Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to investigate the changes of hosts' immunological response against cancer treated with transcatheter arterial embolization (TAE), percent change of surface antigens of peripheral lymphocytes using two color analysis with flow cytometry and NK activity were measured before TAE and 1,2 and 3 weeks after TAE in 41 cases with hepatocellular carcinoma. CD4+2H4+ subset (suppressor inducer cell) significantly increased 1 week after TAE and the increase significantly continued for 3 weeks. CD8+CD11b+ bright subset (suppressor cell), CD8+CD11b- subset (cytotoxic T cell) and CD4+2H4- subset (helper/helper inducer cell) did not change significantly for 3 weeks after TAE. Total of CD16+Leu7-, CD16+Leu7+ and CD16-Leu7+ subsets (NK cell subsets) significantly decreased 1 week after TAE and the decrease significantly continued for 3 weeks. NK activity was significantly suppressed 1 week after TAE, and the suppression of NK activity significantly continued for 3 weeks. It was identified that decrease of NK cell subsets was significantly related to increase of suppressor inducer cell by statistical multivariate analysis. In NK cell subsets composited ratio of CD16-Leu7+ significantly increased 1 week after TAE, of CD16+Leu7+ significantly decreased 1 week after TAE, and of CD16+Leu7- significantly decreased 2 week after TAE. Therefore it is suggested that patients' immunity against cancer is weakened by TAE, and that TAE should not be rashly done in order to preserve the immunological response when it is previously expected that patients might have residual cancer; metastasis or invasion into vessels after TAE.
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PMID:[Changes on hosts' immunological response in HCC patients treated with transcatheter arterial embolization (TAE)]. 132 26

15 cancer specimens resected after hepatic arterial chemoembolization (TCE) were studied pathologically. It was found that residual tumor tissue was present in three forms: failure of complete tumor necrosis; tumor emboli in small portal veins; and multiple cancer foci in adjacent liver parenchyma. It is believed that presenting residual tumor tissue after TCE may be attributed to one of the following conditions: low drug concentration in residual tumor tissue; the larger tumor size after TCE; more residual cancer tissue in ASCCL than in HCC, collaterals formed soon after hepatic arterial occlusion.
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PMID:[Residual liver cancer after transcatheter hepatic arterial chemoembolization in patients with large primary hepatic carcinoma]. 133 15

Using integrated hepatitis B virus (HBV) DNA in the cancer cells as a genetic marker, clonal origin of intrahepatic recurrence of hepatocellular carcinoma was studied by Southern blot technique. Comparing 5 cases of postoperative recurrent hepatocellular carcinoma with their primary tumors, it was found that 1 case had identical HBV DNA integration patterns, 3 cases were of different clonality and 1 case with multiple nodular recurrences contained either a unicentric origin or a new distinctive clone origin. The results suggest that, in addition to recurrence from residual cancer cells, in some cases, hepatocellular carcinoma may develop repeatedly during a continuous process of carcinogen action, even after a radical resection.
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PMID:[Clonal origin of intrahepatic recurrence after resection of hepatocellular carcinoma]. 165 85

Percutaneous alcohol injection (PAI) is reported as a safe, inexpensive and effective method of treatment of small HCC in severely ill patients. Nevertheless, residual cancer can persist after treatment and multiple bioptic manoeveurs are needed to ascertain the actual completeness of treatment. In two cases of HCC treated by ethanol injections, MRI on T2 weighted sequences showed a characteristic change from the previous hyperintense or isointense signal to a hypointense one. This MRI pattern, quite different from the usual HCC features, was correlated to the histologic findings of complete coagulative necrosis of the tumoural mass. Further observations are needed to assess reproducibility and specificity of this finding and the MRI pattern needs to be evaluated also in unsatisfactory percutaneous alcohol treatment of HCC in order to demonstrate that cases with persistent neoplastic tissue display a different pattern. If our report should be confirmed, MRI might be a not invasive tool in evaluating the effectiveness of PAI in patients at risk for multiple histologic samplings. Furthermore MRI could be very useful in assessing the degree and extent of tissutal changes in response to local therapy also after the tumour and its margin are masked by US guided ethanol injections.
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PMID:Hepatocellular carcinoma: magnetic resonance imaging after ultrasonically guided percutaneous alcohol treatment. Preliminary report. 196 7

For the treatment of small hepatocellular carcinoma, intratumor injection of absolute ethanol under ultrasound guidance was performed in 27 tumors in 23 patients, with a tumor diameter of between 1.0 and 3.3 cm. The initially elevated serum alpha-fetoprotein levels in 15 patients decreased during treatment, with 13 returning to normal after this regimen. In the 6 patients who finally received surgical resection, 4 had complete necrosis of the tumor, while the other 2 had a small peripheral residual cancer nest. In the remaining non-resected 17 cases, follow-up CT, multiple biopsies and angiography revealed evidence of viable tumor in only 3 cases. After additional ethanol injections, these 3 cases were successfully treated. Inhomogeneous distribution of the injected ethanol and difficulty in identifying the tumor after previous injections accounted for the incomplete necrosis of the tumor. To cope with these problems, a steel coil was implanted in the tumor before treatment, and a needle with multiple side holes was used in the last 3 cases, with satisfactory results. Ethanol injection is promising and may even be curative in the treatment of small hepatocellular carcinoma.
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PMID:Intratumor injection of absolute ethanol under ultrasound guidance for the treatment of small hepatocellular carcinoma. 244 15

Twenty-three patients with surgically verified unresectable hepatocellular carcinoma (HCC) have been treated by intrahepatic arterial administration of 131I-labeled anti-HCC monoclonal antibody (Hepama-1) combined with hepatic artery ligation. Radioimmunoimaging demonstrated that the median tumor/liver ratio was 2.1 (1.1-3.6) at day 5. A decline in alpha-fetoprotein level and shrinkage of tumor were observed in 75% (12/16) and 78% (18/23) of patients respectively. Sequential resection was done in 11 patients (48%) after treatment. The surgical specimens revealed massive necrosis of tumor, but residual cancer cells were found at the edge of the specimens. Anti-antibody was determined in 43% (10/23) of patients 2-4 weeks after the administration of 131I-Hepama-1 mAb. No marked toxic effects were noted. It is suggested that 131I-Hepama-1 mAb might be of value as one of the multimodality treatments for unresectable HCC.
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PMID:Radioimmunotherapy for unresectable hepatocellular carcinoma using 131I-Hepama-1 mAb: preliminary results. 838 4

The poor prognosis of hepatocellular carcinoma (HCC) was partly a result of the majority of unresectable HCCs in clinical patients. Fortunately, with the progress of regional cancer therapies and multimodality treatment, some of the localized unresectable HCCs were converted to resectable ones. During the period 1960-1994, 72 of the 663 patients with surgically verified unresectable HCCs have been converted to resectable. Successful cytoreduction with median diameter reduced from 10 cm to 5 cm was mainly a result of the triple or double combination treatment with hepatic artery ligation, hepatic artery cannulation with infusion, radioimmunotherapy, and fractionated regional radiotherapy. The interval between the first operation and the sequential resection was 5 months. The operative mortality was 1.4% for sequential resection, and the 5-year survival was 62.1%. Analysis of factor influencing sequential resection rate revealed HCCs that were single nodule, well encapsulated, situated at right lobe or hepatic hilum, associated with micronodular cirrhosis, and treated with triple or double combination modalities had higher sequential resection rate as compared to their counterparts. Analysis of factors influencing survival after sequential resection revealed that HCCs with a solitary tumor confined in one lobe, without tumor embolus, and without residual cancer in specimen of sequential resection, had longer survival. It is suggested that localized unresectable, solitary, well encapsulated, right lobe or hilar HCC, associated with micronodular cirrhosis, will be good candidates for cytoreduction and sequential resection; and HCCs with unilateral involvement, without tumor embolus, and with complete necrosis of tumor after multimodality treatment favored better prognosis.
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PMID:Cytoreduction and sequential resection for surgically verified unresectable hepatocellular carcinoma: evaluation with analysis of 72 patients. 855 66

In the author's institution, 2254 patients with hepatocellular carcinoma (HCC) have been treated during 1958-1994. The overall 5-year survival increased from 5.4% (1958-1970), to 11.9% (1971-1982), to 46.2% (1983-1984), which correlated well with the increasing proportion of small HCC in the series (2.6%, 12.1%, and 33.4%, respectively); with the increasing percentage of limited resection (3.1%, 32.2%, and 58.3%); with the increasing number of re-resections for recurrence (0, 27, and 114 patients); and with the increasing number of second stage resections (0, 5, and 67 patients). In our institution, surgical approaches that resulted in significantly prolonging survival included: small HCC resection, re-resection, and cytoreduction followed by sequential resection for initially unresectable HCC. Experience in these 3 aspects suggests: (a) Small HCCs are mainly found by screening using AFP and ultrasonography (US) in a high risk population, and limited resection is the best treatment in patients with compensated liver cirrhosis, the 5-year survival after resection being 62.9% (n = 549). (b) Postoperative monitoring using AFP/US every 2-3 months for 5-10 years after curative resection is needed to detect subclinical recurrence. Limited re-resection is indicated for liver recurrence less than 3 nodules, and lung lobectomy is of proven merit to prolong survival for solitary lung metastasis. Re-resection of subclinical recurrence has resulted in a 10-20% further increase in 5-year survival after curative resection. (c) Palliative surgery other than resection such as hepatic artery ligation (HAL) and cannulation with arterial infusion (HAI), cryosurgery, etc. are superior to palliative resection with residual cancer. (d) Cytoreduction and sequential resection have provided hope for localized unresectable HCC, particularly in the right cirrhotic liver. Multimodality combination treatments such as HAL+HAI+radioimmunotherapy/regional radiotherapy are acceptable cytoreductive therapies. Repeated transcatheter hepatic arterial chemoembolization (TACE) is an alternative nonsurgical approach. Sequential resection is important to eradicate residual cancer after cytoreduction. The 5-year survival of 72 patients with cytoreduction and sequential resection for initially unresectable HCC was 62.1% and resulted in improving 5-year survival in the entire series of unresectable HCC over the 3 periods from 0% to 7.4% to 25.7%, respectively. However, multicentric origin and tumor invasiveness are two major targets to be studied in the control of recurrence and metastasis.
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PMID:Three decades' experience in surgery of hepatocellular carcinoma. 921 Aug 95

We investigated the effectiveness of continuous arterial infusion of low-dose CDDP, 5-FU for residual cancer after cytoreductive surgery for advanced hepatocellular carcinoma. Thirty-one patients with unresectable advanced hepatocellular carcinoma were classified into two groups by adjuvant therapy after reduction surgery: 1) Low-dose FP Group: 17 patients; continuous arterial infusion of low-dose CDDP, 5-FU via implanted port system; 2) Conventional group: 8 patients; Lipiodolization (6 cases) and transcatheter arterial embolization (2 cases). The five-year survival rate in the low-dose FP group was 34.8%, the efficacy was 64.7%, CR: 6 (35.3%); PR: 5; NC: 4; PD: 2. Thus, continuous arterial infusion of low-dose CDDP, 5-FU was effective as adjuvant therapy in cytoreductive surgery for advanced hepatocellular carcinoma.
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PMID:[Continuous arterial infusion of low-dose cisplatin, 5-fluorouracil as adjuvant therapy in cytoreductive surgery for advanced hepatocellular carcinoma]. 938 1

From 1984 through 1994, 99 consecutive patients with hepatocellular carcinoma (HCC) underwent hepa-tectomy with microwave tissue coagulation (MTC). We performed limited resection (Hr0) in 28 patients, subsegmentectomy (HrS) in 25 patients, segmentectomy (Hr1) in 21 patients, and lobectomy or extended lobectomy (Hr2) in 25 patients. The patients were divided into two groups: group A, 86 patients with tumors smaller than 1 kg and no tumor thrombi in the main portal trunk; and group B, 13 patients with a tumor 1 kg or larger, or with macroscopic tumor thrombi in the main portal trunk. In group A, mean blood loss was 838 ml for Hr0, 1948 ml for HrS, 1765 ml for Hr1, and 1325 ml for Hr2. The mean operative time in group A ranged from 3 h 43 min for Hr0 to 4 h 57 min for Hr2. In group B, the mean operative time was 6 h 3 min and mean blood loss was 6053 ml. Our MTC method was associated with an in-hospital mortality rate of 3% and a major complication rate of 13.1%. The 5-year survival and disease-free survival rates were 43.4% and 25.4%, respectively. The 5-year survival rate of patients without portal tumor thrombi (50.9%) was significantly better than that of patients with portal tumor thrombi (11.9%) (P < 0.001). The 5-year survival rate of patients who underwent curative resection (58.1%) was significantly better than that of patients who underwent noncurative resection (22.9%) (P < 0.001). The 5-year survival rates of patients in group A without portal tumor thrombi did not differ between those who had cancer-negative margins (54.0%) and those with cancerpositive margins (49.6%) at resection. Recurrence and local recurrence rates did not differ in patients with cancer-positive margins (63.6% and 7.3%, respectively) and patients with cancer-negative margins (56.5% and 8.7%, respectively). These results suggested that microscopic residual cancer in the resected margin was coagulated by MTC. Blood loss, operative time, and clinical outcome in this series of 99 consecutive hepatectomies were comparable with values in earlier reports in which such hemostatic methods as the Pringle maneuver were used. We conclude that hepatectomy with MTC is useful and safe and produces consistent results.
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PMID:Hepatectomy with microwave tissue coagulation for hepatocellular carcinoma. 974 86


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