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At least 217 records · Page 12Linked to original sources
PubMed1992

Is necrosis induction therapy relevant to hepatocellular carcinoma? Prognostic evaluation viewed from necrosing feature in HCC occluding the main portal vein after treatment with DBcAMP and MMC.

Intraarterial infusion therapy combining dibutyryl adenosine 3',5'-monophosphate and mitomycin C was administered to 27 patients with hepatocellular carcinoma (HCC) occluding the main portal vein. Twelve patients (44%) survived more than 6 months, among them nine (75%) whose tumors were non-necrosing before treatment. When patients were compared for the presence or absence of necrosis in the tumor, those with necrosis responded poorly to treatment; only 3 of 11 (27%) survived more than 6 months. Although the combination therapy exerted a salutary effect on HCC occluding the main portal vein, the presence of necrosis in the tumor was an unfavorable sign for the prognosis, which casts doubt upon the use of the necrosis-inducing method for the treatment of HCC.

Adult↗
PubMed2003

Preliminary assessment of utility of radiofrequency ablation technique in treatment of primary hepatocellular carcinoma (HCC) in patients with hepatic cirrhosis.

BACKGROUND: Primary hepatocellular carcinoma very often develops in the cirrhotic liver. Surgical treatment of cirrhotic patients is associated with considerable risk. Even partial resection of the liver carries the risk of liver failure in such patients. Therefore, the thermoablation technique used in patients with liver tumors and cirrhosis, arouses considerable interest. The aim of the study was preliminary assessment of the value of radiofrequency (RFA) ablation in the treatment of HCC in patients with hepatic cirrhosis. MATERIAL/METHODS: From April 2001 to April 2002, 14 patients aged 30-79 with cirrhosis and focal lesions of primary liver tumor type (carcinoma hepatocellulare) were treated with transcutaneous thermoablation. Transcutaneous thermoablation with Cool Tip Equipment probe (Radionics) was performed under local anesthesia induced after intravenous sedation, or under general anesthesia with propofol (TIVA). In case of single lesions up to 3 cm in diameter, the exposure to thermal waves lasted 12 min, in case of larger lesions 2 to 4 sessions were used. The effects of RFA were assessed intraoperatively by means of USG, measuring the coagulation area, and then MRI was performed to confirm complete destruction of the lesions. The response to treatment was assessed by CT after 8 weeks. RESULTS: Among 8 patients with single focal lesions complete remission (CR) was obtained in 4, and partial remission (PR) in the remaining 4 cases. One subject with CR died 5 months later because of hemorrhage from esophageal varices. Among 6 patients with more than one HCC focus subjected to RFA, CR was obtained in 1, PR in 3, and one female patient who underwent the procedure in the period of non-compensated liver function, died 1.5 months later because of hepatic failure. Repeated thermoablation is considered in patients with PR. CONCLUSIONS: 1. Radiofrequency ablation is a safe method of treatment of HCC in patients with cirrhosis. 2. One of the advantages of RFA is that it can be performed repeatedly. 3. RFA can be combined with other methods.

Adult↗
PubMedDate not supplied

[Laparoscopic liver resection without a Pringle maneuver for HCC in cirrhotic patients].

In the belief that the advantages stemming from a minimally invasive approach are significant, particularly in cirrhosis patients, we decided to apply this technique in the treatment of a group of patients suffering from HCC associated with cirrhosis. Sixteen patients (10 men, 6 women; mean age 60.1 years) underwent laparoscopic surgery for HCC associated with well compensated HCV-related liver cirrhosis (Child-Pugh class A; mean tumour size 2.9 cm). Seven of these lesions were located in the left liver and 9 in the right lobe. Laparoscopy was performed with a CO2 pneumoperitoneum (12-14 mmHg). The Pringle manoeuvre was not used. There was one conversion to laparotomy due to inadequate exposure. We performed 13 non-anatomical resections, 1 VI segmentectomy and 1 anatomical left lobectomy. None of the patients required blood transfusions. One patient died of severe respiratory distress syndrome on postoperative day 3. Major morbidity included 2 moderate postoperative ascites successfully resolved with conservative treatment. To date (mean follow-up: 18 months) no recurrences at the resection site or port-site metastases have been observed. Limited laparoscopic liver resections for HCC in cirrhotic patients are technically feasible and safe when careful selection criteria are adopted (hepatic involvement limited and located in the left or anterior right segments, tumour size smaller than 5 cm, Child-Pugh class A).

Aged↗
PubMed2005

[Recombinant adenovirus vectors carrying antisense MMP2 inhibit invasion of HCC cells in vitro].

OBJECTIVES: To construct a recombinant adenoviral vector carrying antisense matrix metalloproteinase-2 (MMP2) and to study its inhibitory effects on the invasiveness and migratory capacity of hepatocellular carcinoma (HCC) cell line HepG2 in vitro. METHODS: Total RNA was extracted from HCC. Then a 500 bp fragment at the 5' end of the human MMP2 cDNA sequence was synthesized by polymerase chain reaction (PCR) and was reversely inserted into the multiclone site (MCS) of the shuttle plasmid pAdTrack-CMV. With the resultant plasmid and the backbone plasmid pAdEasy-1, the homologous recombination took place in the E.coli BJ5183 and the recombinant adenoviral plasmid carrying the antisense MMP2 gene was constructed. The adenovirus (Ad-MMP2AS) was packaged and amplified in the HEK 293 cells and the viral titer was checked by GFP. Using the Boyden chamber model, the influence of Ad-MMP2AS on the invasion ability of HepG2 cells was determined in vitro. RESULTS: The recombinant adenovirus vector carrying antisense MMP2 was constructed successfully and a strong green fluorescence was observed in HepG2 cells under a fluorescence microscope. The viral titer was 1 x 10(8); Ad-MMP2AS can effectively inhibit the penetrating capacity of HepG2 cells through Matrigel in vitro. CONCLUSION: The recombinant adenovirus with antisense MMP2 can effectively inhibit the invasiveness and migratory capacity of HepG2 in vitro and may have potential in treating HCC.

Adenoviridae↗
PubMedDate not supplied

Intraoperative radiofrequency thermal ablation combined with portal vein infusion chemotherapy and transarterial chemoembolization for unresectable HCC.

BACKGROUND/AIMS: We conducted a preliminary study to determine the feasibility of therapy consisting of intraoperative radiofrequency thermal ablation combined with portal vein infusion chemotherapy and transarterial chemoembolization (IRFAPA) for unresectable hepatocellular carcinoma (HCC). METHODOLOGY: Between September 2001 and June 2004, 34 patients with unresectable HCC were enrolled into a prospective study. 18 cases underwent IRFAPA (group I and 16 cases underwent percutaneous RF ablation (PRFA, group II). Patients' outcomes for IRFAPA and PRFA were recorded and compared. RESULTS: Patients undergoing IRFAPA or PRFA were similar in age, liver function, tumor size, serum AFP, distribution of tumor, mortality, complication and complete ablation rates. In five patients in group II seven new lesions were found during operation. The rate of distant intrahepatic recurrence between the two groups had differences (11.1% vs. 50.0%, P=0.023) although the cumulative recurrence-free survival between the two groups had no differences (P=0.7808). There was a significant difference in the overall survival (P=0.0407). The 1-year and 3-year cumulative overall survival rate was 87.5% and 73.3%, 52.2% and 20.4% in group I and group II, respectively. CONCLUSIONS: IRFAPA is an effective and safe procedure for unresectable HCC. IRFAPA is preferred to PRFA therapy if the patients' conditions can tolerate laparotomy.

Adult↗
PubMedDate not supplied

Well-differentiated HCC manifesting hyperattenuation on CT during arterial portography.

A rare case of well-differentiated minute hepatocellular carcinoma (HCC) with hepatitis C virus-related cirrhosis, with unusual radiologic features, is presented. A 10-mm hypoechoic nodule disclosed by ultrasound in segment six showed hypoattenuation on computed tomography hepatic arteriography and hyperattenuation on computed tomography during arterial portography, indicating that the portal vein may have been the dominant vascularity of the nodule. Contrast-enhanced ultrasound revealed hypovascularity in the early arterial phase, isovascularity in the late vascular phase, and the same perfusion as that surrounding the liver parenchyma in the post-vascular phase, with the same pattern observed on the two imaging techniques. These findings were considered not compatible with those of well-differentiated HCC. Ultrasound-guided biopsy showed histological features of well-differentiated HCC with over two-fold the cellularity of the non-tumorous area with a high nuclear/cytoplasmic ratio, increased cytoplasmic eosinophilia, slight atypia and fatty change with an irregular thin trabecular pattern. Further studies may provide insights into the correlation between tumor neovascularity in multistep hepatocarcinogenesis and dual hemodynamics, including the artery and the portal vein.

Aged↗
PubMed1990

Hepatocellular carcinoma coexisted with second malignancy--a study of 13 cases from a consecutive 440 autopsy cases of HCC.

In a consecutive 440 autopsy cases of hepatocellular carcinoma (HCC), 13 patients (2.95%) were found to have a second primary malignant tumor. All of the patients were male. The age ranged from 40 to 69 years old. (mean: 56.5) Peak incidence occurred in the seventh decade. The associated neoplasms included 4 cases of colorectal adenocarcinoma, 2 cases of thyroid cancer, 2 cases of retroperitoneal sarcomas, 1 case of pancreatic adenocarcinoma, 1 case of esophageal squamous cell carcinoma, 1 case of common bile duct adenocarcinoma, 1 case of renal cell carcinoma, and 1 case of prostatic adenocarcinoma. The organ most commonly involved was large bowel (4 cases). Epithelial origin neoplasms comprised the vast majority (84.6%). Of the 13 cases, 2 associated malignancies existed metachronously, 4 and 5 years before HCC. The others were found at the same time as HCC. The clinical and pathological observations included age, sex, serum alpha-fetoprotein (AFP), serum hepatitis B surface antigen (HBsAg), cirrhosis, gross and histologic appearance. The above presentations were similar in cases with and without second malignancy. We failed to find any factor that was possibly related to the etiology of the second neoplasm. Much more such cases are needed for further evaluation.

Adult↗
PubMed1990

[A long surviving case (1 year 9 months) with stage IV ruptured HCC treated by emergency embolization].

The spontaneous rupture of hepatocellular carcinoma (HCC) constitutes usually critical and life threatening condition because of hypovolemic shock due to massive hemorrhage, underlying liver cirrhosis and extensive tumor growth. Recently, transcatheter arterial embolization (TAE) has been used for controlling arterial bleeding of spontaneous rupture of HCC. We report a long surviving case (1 year 9 months) with stage IV ruptured HCC treated by emergency TAE.

Aged↗
PubMed1989

[A case of hepatocellular carcinoma (HCC) with lung metastasis which responded to chemotherapy with a single use of 1-hexylcarbamoyl-5-fluorouracil (HCFU)].

To our knowledge, there has been only one report pertaining to the efficacy of HCFU for treatment of metastatic lung lesion of HCC, so we reported a case of HCC with lung metastasis which responded to chemotherapy with a single use of HCFU. A 64-year-old male was diagnosed as having HCC with lung metastasis by biochemical examination, abdominal CT, hepatic arteriogram and chest X-P. He had been treated previously with gamma-interferon and mitoxantrone, which were assessed as NC and PD, respectively. Two months after last chemotherapy, HCFU was administrated at a dose of 400 mg/body everyday for 8 months. After 4 weeks metastatic lung lesions showed remarkable regression (47% decrease) and disappeared completely 9 weeks later. The size of primary liver tumor gradually decreased during therapy and revealed marked improvement (85.7% decrease) after about 2 months of this therapy. During these periods serum levels of alpha-fetoprotein dropped from 430 ng/ml to less than 10 ng/ml. He is presently still alive and the duration of the PR attained to 35 weeks. As side effects, hypoproteinemia, anorexia and hot sensation were observed.

Antineoplastic Agents↗
PubMed1989

[A case of hepatocellular carcinoma (HCC) with a huge tumor thrombus in the right atrium].

A case of HCC with a huge tumor thrombus in the right atrium is reported. CT and celiac angiography revealed HCC in the liver. Inferior vena cavography and cardiac blood pool scintigraphy demonstrated a large defect in the right atrium, and 67Ga-citrate scintigraphy showed a lesion of abnormal accumulation in the right atrium. With these findings, diagnosis of HCC with a tumor thrombus in the right atrium was made, and the clinical diagnosis was confirmed by autopsy.

Carcinoma, Hepatocellular↗
PubMed1989

[Hepatocellular carcinoma (HCC): the long-term response to tamoxifen. A clinical case report and review of the literature].

A 52 years old female with hepatocellular carcinoma (HCC) was treated successfully with Tamoxifen. The tumor involved IV hepatic segment with hilar extension and biliary obstruction, was unresectable, and had been pretreated with hormone-chemotherapy. Tamoxifen treatment induced a PR of 6 months, with normalization of serum bilirubin, reduction of alfa-fetoprotein level and improvement of PS, and was free of toxicity. At disease progression intra-arterial chemotherapy with Cis platinum (CDDP) and 5-FU gave a further 4 months PR, until disease progression and exitus in hepatic coma. Tamoxifen therapy, even in the absence of E.R. assay is a useful tool in the management of HCC patients. Further randomized studies are necessary to ascertain the role of Tamoxifen in the treatment of HCC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Study on the evaluation of recurrence of HCC and the effect after transcatheter hepatic arterial embolization--fluctuations in AFP values].

To determine the usefulness of alpha-fetoprotein (AFP) in determining recurrence of HCC after interventional angiography (IVA) and to define the relation between AFP and the imaging diagnosis of HCC recurrence, changes in AFP values in 160 patients with hepatocellular carcinoma who were treated by IVA > or = two times were classified into four patterns: A: the AFP value was decreased after the first IVA, increased at recurrence and decreased again after the second IVA; B: the AFP value was unchanged after the first IVA, but increased at recurrence and decreased after the second IVA; C: the AFP value was decreased after the first IVA, but was not increased at recurrence; D: the AFP value showed no change. The frequency of each AFP pattern and the diagnosis of recurrence by AFP were determined. The relation between tumor type and AFP was defined. Pattern A was the most frequently detected. In 62.6%, AFP was increased at recurrence (A and B), and there was a positive correlation between changes in the AFP value and the findings of imaging diagnosis. In another 37.5%, AFP was not increased at recurrence (C and D), and therefore, the diagnosis of HCC recurrence by imaging methods was very important.

Aged↗
PubMed1995

Recombinant a2 interferon (a-IFN) with chemo-hormonal therapy in patients with hepatocellular carcinoma (HCC).

Recent studies on HCC treatment reveal a tendency to use combined immuno-chemo-therapy. Additionally, new agents have been suggested in this field. We therefore studied 7 patients with proven inoperable HCC who were treated in accordance with the following protocol, and 5 untreated patients used as controls. Therapeutic trial: 1) 1FNa (Roferon): 6 MU x 7 days consecutively every 3 weeks, 2) Adriamycin (doxorubicin): 60 mg/m2 i. v. once every 3 weeks (500 mg total dose), 3) Tamoxifen: 10 mg p.o. twice daily continuously 4) Desferrioxamine (DFO): 500 mg i.m. daily x 7 days consecutively every 3 weeks, 5) ascorbic acid: 300 mg p.o. daily 1 hour after DFO administration x 7 days consecutively every 3 weeks. Follow-up studies were performed monthly and comprised clinical, biochemical, radiological and immunological (T-cell subsets, NK cells, monocyte-macrophage function, IL-2r expression, HLA-DR expression) parameters. Compared with the control group, the treated group had a longer survival rate (p < 0.001), increased tumor regression and less progressive disease. Immunologically, the treated patients with the maintenance of a sufficient immune status were associated with a prolonged survival rate. No serious side effects of the regimen were observed. In conclusion, IFNa combined with chemohormonal therapy appears to be beneficial in HCC patients. In addition, a prolonged survival rate might correlate with the maintenance of an adequate immune status in the patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1994

Classification and surgical treatment of hepatocellular carcinoma (HCC) with bile duct thrombi.

Nine (1.66%) out of 542 cases of HCC treated surgically in our hospital between 1985 and 1992, had macroscopic bile duct thrombi. Three cases presented preoperatively with obstructive jaundice. Two of these received thrombectomy in the hilar bile duct and died of hepatic insufficiency on postoperative days 10 and 66, the other case underwent extended left lobectomy, but also died of renal failure and sepsis 3 months after the operation. In addition, we also treated 6 cases diagnosed at earlier stages than those presenting with obstructive jaundice with both hepatectomy and thrombectomy. In these patients the outcome was as follows: 2 died of recurrent HCC 3 months and 16 months, respectively, after operation, 1 died of apoplexy with no recurrence after 19 months, 1 had a recurrence 5 months after the operation, but is still alive after 7 months, and 2 are still alive 24 months and 60 months after surgery with no recurrence. The outcome is still poor in our series with obstructive jaundice. But in this report, we propose radical surgical treatment for HCC with bile duct thrombi in accordance with our classification, especially for those cases without obstructive jaundice.

Adult↗
PubMed1993

[Clinical study of continuous local arterial-infusion chemotherapy for severely advanced hepatocellular carcinoma (HCC) using reservoir].

We attempted continuous local arterial-infusion chemotherapy using reservoir for patients with severely advanced hepatocellular carcinoma (HCC), with no indications for operation, PEIT or TAE because of the advanced clinical stage, Vp-factor, and so on. Twenty-two HCC patients were given continuous arterial-infusion of 5-FU + CDDP and were observed for 36-443 days from June, 1991 to December, 1992. Until the end of 1992, we had 3 partial response (PR) cases and 3 progressive disease (PD) cases, and the other cases showed no change (NC). Except for a case in which therapy was stopped because of renal failure, no patients were disturbed by side effects, and 68.2% of the patients completed all of their therapy as outpatients. Because CDDP can amplify the effect of 5-FU in addition to its own effect as a biochemical modulator, and because continuous infusion can strengthen the effect of 5-FU and reduce the side effects of CDDP, we consider continuous local arterial-infusion of 5-FU and CDDP to be an effective therapy for severely advanced HCC. This treatment does not cure the carcinoma but helps to slow its progress and assure good QOL.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

[A patient with HCC successfully treated by ethanol injection therapy with etoposide].

A patient with hepatocellular carcinoma (HCC) who underwent successfully percutaneous ethanol injection therapy (PEIT) with etoposide was reported. A 72-year-old Japanese man with positive HCV-Ab developed multiple tumors of HCC. He underwent transcatheter arterial embolization (TAE) four times and PEIT three times, but the growth of tumors (particularly, S8) could not be controlled by these modalities. Then, the mixture of etoposide (20 mg), ethanol (8.5 ml) and lipiodol (1.5 ml) was injected into S6 tumors. Consistent with the normalization of serum AFP level, CT scan revealed the marked remaining lipiodol in these tumors. PEIT with etoposide is the treatment of choice in patients with HCC refractory to treatment by conventional TAE or PEIT.

Aged↗
PubMed1998

[Three-dimensional MR angiography of HCC and portal and hepatic veins using superparamagnetic iron oxide].

We examined a new MR technique for obtaining 3D-MRA images of the liver that simultaneously depicts HCC and the portal and hepatic veins. Five patients with clinically suspected HCC were studied with superparamagnetic iron oxide (SHU-555A) used as a negative contrast medium for the liver. In our study, a 3D-rotational display was provided on the CTR monitor from 2D-TOF images by computed reconstruction, clearly showing HCC and portal and hepatic veins on the same image. Our method was found to be of great value in planning surgery of the liver.

Aged↗
PubMed2000

Two-dimensional electrophoresis map of the human hepatocellular carcinoma cell line, HCC-M, and identification of the separated proteins by mass spectrometry.

Currently, one of the most popular applications of proteomics is in the area of cancer research. In Africa, Southeast Asia, and China, hepatocellular carcinoma is one of the most common cancers, occurring as one of the top five cancers in frequency. This project was initiated with the purpose of separating and identifying the proteins of a human hepatocellular carcinoma cell line, HCC-M. After two-dimensional gel electrophoresis separation, silver staining, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) analyses, tryptic peptide masses were searched for matches in the SWISS-PROT and NCBI nonredundant databases. Approximately 400 spots were analyzed using this approach. Among the proteins identified were housekeeping proteins such as alcohol dehydrogenase, alpha-enolase, asparagine synthetase, isocitrate dehydrogenase, and glucose-6-phosphate 1-dehydrogenase. In addition, we also identified proteins with expression patterns that have been postulated to be related to the process of carcinogenesis. These include 14-3-3 protein, annexin, prohibitin, and thioredoxin peroxidase. This study of the HCC-M proteome, coupled with similar proteome analyses of normal liver tissues, tumors, and other hepatocellular carcinoma cell lines, represents the first step towards the establishment of protein databases, which are valuable resources in studies on the differential protein expressions of human hepatocellular carcinoma.

Carcinoma, Hepatocellular↗