National Cancer Institute®
Last Modified: January 1, 2002
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. firstname.lastname@example.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.
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.
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.
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.
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.
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
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.
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. email@example.com
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.
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. firstname.lastname@example.org
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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. email@example.com
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.
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.
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