4 weeks followed by a 2
week break, which constituted 1 treatment cycle. Patients were restaged
radiologically after two cycles of therapy. Dose attenuations were made
as indicated for toxicity. RESULTS: Fourteen patients were enrolled over
a 10-week period in 1997. There were ten males and four females. The
median age was 58 years (range, 38-74 yrs). The Eastern Cooperative
Oncology Group median performance status was 1 (range, 0-1). Two
patients had prior chemotherapy (14%), and 1 patient (7%) had had
radiation. A total of 30 cycles of therapy were delivered (median, 1;
range, 1-6). Considerable toxicity was observed, mostly neutropenia,
diarrhea, nausea, vomiting, and fatigue. All patients required at least
one dose attenuation for toxicity. One partial response (7%; confidence
interval, 0-20%) was noted to last 7 months. One patient had transient
stable disease, and all others (86%) had progression of disease as their
best response. CONCLUSIONS: Irinotecan had modest activity in advanced
hepatocellular cancer. Toxicity was substantial, presumably reflecting
impaired underlying liver function or poor ability to metabolize and
eliminate the drug. The current study indicated that continued new
therapy assessment is warranted for this disease. Copyright 2001
American Cancer Society.
2
UI - 11291876
AU - Ido K; Isoda N; Sugano K
TI -
Microwave coagulation therapy for liver cancer: laparoscopic microwave
coagulation.
SO - J Gastroenterol 2001 Mar;36(3):145-52
AD - Department of Endoscopy, Jichi Medical School, Tochigi, Japan.
3
UI - 11291880
AU - Matsueda K; Yamamoto H; Umeoka F; Ueki T; Matsumura T; Tezen T; Doi I
TI -
Effectiveness of endoscopic biliary drainage for unresectable
hepatocellular carcinoma associated with obstructive jaundice.
SO - J Gastroenterol 2001 Mar;36(3):173-80
AD - Department of Internal Medicine, Kurashiki Central Hospital, Japan.
Endoscopic biliary drainage (EBD) for unresectable hepatocellular
carcinoma (HCC) associated with obstructive jaundice remains
controversial because of the short survival of these patients. To
evaluate the effectiveness of this procedure, we retrospectively studied
18 patients who had unresectable HCC with obstructive jaundice and
underwent EBD with polyethylene stents, over a 10-year period. Nine
patients with tumor thrombus involving the first branches of the portal
vein or portal trunk (Vp3) formed group A and the other 9 (Vp0-Vp2)
formed group B. The serum albumin level and serum total bililubin level
differed significantly between the two groups (P < 0.05 and P < 0.005.
Student's t-test), but prothrombin time did not. The obstructive
jaundice was mainly caused by direct tumor invasion in 6 patients from
group A and 3 from group B, by blood clots and/or tumor fragments in 2
patients from group A and 3 from group B, by the tumor protruding into
the common hepatic duct in 2 patients from group B. and by tumor
compression of the common bile duct in 1 patient from each group.
Drainage was successful in 4 patients (44%) from group A and in all 9
patients (100%) from group B. Among the 5 patients with unsuccessful
drainage in group A, 4 had obstruction of both the left and right
hepatic ducts and 3 had multiple tumors in both lobes. The mean survival
time (mean +/- SD) after EBD was 47 +/- 44 days in group A and 181 +/-
70 days in group B. In group A. the average survival time was only 85
days in the 4 patients with successful drainage. However, an improvement
in the quality of life after EBD was observed in one-third of the Vp3
patients and in all of the Vp0-Vp2 patients. In summary, satisfactory
palliation is possible with successful EBD, but this is difficult in
most patients with Vp3 portal thrombus, direct tumor invasion involving
both hepatic ducts, and multiple tumors in both lobes. It is important
to determine the site, extent, and nature of the obstruction, as well as
liver function and the presence of portal thrombus, before performing
EBD.
4
UI - 11328263
AU - Papatheodoridis GV; Papadimitropoulos VC; Hadziyannis SJ
TI -
Effect of interferon therapy on the development of hepatocellular
carcinoma in patients with hepatitis C virus-related cirrhosis: a
meta-analysis.
SO - Aliment Pharmacol Ther 2001 May;15(5):689-98
AD - Academic Department of Medicine, Hippokration General Hospital, Athens,
Greece.
BACKGROUND: The role of interferon in the prevention of hepatocellular
carcinoma remains controversial. AIM: In this meta-analysis we evaluated
the hepatocellular carcinoma incidence in interferon-treated and
-untreated patients with hepatitis C virus-related cirrhosis. METHODS:
Eleven studies with 2178 patients were found to fulfil our inclusion
criteria. The pooled odds ratio (OR) and 95% confidence intervals (CI)
were calculated from the raw study data. RESULTS: Hepatocellular
carcinoma development was significantly more frequent in untreated
(21.5%) than in interferon-treated patients (8.2%; OR: 3.0, 95% CI:
2.3-3.9). In the five studies reporting hepatocellular carcinoma
incidence in patients with and without sustained response to interferon,
hepatocellular carcinoma was detected at a much higher rate in patients
without (9%) than with a sustained response (0.9%; OR: 3.7, 95% CI:
1.7-7.8). Moreover, hepatocellular carcinoma developed significantly
more frequently in the untreated patients than in the non-sustained
responders (OR: 2.7, 95% CI: 1.9-3.9). The benefit from interferon on
hepatocellular carcinoma incidence was not influenced by the study type
(prospective or retrospective), the follow-up duration, or the study
origin. CONCLUSIONS: Interferon therapy significantly reduces the
hepatocellular carcinoma risk in patients with hepatitis C virus
cirrhosis. Hepatocellular carcinoma development becomes almost
negligible among sustained responders, but a reduction in hepatocellular
carcinoma incidence is also achieved even in the non-sustained
responders.
5
UI - 11496505
AU - Borisov AE; Zemlianoi VP; Borisova NA; Nepomniashchaia SL
TI -
[Surgical strategy in liver hemangiomas]
SO - Vestn Khir Im I I Grek 2001;160(2):99-103
The authors made an analysis of results of surgical treatment of 129
patients with hepatic hemangiomas and of the 9-year follow-up of these
patients. The dynamic care of these patients is recommended in cases of
5 cm diameter hemangiomas and the absence of clinical symptoms. The
surgical treatment was necessary but in 10% of such patients. In the
majority of such patients embolisation of the hepatic artery is
expedient if surgical treatment is necessary. Indications for resection
of the liver are restricted.
6
UI - 11383874
AU - Toubeau M; Touzery C; Berriolo-Riedinger A; Cochet A; Brunotte F;
TI -
Bedenne L; Cercueil JP; Krause D
131I thyroid uptake in patients treated with 131I-Lipiodol for
hepatocellular carcinoma.
SO - Eur J Nucl Med 2001 May;28(5):669-70
7
UI - 11419162
AU - Buscarini L; Buscarini E; Di Stasi M; Vallisa D; Quaretti P; Rocca A
TI -
Percutaneous radiofrequency ablation of small hepatocellular carcinoma:
long-term results.
SO - Eur Radiol 2001;11(6):914-21
AD - Department of Gastroenterology, General Hospital, Via Taverna 49, 29100
Piacenza, Italy.
The aim of this study was to evaluate the effectiveness and the safety
of percutaneous radiofrequency (RF) thermal ablation of hepatocellular
carcinoma (HCC) in 88 patients with a long follow-up, and to compare
conventional electrodes and expandable electrodes. Eighty-eight patients
with 101 hepatocellular carcinoma nodules (< or = 3.5 cm in diameter)
underwent RF thermal ablation by means of either conventional electrodes
or an expandable electrode. Therapeutic efficacy was evaluated with
dynamic contrast CT, serum alpha-feto protein level, US examination at
the end of the treatment, and during follow-up. Complete necrosis was
obtained in all tumor nodules in a mean number of 3.3 sessions (tumor
treated by conventional electrodes) or 1.5 sessions (tumor treated by
expandable electrode). The mean follow-up was 34 months; overall
survival rate was 33% at 5 years. Disease-free survival at 5 years was
3%; local recurrence rate was 29% in patients treated with conventional
electrodes; 14% in patients treated with the expandable electrode. Two
major complications and 14 minor complications were observed.
Radiofrequency thermal ablation in small HCC is very effective with a
low percentage of major complications. The use of an expandable
electrode substantially reduced the number of treatment sessions but did
not modify the overall survival rate and the disease-free survival rate.
8
UI - 11436578
AU - Leyendecker JR; Dodd GD 3rd
TI -
Minimally invasive techniques for the treatment of liver tumors.
SO - Semin Liver Dis 2001 May;21(2):283-91
AD - Department of Radiology, University of Texas Health Science Center at
San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284-7800, USA.
leyendecker@uthscsa.edu
Recently, several minimally invasive, image-guided therapies have been
developed for the local treatment of hepatocellular carcinoma (HCC) and
hepatic metastases in patients who are considered poor candidates for
surgical resection. Radio-frequency ablation, microwave ablation, and
laser ablation all destroy tumor by creating a hyperthermic injury.
Cryoablation and ethanol ablation achieve cellular death through
freezing and direct toxicity, respectively. Chemoembolization is unique
in that the entire liver can be treated over time with a combination of
cytotoxic drugs and embolic agents, potentially reducing the rate of
recurrence from radiologically occult tumor. Outcomes for minimally
invasive therapy have approached the success rate of surgical resection
in some series with considerably fewer complications. However, a paucity
of randomized trials and variability in reporting limit assessment of
the relative role of these techniques in clinical practice. With a few
exceptions, the indications, contraindications, and complications
associated with the different techniques are similar, and success with
HCC has exceeded that for metastatic disease independent of technique.
9
UI - 11449176
AU - Tocchi A; Mazzoni G; Liotta G; Lepre L; Costa G; Agostini N; Miccini M
TI -
Clinical significance of normobasemia in early post-operative outcome of
hepatic resections.
SO - Panminerva Med 2001 Jun;43(2):81-4
AD - First Surgical Department, University of Rome La Sapienza, Medical
School, Rome, Italy. gluca.costa@iol.it
BACKGROUND: Major hepatic resections are usually followed by acid-base
unbalance. Adjustment of the acid-base disorders is considered central
when dealing with these critical patients and normobasemia is thought to
be a favourable prognostic factor when occurring in the immediate
postoperative outcome after major surgery. The present study was
undertaken to investigate the influence of acid base balance on the
early outcome after hepatic resection. METHODS: A series of fifty-seven
cirrhotic patients was submitted to liver resection for hepatocellular
carcinoma. Forty-eight patients experienced an uneventful early
postoperative outcome (CTR group). Nine died in the postoperative course
(HD group). In all patients pulmonary, renal and hepatic functions were
monitored pre- and postoperatively. The pH values were detected daily
preoperatively and in the course of the first three days after hepatic
resection. In the same days acid base balance and arterial ketone body
ratio were assessed on arterial blood samples. Data were collected in a
data base and statistical analysis was performed. RESULTS: A
significantly higher metabolic alkalosis was found to characterize the
first and second postoperative days (POD1 and POD2) in the CTR group (pH
7.43+/-0.007 vs pH 7.33+/-0.001; pH 7.45+/-0.006 vs pH 7.35+/-0.009;
p<0.05). Lower values of pH and an associated impaired energetic status
of the liver were found to characterise the postoperative course of the
poor prognosis patients. At POD1 AKBR decreased in both groups but while
recovering at POD2 in patients of CTR group maintained significantly
lower values in HD group (AKBR 1+/-0.3 vs 0.5+/-0.2; p<0.01). A lower
energetic status of the liver is associated with an inadequate
tricarboxylic acid cycle and is responsible for an impaired production
of HCO3-. CONCLUSIONS: Apparent normobasemia is then expressive of liver
failure leading to poor postoperative outcome.
10
UI - 11494547
AU - Ichida T; Ohkoshi S; Takimoto M; Ishikawa T
TI -
[Interferon therapy to chronic hepatitis type C for the prevention of
hepatocarcinogenesis]
SO - Nippon Rinsho 2001 Jul;59(7):1331-7
AD - Third Department of Internal Medicine, Niigata University School of
Medicine.
Interferon(IFN) therapy for chronic hepatitis(CH) related by hepatitis C
virus is useful for the prevention of the appearance of hepatocellular
carcinoma(HCC) by both prospective and retrospective study. IFN could be
reduced an activity of necro-inflammatory reaction leading toward the
reduction of fibrogenesis. Therefore, IFN treated group had a low
potential carcinogenesis of the liver indicating the prevention of HCC
from CH type C, even if virological complete remmision(CR) could not be
obtained after IFN treatment. Biochemical response(BR) group as well as
CR group could be inhibited hepatocarcinogenesis compare with non-IFN
treated group. Recently, IFN applied for liver cirrhosis as same concept
for the prevention of HCC.
11
UI - 11473331
AU - Okada K; Koda M; Murawaki Y; Kawasaki H
TI -
Changes in esophageal variceal pressure after transcatheter arterial
embolization for hepatocellular carcinoma.
SO - Endoscopy 2001 Jul;33(7):595-600
AD - Second Dept. of Internal Medicine, Faculty of Medicine, Tottori
University, Yonago, Japan.
BACKGROUND AND STUDY AIM: The aim of this study was to investigate the
influence of transcatheter arterial embolization on esophageal variceal
pressure and portal hemodynamics. PATIENTS AND METHODS: Out of 18
cirrhotic patients with hepatocellular carcinoma, 12 underwent
transcatheter arterial embolization and the remaining six patients
underwent angiography alone as a control. We examined esophageal
variceal pressure with an endoscopic pneumatic pressure sensor and
portal blood flow with Doppler ultrasonography immediately before and 3
days after transcatheter arterial embolization or angiography. RESULTS:
Angiography alone did not influence esophageal variceal pressure or
portal blood flow. Transcatheter arterial embolization resulted in an
increase in variceal pressure in five (42%) of the 12 patients and in a
marked increase in portal blood flow in eight (88.9%) of nine patients,
although no change in the endoscopic variceal findings was observed
after transcatheter arterial embolization. The change in esophageal
variceal pressure did not correlate with the change in portal blood
flow. We could not find predictive factors for the elevation of variceal
pressure after transcatheter arterial embolization. CONCLUSION: Our
study demonstrated that transcatheter arterial embolization resulted in
an increase in esophageal variceal pressure in about half of the
patients, bearing little relation to portal hemodynamic parameters.
12
UI - 11490807
AU - Utsunomiya T; Shimada M; Shirabe K; Kajiyama K; Gion T; Takenaka K;
TI -
Sugimachi K
Clinicopathological characteristics of patients with extrahepatic
recurrence following a hepatectomy for hepatocellular carcinoma.
SO - Hepatogastroenterology 2001 Jul-Aug;48(40):1088-93
AD - Department of Surgery II, Kyushu University, Faculty of Medicine,
Fukuoka 812, Japan.
BACKGROUND/AIMS: None of the previous studies have compared the
prognosis or clinicopathological factors between the patients with
extrahepatic recurrence and those with intrahepatic recurrence of
hepatocellular carcinoma after a hepatic resection. METHODOLOGY: The
clinicopathological features and prognoses of patients with extrahepatic
recurrence after a curative hepatectomy for hepatocellular carcinoma
were investigated. RESULTS: Twenty-three patients with extrahepatic
recurrence had more advanced-stage hepatocellular carcinoma at the
primary operation compared to 186 patients with intrahepatic recurrence.
After adjusting for tumor size, the prognosis of the 2 groups were
comparable. However, among the patients with hepatocellular carcinoma
exceeding 5 cm in diameter, the number of patients whose plasma levels
of des-gamma-carboxy prothrombin was higher than 2.0 AU/mL in the
patients with extrahepatic recurrence (62.5%) was significantly more (P
< 0.05) than that in the patients with intrahepatic recurrence (20.0%).
On the other hand, the prognosis of the 13 patients with extrahepatic
recurrence alone was significantly better than in the 10 patients with
both intrahepatic and extrahepatic recurrences. The prognoses of the 3
patients who underwent a surgical resection for isolated extrahepatic
recurrence were markedly better than that of the remaining 10 patients
only treated palliatively. CONCLUSIONS: If patients have tumors
exceeding 5 cm in diameter and their plasma levels of des-gamma-carboxy
prothrombin are higher than 2.0 AU/mL, more careful follow-up
examinations than usual may thus be necessary in order to detect
extrahepatic recurrence as early as possible. Furthermore, a surgical
resection for the isolated extrahepatic recurrence of hepatocellular
carcinoma is also recommended to produce long-term survivors.
13
UI - 11490812
AU - Hirano S; Kondo S; Omi M; Anbo Y; Katoh H
TI -
Treatment of hepatocellular carcinoma occurring after distal splenorenal
shunt for esophagogastric varices.
SO - Hepatogastroenterology 2001 Jul-Aug;48(40):1110-3
AD - Department of Second Surgery, Hokkaido University School of Medicine,
Kita-15, Nishi-7, Kita-ku, Sapporo 060-8638, Japan.
BACKGROUND/AIMS: Whereas endoscopic therapy is hardly effective, distal
splenorenal shunt is expected to have permanent hemostatic effects on
the esophagogastric varices complicated with hepatocellular carcinoma
and to sustain favorable general condition of the patient. In this
study, we examined the effects of the shunt in the patients who
developed hepatocellular carcinoma during the follow-up of the shunt
operation. METHODOLOGY: Among the patients who had undergone distal
splenorenal shunt operation for portal hypertension caused by cirrhosis,
we selected only those who developed hepatocellular carcinoma during the
follow-up, and then we reviewed our treatment of hepatocellular
carcinoma. RESULTS: Hepatocellular carcinomas developed postoperatively
in 12 out of 59 patients with the shunt operation. At onset of the
carcinomas, the varices were well controlled with no risk of bleeding;
and the liver function was reasonably maintained and pancytopenia was
alleviated, compared to those at shunt operation. We performed
hepatectomy in 4 cases and nonoperative therapies in 8 cases. After the
therapies, no variceal bleeding occurred. Those therapies caused minor
complications but no death. CONCLUSIONS: Distal splenorenal shunt is a
useful therapy for postcirrhotic esophagogastric varices as it enables
us to safely perform therapies for the hepatocellular carcinomas that
develop during the follow-up period.
14
UI - 11504090
AU - Risse JH; Ponath C; Palmedo H; Menzel C; Grunwald F; Biersack HJ
TI -
Radiation exposure and radiation protection of the physician in
iodine-131 Lipiodol therapy of liver tumours.
SO - Eur J Nucl Med 2001 Jul;28(7):914-8
AD - Department of Nuclear Medicine, University of Frankfurt/Main, Germany.
J.Risse@em.uni-frankfurt.de
Intra-arterial iodine-131 labelled Lipiodol therapy for liver cancer has
been investigated for safety and efficacy over a number of years, but
data on radiation exposure of personnel have remained unavailable to
date. The aim of this study was to assess the radiation exposure of the
physician during intra-arterial 131I-Lipiodol therapy for liver
malignancies and to develop appropriate radiation protection measures
and equipment. During 20 intra-arterial administrations of 131I-Lipiodol
(1110-1924 MBq), radiation dose equivalents (RDE) to the whole body,
fingers and eyes of the physician were determined for (a) conventional
manual administration through a shielded syringe, (b) administration
with an automatic injector and (c) administration with a lead container
developed in-house. Administration by syringe resulted in a finger RDE
of 19.5 mSv, an eye RDE of 130-140 microSv, and a whole-body RDE of
108-119 microSv. The injector reduced the finger RDE to 5 mSv. With both
technique (a) and technique (b), contamination of angiography materials
was observed. The container allowed safe transport and administration of
the radiopharmaceutical from 4 m distance and reduced the finger RDE to
<3 microSv and the eye RDE to <1 microSv during injection. During
femoral artery compression, radiation exposure to the fingers reached
170 microSv, but the whole-body dose could be reduced from a mean RDE of
114 microSv to 14 microSv. No more contamination occurred. In
conclusion, radiation exposure was high when 131I-Lipiodol was
administered by syringe or injector, but was significantly reduced with
the lead container.
15
UI - 11521177
AU - Pal S; Pande GK
TI -
Current status of surgery and transplantation in the management of
hepatocellular carcinoma: an overview.
SO - J Hepatobiliary Pancreat Surg 2001;8(4):323-36
AD - Department of Gastrointestinal Surgery and Liver Transplantation, R.,
No. 1002, 1st floor P C Block, All India Institute of Medical Sciences,
Ansari Nagar, New Delhi-110029, India.
Despite many therapeutic advances in the field of hepatocellular
carcinoma over the past two decades, this disease continues to be a
major cause of cancer-related mortality worldwide. This review focuses
on the recent advances in surgical technique, perioperative management,
and transplantation of cirrhotic and noncirrhotic patients with
hepatocellular carcinoma. Liver resection continues to be the mainstay
of curative treatment in noncirrhotic patients and selected cirrhotic
patients with small tumors and preserved liver function. Transplantation
should be advocated for patients with poor liver function and localized
lesions or for patients with large fibrolamellar carcinomas that are
otherwise unresectable. Surgery has a definite role in the management of
hepatic recurrences in the absence of systemic dissemination. Newer
advances in the therapeutic armamentarium, such as cryotherapy,
radiofrequency ablation, microwave coagulation, and ethanol injections
are discussed, and their overall efficacy assessed.
16
UI - 11521181
AU - Matsuda M; Fujii H; Kono H; Matsumoto Y
TI -
Surgical treatment of recurrent hepatocellular carcinoma based on the
mode of recurrence: repeat hepatic resection or ablation are good
choices for patients with recurrent multicentric cancer.
SO - J Hepatobiliary Pancreat Surg 2001;8(4):353-9
AD - First Department of Surgery, Yamanashi Medical University, Tamaho,
Nakakoma, Yamanashi 409-3898, Japan.
Hepatocellular carcinomas (HCC) often recur after curvative resection.
Recurrence in the remnant liver originates from intrahepatic metastasis
(IM) from the primary resected tumor, and/or from multicentric (MC)
occurrence. In order to achieve better survival after intrahepatic
recurrence in HCC patients, we have surgically treated patients
according to the recurrence pattern. In this study, we investigated the
advantage of repeat surgery for MC recurrent HCC. The subjects were 176
patients who had undergone primary macroscopically complete tumor
removal for HCC at our department from 1984 to 1999. Differential
diagnosis of IM and MC recurrence was done by pathological analysis.
Twenty-nine of the 149 patients with recurrence (19.5%) underwent a
total of 31 second and third operations. Of the 29 patients, 18 had MC
(14 received repeat hepatectomy and 4, microwave tissue coagulation
[MTC]), 7 had IM (4 had repeat hepatectomy and 3, MTC), and, in 4
patients, pathological investigation failed to determine the mode of
recurrence. The 1-, 3-, and 5-year survival rates for MC patients after
the repeat operations were 100%, 69.7%, and 58.1%, respectively, and the
1-, 3-, and 5-year survival rates for the IM patients were 57.1%, 14.3%,
and 14.3%, respectively. Survival after the repeat operation was
significantly better in the MC group than in the IM group (P = 0.0016).
Moreover, there was no significant difference between survival in the MC
group after a repeat operation and survival in control patients after an
initial hepatectomy (P = 0.9282). These results indicated that patients
with resectable or ablative recurrent MC HCC have almost the same
survival benefit after repeat operations as patients who undergo initial
curative resection of HCC.
17
UI - 11509143
AU - Zhao J; Wang Z; Guo D; Yu C; Xie W; Li G
TI -
[CT appearance and its diagnosis value in liver cancer after
transcatheter oily chemoembolization combining with high intensity
focused ultrasound therapy]
SO - Zhonghua Gan Zang Bing Za Zhi 2001 Jul;9 Suppl():61-3
AD - Department of Radiology and Center for Tumor Therapy, Second Affiliated
Hospital of Chongqing Medical University, Chongqing 400010, China.
OBJECTIVE: To study the CT appearances of liver cancer after
transcatheter oily chemoembolization (TOCE) combining with high
intensity focused ultrasound (HIFU) therapy. METHODS: Fifty cases of
clinically-proved liver cancer were included into this study. For each
case, CT scanning before and after TOCE, HIFU treatment was performed.
The volumes of the masses were measured. The appearances of the oily
deposition and the density, shape, border of the lesions were observed.
RESULTS: The lesions became smaller in 38 cases (38/50, 76%) after the
treatment. The differences were detected statistically in the ratio of
the tumor shrinkage between the single TOCE therapy and the combined
treatment (P<0.05). The ratio of the tumor shrinkage was closely
correlative with the quantity of the oily deposition, but not with the
diameter of the tumor before treatment. The lowered densities were
showed in 30 cases (30/50, 60%) and the borders became regular and clear
in 16 cases after HIFU therapy. CONCLUSIONS: TOCE combining with HIFU
therapy in the patients with liver cancer can make the tumor smaller. CT
is of great value in the evaluation of efficacy and prognosis.
18
UI - 11593564
AU - Wang Y; Zhang J; Gao Y; Yu M; Gong Y; Yu G
TI -
Therapeutic efficacy of transcatheter arterial embolization of primary
hepatocellular carcinoma: discrepancy in different histopathologic
subtypes.
SO - Chin Med J (Engl) 1999 Mar;112(3):264-8
AD - Department of Diagnostic Radiology, General Hospital of PLA, Beijing
100853, China.
OBJECTIVE: To evaluate preliminarily the therapeutic efficacy of
transcatheter arterial embolization (TAE) for different histopathologic
subtypes of primary hepatocellular carcinoma (HCC). METHODS: A
retrospective study of 226 patients with histopathologically diagnosed
primary HCC was performed. The patients were treated with either single
TAE, surgical resection of tumor alone, or TAE combined with surgical
resection. Follow-up information was achieved in 157 of 226 patients.
Comparative analyses of survival data and image findings were performed
with correlation to histopathologic classification and different
therapeutic methods, respectively. RESULTS: Eight histopathologic
subtypes of primary HCC were found in this group, including HCC of
trabecular pattern, pseudoglandular pattern, fibrolamellar HCC and
sclerosing HCC, as well as HCC of clear cell, of small cell, poorly
differentiated or undifferentiated HCC, and hormonally active HCC. The
accumulated survival rate for these 157 patients was 74.52% of 1 year,
53.50% of 2 years, 31.85% and 14.01% of 3 and 5 years, respectively.
Fibrolamellar HCC and clear cell HCC had relatively higher survival rate
(25.00% and 33.22% of 5 years, respectively) than that of other
subtypes, and the median survival time of the latter was 71 months. The
mean survival time was 25.06 months (SE = 1.87) in single TAE group,
30.38 (SE = 2.05) months in surgical resection, and 72 months (SE =
6.90) in TAE combined with resection. CONCLUSIONS: Discrepancies do
exist in therapeutic effect of different subtypes of HCC. In this study,
clear cell HCC was more sensitive to TAE than other subtypes, and, in
contrast, small cell HCC and poorly differentiated or undifferentiated
HCC were of lower sensitivity to TAE.
19
UI - 11593648
AU - Ho S; Johnson PJ; Leung WT; Lau WY
TI -
Combating hepatocellular carcinoma with an integrated approach.
SO - Chin Med J (Engl) 1999 Jan;112(1):80-3
AD - Joint Hepatoma Clinic, Prince of Wales Hospital, Shatin, Hong Kong,
China.
This short review summarizes an integrated approach to new methods of
managing hepatocellular carcinoma (HCC) developed at our centre.
HCC-specific isoforms of alpha-fetoprotein were detected by isoelectric
focusing and their value in the differential diagnosis of early HCC on a
background of chronic liver disease has been shown. Selective internal
radiation therapy using yttrium-90 (90 Y) microspheres has been shown to
be an effective treatment for inoperable HCC in a phase I and II study.
A partition model for estimating the radiation doses from the 90 Y
microspheres to the tumour and the non-tumorous liver during the therapy
was then formulated, verified by correlating with intraoperative
dosimetry, and evaluated in clinical settings. This permits 90 Y
microspheres to be administered safely without the need of an open
surgery and a randomized therapeutic controlled trial is in progress.
Another randomized controlled trial using iodine-131 Lipiodol as a
post-operative adjuvant therapy, aiming at reducing the recurrence rate
is also on-going. HCC may be more effectively combated with a better
understanding of its pathogenesis from chronic liver disease.
20
UI - 11585688
AU - Steenkamp V; Stewart MJ; van der Merwe S; Zuckerman M; Crowther NJ
TI -
The effect of Senecio latifolius a plant used as a South African
traditional medicine, on a human hepatoma cell line.
SO - J Ethnopharmacol 2001 Nov;78(1):51-8
AD - Department of Chemical Pathology, South African Institute for Medical
Research, University of the Witwatersrand Medical School, 7 York Road,
Parktown 2193, Gauteng, South Africa.
A number of traditional remedies used in South Africa contain
pyrrolizidine alkaloids, some of which are hepatotoxic. We investigated
the effect on human HuH-7 cells of Senecio latifolius DC., a plant that
is a component of some traditional remedies and which is known to
contain toxic pyrrolizidine alkaloids. Cells were also treated with
extracts of a standard pyrrolizidine, retrorsine. The changes in the
gross morphology of the cells were studied using light microscopy after
haematoxylin and eosin staining. The cytoskeleton was investigated using
fluorescence-labelled anti-beta-tubulin antibody and the nuclear
organisation was studied using fluorescence-labelled antinuclear
antibodies. The plant extracts gave rise to dose-dependent gross
morphological changes. At high doses, we observed necrosis and at lower
doses, destruction of the cytoskeleton, nuclear fragmentation and
apoptosis. Doses of less than the equivalent of 330 ng/ml retrorsine led
to multinucleated cells with failure in spindle formation and clumping
of nuclear chromatin. This latter finding suggests that chronic low-dose
treatment with such traditional remedies could give rise to teratogenic
and/or carcinogenic effects.
21
UI - 11585879
AU - Dupuy DE; Goldberg SN
TI -
Image-guided radiofrequency tumor ablation: challenges and
opportunities--part II.
SO - J Vasc Interv Radiol 2001 Oct;12(10):1135-48
AD - Department of Radiology, Rhode Island Hospital, Brown University School
of Medicine, Providence, Rhode Island, USA.
22
UI - 11598245
AU - Rhim H; Goldberg SN; Dodd GD 3rd; Solbiati L; Lim HK; Tonolini M; Cho OK
TI -
Essential techniques for successful radio-frequency thermal ablation of
malignant hepatic tumors.
SO - Radiographics 2001 Oct;21 Spec No():S17-35; discussion S36-9
AD - Department of Diagnostic Radiology, Hanyang University Hospital, 17
Haengdang-Dong, Sungdong-Ku, 133-792 Seoul, Korea. rhimhc@hanyang.ac.kr
Radio-frequency thermal ablation is one of the most promising minimally
invasive techniques for the treatment of nonresectable hepatic tumors.
Essential technical tips to successful radio-frequency ablation therapy
were collected from five international experts. They were organized into
five categories: understanding the mechanisms and principles of
radio-frequency ablation, modulation of tissue physiologic
characteristics to increase tumor destruction, strategies of overlapping
ablations, strategies to improve ablation according to tumor location,
and imaging strategies after ablation to ensure adequate therapy.
Established factors for optimal ablation, as well as emerging technical
tips, are addressed with illustrations in each section. These essential
tips will be very helpful for physicians performing radio-frequency
ablation of hepatic tumors.
23
UI - 11598247
AU - Choi H; Loyer EM; DuBrow RA; Kaur H; David CL; Huang S; Curley S;
TI -
Charnsangavej C
Radio-frequency ablation of liver tumors: assessment of therapeutic
response and complications.
SO - Radiographics 2001 Oct;21 Spec No():S41-54
AD - Division of Diagnostic Imaging, University of Texas M. D. Anderson
Cancer Center, 1515 Holcombe Blvd, Box 57, Houston, TX 77030, USA.
An alternative to surgical resection of liver tumors, radio-frequency
ablation induces in situ thermal coagulation necrosis through the
delivery of high-frequency alternating current to the tissues. Imaging
helps to detect treatable lesions, guide the placement of the probe, and
assess the effect of therapy. Computed tomography (CT) is used most
frequently to determine whether the ablation is complete and to screen
for early recurrences that may benefit from reablation. Complete
ablation creates an area of necrosis that, at CT, is of low attenuation
compared with the surrounding liver tissue, is often homogeneous, and
has smooth margins. The most important features are the size of the
necrotic defect, which, immediately after treatment, should be larger
than that of the pretreatment tumor, and the sharpness of the margins,
which indicates an abrupt change in attenuation between the necrotic
tissue and surrounding liver tissue. Enhancement, when present, is due
to perfusion abnormality or granulation tissue and forms a regular rim
or a homogeneous zone at the margin of the defect. It is seen
immediately after ablation but may be prolonged. Enhancement is affected
by the scanning technique. Over time, the size of the defect remains
stable or decreases. Any variation from this general pattern is
suggestive of incomplete ablation or recurrence.
24
UI - 11594784
AU - di Bartolomeo S; Spinedi A
TI -
Differential chemosensitizing effect of two glucosylceramide synthase
inhibitors in hepatoma cells.
SO - Biochem Biophys Res Commun 2001 Oct 19;288(1):269-74
AD - Department of Biology, University of Rome Tor Vergata, Via della Ricerca
Scientifica, 00133 Rome, Italy.
It has been proposed that ceramide mediates anthracyclin-induced
apoptosis and that drug resistance may arise due to upregulated removal
of this active lipid through glucosylation. We report that HepG2
hepatoma cells displayed only a modest apoptotic response to doxorubicin
treatment, accompanied by a substantial elevation of ceramide levels
only at toxic drug concentrations.
D,L-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) and
D,L-threo-1-phenyl-2-hexadecanoylamino-3-pyrrolidino-1-propanol (PPPP),
used at concentrations causing a 90% inhibition of ceramide
glucosylation, enhanced doxorubicin-elicited ceramide elevation, but
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