The effect of perioperative blood transfusions on the survival rate of patients with gastric cancer was studied. The survival rate of the transfusion group was significantly lower than that of the nontransfusion group in each of the 5 postoperative years. When no adjuvant immunochemotherapy was performed postoperatively, the prognosis was definitely worse in the transfusion group than in the nontransfusion group. Furthermore, the survival rate of the transfusion group was lower than that of the nontransfusion group in both histopathologic classifications of gastric cancer, and it was lower to a statistically significant extent among the well-differentiated types. These results indicate that transfusions might adversely affect postoperative survival of patients with gastric cancer.

Combined Modality Therapy↗

PubMedDate not supplied

The efficacy of continuous local arterial infusion of 5-fluorouracil and cisplatin through an implanted reservoir for severe advanced hepatocellular carcinoma.

There is not yet an effective standard therapy for severe advanced hepatocellular carcinoma (HCC). We attempted continuous local arterial infusion chemotherapy using 5-fluorouracil (5-FU) and cisplatin (CDDP) with an implanted reservoir for these patients, and evaluated its efficacy. Twenty-one HCC patients received continuous arterial infusion of 5-FU and CDDP for 1 week, followed by a 1-week no-infusion period; this regimen was repeated 1-32 times, and patients were observed for 36-549 days. The 1-year survival rate was 61.1%, and alpha fetoprotein levels decreased in 13 patients. All could continue as outpatients for 94.0% of the entire course of therapy. Because CDDP amplifies the effect of 5-FU as a biochemical modulator, and because continuous infusion strengthens the effect of 5-FU and reduces the side effects of CDDP, we consider this therapy to be effective for patients with severe advanced HCC, prolonging survival and improving the quality of life.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Treatment of chronic hepatitis C with interferon-alpha: sustained absence of hepatitis C virus RNA from serum after four courses of therapy.

A patient with chronic hepatitis type C, confirmed by the detection of hepatitis C virus RNA (HCV RNA) in the serum and by histological examination of the liver biopsy specimen, was treated with four courses of interferon-alpha (IFN-alpha). For the first three courses of IFN-alpha the patient's serum alanine aminotransferase (ALT) level normalized during the administration of IFN-alpha but rose again after its cessation; similarly, HCV RNA was absent from the serum by the end of each course of treatment but could be detected once again after treatment stopped. The fourth course of IFN-alpha therapy, however, produced a sustained normalization of the ALT level and sustained absence of HCV RNA from the serum for 20 months after the end of treatment. This case suggests that patients with the potential for an eventual complete response to IFN-alpha therapy may show a normalization of serum ALT levels during IFN-alpha administration and the absence of HCV RNA in the serum by the end of each course of treatment (even if that particular course of treatment does not produce a sustained response).

Alanine Transaminase↗