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At least 289 records · Page 16Linked to original sources
PubMed2005

[Local ablation therapy for hepatocellular carcinoma (HCC) on the liver surface: radio-frequency ablation aimed at tumor marginal pre-ablation under endoscopic surgery].

RFA for the hepatocellular carcinoma localized on the surface of the liver tends to have some complications such as bleeding, an ejection of tumor and a heat injury to other internal organs even if percutaneous RFA seemed to be done easily. Therefore, we should first choose the RFA treatment under endoscopic (either laparoscope or thoracoscope) surgery for the hepatocellular carcinoma localized on the surface of the liver. Moreover, a direct central puncture should be avoided from the viewpoint of securing a margin, prevention of bleeding and rise in the intratumorale pressure. Now, we selected the unique operation method of RFA: First, the tumor is confirmed under the endoscope, and the tumor range is marked with the endoscopic echo. Second, several times of RFA applied to the tumor surroundings are done, and the margin is secured with avoiding a direct central puncture. If tumor diameter is over 2.5 cm, central ablation of the tumor is considered to be necessary, we can directly puncture the center of the tumor without bleeding since the tumor already has the congelation by surrounding heat effect. We have done RFA by this way for 29 patients with HCC since April 1st, 2004. The complications such as a heat injury to the neighboring organ could be well prevented. An enough margin of ablation about 1 cm around the tumor was confirmed by the postoperative CT image. There was no local recurrence during the average observation period of 290 days, and a severe post operative complication has not occurred. The average of hospitalized period after the operation was about 10 days. Therefore, pre-surrounding ablation preceding central puncture under the endosope for hepatocellular carcinoma on the liver surface is a feasible technique.

Aged↗
PubMed2005

[A case of HCC with inferior caval vein tumor thrombus and multiple pulmonary metastases that remarkably responded to combination therapy of TS-1 and interferon-alpha].

A 56-year-old male was admitted to our hospital for hepatoma with portal vein thrombus and multiple intrahepatic metastases. He underwent an extended left lobectomy and a partial resection of the liver in May 2002. After two weeks from the surgery, he received intra arterial 5-FU infusion chemotherapy combined with subcutaneous interferon-alpha injection to treat the lesions in the residual liver. Four months after the surgery, hepatic vein tumor thrombus appeared in the remnant liver and it extended to the inferior caval vein. And another 4 months later, multiple pulmonary metastases were detected with computed tomography and they grew rapidly in the view of their sizes and numbers. Because the combined therapy of 5-FU/interferon-alpha was not effective to distant metastases, we started a new regimen of oral administration of TS-1 and a subcutaneous interferon-alpha injection. After 1 treatment cool, hepatic vein thrombus was markedly reduced the size and vascularity in the CT. Multiple pulmonary metastases also decreased in their sizes and numbers. No adverse effect was seen during this treatment. It was suggested that a combination therapy of TS-1 and interferon-alpha may be one of the most effective treatment modalities against advanced HCC with distant metastasis.

Administration, Oral↗
PubMed1991

[Significance of reduction surgery for stage IV hepatocellular carcinoma (HCC) and postoperative immunochemotherapy for extension of survival period].

A retrospective analysis of 35 stage IV HCC (26 IV-A case and 9 IV-B cases) which underwent reduction surgery from 1983 suggested a possibility to extend their survival period by decrease in their tumor-mass and subsequent immunochemotherapy for improvement of their depressed immunity. Their operability depended on the clinical stage of accompanying liver cirrhosis and extent of distant organ metastasis. It is of first importance for reduction surgery to select intrahepatic multiple tumors, slow-growing and not rapidly to induce distant organ metastases, among them. Intrahepatic tumors arising from multicentric origins were found in 42% in IV-A cases but 0% in IV-B. DNA ploidy analysis of the multicentric tumors in 8 cases did not show any clear indication of resectable tumors according to DNA index. The present immunochemotherapy is composed of a continuous infusion of IL2 and intermittent one-shot injections of 10mg ADR to the remnant liver by using subcutaneously implanted pump. In patients who could enhance peripheral NK and LAK activities by the immunotherapy, decreases in intra- and extra- hepatic tumors were observed. The 2 year-survival rate was 49% in IV-A, but only one case who is receiving the immunotherapy is surviving over 2 years in IV-B.

Carcinoma, Hepatocellular↗
PubMed1991

[The assessment of preoperative transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC)--the comparison between "whole-liver" TAE and "lobar or segmental" TAE].

In 180 patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy, 52 patients were received preoperative arterial chemoembolization (TAE) for the whole liver (whole-liver TAE group: group A), 39 for the limited area of the liver (lobar or segmental TAE group: group B) and the remaining 89 had no treatments before surgery (control group: group C). In order to evaluate the significance of preoperative TAE, long-term prognoses were compared among the three groups. Although there were no significant differences in survivals between A and C, the 2- and 6-year survivals in group B were significantly better than those in group C (P less than 0.05). With regard to reduction rates of tumors and necrotizing effect for daughter nodules after TAE, the lobar or segmental TAE was significantly superior to the whole-liver TAE. Moreover, the lobar or segmental TAE deteriorated the liver function significantly less than the whole-liver TAE. These findings suggest that the lobar or segmental TAE is more advantageous than the whole-liver TAE as a preoperative adjuvant therapy.

Carcinoma, Hepatocellular↗
PubMed2003

Hepatic resections for hepatocellular carcinoma (HCC): short and long-term results on 106 cirrhotic patients.

To evaluate the short and long term outcome of liver resections for hepatocellular carcinoma in cirrhotic patients. A retrospective analysis was performed on 106 consecutive cirrhotic patients with hepatocellular carcinoma resected between June 1974 and September 2002 at the Department of Surgery "Pietro Valdoni" - University of Rome "La Sapienza" and at the Liver and Multivisceral Transplant Unit of the University of Modena. Univariate and multivariate analyses were performed on several clinicopathological variables to analyze factors affecting the long-term outcome and intrahepatic recurrence. Overall mortality and morbidity were 10.7% and 26% respectively. These rates significantly decreased in the last years: from 1997 to 2002 no hospital mortality has been recorded. After a median follow-up of 19 months (interquartile range: 10-36), tumour recurrence appeared in 25 patients (23,5%). The 1-, 3-, and 5-year overall survival rates were 86,6%, 70,3%, and 60,6%, respectively. The 1-, 3-, and 5-year disease-free survival rates were 86,3%, 58,1%, and 40,7%. On univariate analysis, viral ethiology of cirrhosis (p=0.03), presence of multiple nodules (p=0.02) and vascular invasion (p=0.05) were found to be related to a worse long-term survival. At the multivariate analysis only the viral ethiology of cirrhosis and the presence of multiple nodules were confirmed as indipendent prognostic factors. Early results after hepatic resection for HCC can be improved by using a limited surgical approach. The viral ethiology of cirrhosis, the presence of multiple nodules and vascular invasion negatively affected recurrence rate and long-term survival.

Aged↗
PubMed1990

[Portal perfusion defect after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC)].

Serial changes of intrahepatic portal blood flow were studied before and after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC). In all eight patients examined, wedge-shaped perfusion defects distal to the tumor were clearly demonstrated by dynamic sequential computed tomography during arterial portography (CT-AP). However, no abnormalities of arterial blood flow were detected in the areas of reduced portal blood flow by enhanced computed tomography (CT), indicating that portal blood flow of the liver was selectively decreased by PEIT. Moreover, histopathological finding of two resected liver tissues after PEIT revealed organized thrombi in the portal veins in the non-cancerous liver tissues distal to the tumors. These findings suggest that decreased segmental portal flow is frequent after PEIT and obstructive vasculitis is caused by the drainage of ethanol injected in the tumor.

Carcinoma, Hepatocellular↗
PubMed1990

[A hepatocellular carcinoma (HCC) with intrahepatic bile duct dilatation and right lobe atrophy following percutaneous ethanol injection therapy].

Reported is the case of a 67-year-old man with an HCC who was being treated by percutaneous ethanol injection therapy (PEIT). After a year, CT and ultrasonography demonstrated the dilatation of the intrahepatic bile duct and the atrophy of the right lobe. Endoscopic cholangiography also showed stenosis of the right hepatic duct. This severe complication and injury to the hepatic duct and portal vein was determined as having occurred because of treatment by PEIT.

Aged↗
PubMed1989

[A case of hepatocellular carcinoma (HCC) with bleeding due to duodenal perforation by the tumor].

On June 11, 1986, a 70-year-old man was introduced to our hospital because of an elevated AFP and hepatomegaly. He was diagnosed as having an HCC in the left medial segment and a transcatheter arterial embolization (TAE) was able to reduce his AFP level. In December, 1986, repeated tarry stool was noted, and he was readmitted to hospital on January, 28, 1987, because of severe anemia. An ordinary X-ray revealed an abnormal gas shadow in the right upper abdomen. A subsequent endoscopic examination showed a tumoral mass protruding into the duodenal lumen through a duodenal perforation. After death an autopsy revealed that the perforation was due to the expansive growth of the tumoral mass to the duodenum.

Aged↗
PubMed1995

[Changes in distribution of reticuloendothelial function in transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC), estimated by single photon emission computed tomography (SPECT)].

In order to study the changes in distribution of reticuloendothelial function in transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC), the radioactivity of 99mTc-phytate was calculated by the accumulation rate in the organs by means of the single emission computed tomography (SPECT). It was regarded as the reticuloendothelial function in the liver and spleen, and was evaluated independently. Before TAE, significant increases were noted in both splenic activity and splenic volume in the cirrhotic patients, as compared with non-cirrhotic patients. After TAE, the activity in the liver was reduced at the first day after TAE, which returned to the normal level by 5 days. While that in the spleen increased immediately after TAE. After one day of TAE, reticuloendothelial functions of the spleen was significantly higher in the cirrhotic cases then in the non-cirrhotic cases. Furthermore, in the cirrhotic patients, it was significantly higher in the cases embolizated in more than two segments than in those embolizated in one segment only. In conclusion, the reticuloendothelial function of the liver was significantly reduced by the TAE in the cirrhotic patients as compared with non-cirrhotic patients. However the reduced reticuloendothelial function of the liver in the cirrhotic patients was compensated by the increased reticuloendothelial function of the spleen.

Adult↗
PubMed1993

[Vanishing tumor thrombus in IVC after oral administration of UFT and TAE in a patient with HCC; a case report].

A 74-year-old man was diagnosed as hepatocellular carcinoma (HCC) in the area of S6-7 with tumor thrombus continuously developed from hepatic vein to inferior vena cava (IVC). AFP value remained high despite two transcatheter arterial embolizations with adriamycin, mitomycin and Lipiodol (Lp-TAE). The AFP value gradually decreased two weeks after oral administration of UFT. Nine months after, the AFP level was 26.4 ng/ml and the tumor thrombus in the IVC disappeared. The size of the main tumor did not change. This case suggests Lp-TAE and UFT are useful for suppressing the growth of the main tumor and to extinguish the tumor thrombus.

Aged↗
PubMed1993

[The study of continuous local arterial-infusion chemotherapy with 5-FU + CDDP for patients with severely advanced HCC--for the elongation of the life-span and the improvement of QOL].

We tried continuous local arterial-infusion chemotherapy using 5-FU + CDDP with an implanted reservoir, for patients with severely advanced hepatocellular carcinoma (HCC), who had no indications for operation, PEIT or TAE. Arterial-infusion was continued for one week, followed by a one-week no-infusion period, and this treatment was repeated 1-32 times, and patients were observed for 36-549 days. Until the end of April 1993, the one-year survival rate was 61.1%. There were 3 partial remission (PR) cases, 3 progressive disease (PD) cases and the other cases showed no change (NC). Only one patient had any side effects, and all could continue as outpatients for 94.0% of the entire therapy. The patients' evaluation of QOL revealed no differences of QOL according to the length of the whole therapy, the history of rehospitalization during therapy, response to therapy, etc. But PR cases tended to show improved QOL. Therefore we considered this as effective therapy for the elongation of the life-span and the improvement of QOL.

Activities of Daily Living↗
PubMed1996

[A case of recurrent multiple HCC after surgical resection showing regression by two TAEs using 5-FU and zinostatin stimalamer].

A-68-year-old man had hepatocellular carcinoma (HCC) in the area of S6 segment which was resected surgically. Three months after surgery, multiple recurrent lesions were found in both lobes of the liver. A transcatheter arterial embolization (TAE) with 5-FU and zinostatin stimalamer (SMANCS) was done. After TAE, the tumor mass disappeared in the right lobe and reduced to 10% in the left lobe. Although mass lesions remained unchanged for 3 months, the increased of AFP (143.9 ng/ml) was noticed after 4 months. Ten months after the second TAE with 5-FU and SMANCS, the disappearance of tumor masses was confirmed by diagnostic images.

Aged↗
PubMed2006

Genotype-phenotype correlation in hepatocellular adenoma: new classification and relationship with HCC.

Hepatocellular adenomas are benign tumors that can be difficult to diagnose. To refine their classification, we performed a comprehensive analysis of their genetic, pathological, and clinical features. A multicentric series of 96 liver tumors with a firm or possible diagnosis of hepatocellular adenoma was reviewed by liver pathologists. In all cases, the genes coding for hepatocyte nuclear factor 1alpha (HNF1alpha) and beta-catenin were sequenced. No tumors were mutated in both HNF1alpha and beta-catenin enabling tumors to be classified into 3 groups, according to genotype. Tumors with HNF1alpha mutations formed the most important group of adenomas (44 cases). They were phenotypically characterized by marked steatosis (P < 10(-4)), lack of cytological abnormalities (P < 10(-6)), and no inflammatory infiltrates (P < 10(-4)). In contrast, the group of tumors defined by beta-catenin activation included 13 lesions with frequent cytological abnormalities and pseudo-glandular formation (P < 10(-5)). The third group of tumors without mutation was divided into two subgroups based on the presence of inflammatory infiltrates. The subgroup of tumors consisting of 17 inflammatory lesions, resembled telangiectatic focal nodular hyperplasias, with frequent cytological abnormalities (P = 10(-3)), ductular reaction (P < 10(-2)), and dystrophic vessels (P = .02). In this classification, hepatocellular carcinoma associated with adenoma or borderline lesions between carcinoma and adenoma is found in 46% of the beta-catenin-mutated tumors whereas they are never observed in inflammatory lesions and are rarely found in HNF1alpha mutated tumors (P = .004). In conclusion, the molecular and pathological classification of hepatocellular adenomas permits the identification of strong genotype-phenotype correlations and suggests that adenomas with beta-catenin activation have a higher risk of malignant transformation.

Adenoma, Liver Cell↗