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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Color Doppler sonographic findings on 38 lesions in 31 patients who had primary hepatocellular carcinoma were evaluated before and after transcatheter arterial embolization and compared with dynamic CT and hepatic arteriographic findings. All lesions that were observed with dynamic CT or arteriography were correctly identified on color Doppler sonography. Peritumoral pulsatile flow was the predominant color Doppler flow seen in all lesions. Mixed pulsatile and continuous flow were noted in larger tumors and in tumors with a higher degree of vascularity, as determined by arteriography. Two weeks after treatment, color Doppler flow was still identified in 18 lesions (47%), corresponding to dynamic CT or arteriographic findings documenting residual tumor. Histopathologic examination, performed in 10 other lesions, showed that the tumor was completely necrotic in five. These five necrotic tumors were not visible on color Doppler flow images after treatment. Viable tumor was observed in the five remaining lesions, all of which were shown on color Doppler flow images after treatment. During the 6- to 16-month follow-up period, color Doppler flow images showed recurrence of 13 (50%) of 26 lesions, corresponding to tumor recurrence as shown by CT and arteriography. We conclude that color Doppler sonography is useful for imaging hepatocellular carcinoma, for evaluating residual tumor after treatment, and for imaging tumor recurrence during follow-up.
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PMID:Color Doppler sonography of hepatocellular carcinoma before and after treatment by transcatheter arterial embolization. 131 Aug 26

Three cases of hepatocellular carcinoma with ovarian metastases discovered during the patient's life are reported. A 31-year-old woman presented with back pain, and radiographic studies disclosed massive liver enlargement and bilateral ovarian tumors. The second patient, a 38-year-old woman, had an enlarged liver at the time of laparoscopic tubal ligation, and subsequently underwent right hepatic lobectomy for hepatocellular carcinoma. Three months later a left ovarian tumor was detected and a total abdominal hysterectomy with bilateral salpingo-oophorectomy performed. The third patient, a 68-year-old woman, presented with gastrointestinal symptoms and weight loss, and had bilateral ovarian tumors and widespread tumor at laparotomy. Two patients died of their disease at 18 months and 4 years 7 months; the third patient is alive with residual tumor at 7 months. The ovarian tumors, which were bilateral and multinodular in two cases and focally cystic in one case, ranged from 4 to 11 cm in maximum dimension, and had yellow-green or yellow sectioned surfaces. On microscopic examination, they were composed of cells with moderate to abundant eosinophilic cytoplasm growing diffusely and in nodules, nests, and trabeculae; cysts or glands were conspicuous in two cases. Bile was present in one tumor. The main differential diagnostic considerations were hepatoid yolk sac tumor and hepatoid carcinoma, primary or metastatic in the ovary. A variety of features, including the age of the patient, unilaterality or bilaterality of the ovarian tumors, distribution of disease, and microscopic features of the neoplasm, including the identification of bile, established the diagnosis. Metastatic hepatocellular carcinoma must be included in the differential diagnosis of oxyphil cell tumors of the ovary.
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PMID:Hepatocellular carcinoma metastatic to the ovary: a report of three cases discovered during life with discussion of the differential diagnosis of hepatoid tumors of the ovary. 131 79

Totally 135 series of computed tomography (CT) and angiographic examination were performed in 53 patients with proved hepatoma treated by TAE. CT examination was performed four to six weeks after TAE, and a comparative angiographic examination was performed within three weeks after CT examination. The pictures of CT scanning were read to determine 1). the grading of lipiodol retention inside the tumor, 2). the presence/absence of filling defect in the tumor margins coated by lipiodol, 3). the presence/absence of residual tumor tissue within or surrounding the main tumor, and 4). the presence/absence of developed satellite nodules. In comparison with angiographic findings, CT demonstrated 96.3% specificity and 58.2% sensitivity in the grading of lipiodol filling, and 96.3% specificity and 65.7% sensitivity in the tumor margins of lipiodol coating. However, it was difficult for CT to detect small nodules, especially those less than 1 cm in diameter. We find no statistically significant association between newly developed satellite nodules and grading of lipiodol retention inside the tumor or tumor margins of lipiodol coating. Therefore, when CT pictures reveal filling defect over the margins of the tumor coated by lipiodol or less-than-50% lipiodol filling inside the tumor, repeated angiography and further treatment with TAE are suggested.
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PMID:[Computed tomography for evaluation of hepatocellular carcinoma after treatment with transarterial chemoembolization]. 131 91

A retrospective analysis of 194 patients who underwent hepatic resection for primary or metastatic malignant disease from January 1962 to December 1988 was undertaken to determine variables that might aid the selection of patients for hepatic resection. Hepatic metastases were the indication for resection in 126 patients. The 5-year survival rate was 17 per cent. For patients with resected metastases from colorectal cancer (n = 104), the survival rate at 5 years was 18 per cent. The 5-year survival rate was 27 per cent when the resection margin was > 5 mm compared with 9 per cent when the margin was < or = 5 mm (P < 0.01). No patient with extrahepatic invasion, lymphatic spread, involvement of the resection margin or gross residual disease survived to 5 years, compared with a 23 per cent 5-year survival rate for patients undergoing curative resection (P < 0.02). The survival rate of patients with poorly differentiated primary tumours was nil at 3 years compared with a 20 per cent 5-year survival rate for patients with well or moderately differentiated tumours (P not significant). The site and Dukes' classification of the primary tumour, the sex and preoperative carcinoembryonic antigen level of the patient, and the number and size of hepatic metastases did not affect the prognosis. The 5-year survival rate for patients with hepatocellular carcinoma (n = 42) was 25 per cent. An improved survival rate was found for patients whose alpha-fetoprotein level was normal (37 per cent at 5 years) compared with those having a raised level (nil at 3 years) (P < 0.01). Involvement of the resection margin, extrahepatic spread and spread to regional lymph nodes were associated with an 8 per cent 5-year survival rate versus 44 per cent for curative resection (P < 0.005). The presence of cirrhosis, the presence of symptoms, and the multiplicity and size of the tumour did not affect the prognosis. The 5-year survival rate of 11 patients with hepatic sarcoma was 25 per cent. No patient with peripheral cholangiocarcinoma survived to 1 year in contrast to patients with hilar cholangiocarcinoma, all four of whom survived for more than 14 months.
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PMID:Survival after hepatic resection for malignant tumours. 133 Jan 97

From January 1992 to October 1992, nine patients with unresectable primary hepatocellular carcinoma were treated either by liver resection combined with transarterial on-target chemotherapy (n = 4) or by transarterial on-target chemotherapy alone (n = 5). All nine patients were seen with diffuse spread of their disease and were considered as refractory to surgical treatment. The patients who had liver resection combined with alcohol transtumoral injection of the residual tumor in the liver remnant and transarterial lipiodol on-target chemotherapy, responded well and were seen postoperatively with a significant decrease in size of their residual tumor, which was found histologically to have advanced necrotic changes. Similarly, the remaining patients, who had only alcohol injection and frequent administration of on-target chemotherapy, were seen with necrosis of their tumor and with decrease in its size. The fetoprotein serum levels were decreased in all patients. None of the patients showed systemic effects from the use of chemotherapy, nor did they demonstrate any hepatotoxic side effects.
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PMID:A new look in the management of unresectable primary hepatocellular carcinoma. 133 77

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

21 cases of hepatocellular carcinoma (HCC) were surgically resected about 14 or 21 days after transcatheter hepatic arterial chemo-embolization (TACE) mostly for histopathologic assessment of effectiveness. Results showed that complete necrosis of all the tumor bulk was seen in one case (case no. 8) in this series. Partial necrosis of the tumor mass was demonstrated in 19 cases. In 6 cases, the necrotic area was over 50%. In 8 cases, it was between 25-49% and in 5 cases it was below 25%. This strongly indicates a certain effectiveness of TACE on HCC. However, the presence of viable residual tumor in 20 cases, including one with complete viability of the tumor (case no. 1), also suggested the necessity of surgical resection. The case of complete necrosis was related to the frequency of the catheter arriving at the tumor, to the types of embolizing drug, and to the morphopathologic features of the tumor.
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PMID:[Histopathologic study on resected hepatocellular carcinoma after transcatheter hepatic arterial chemo-embolization]. 165 76

The Childrens Cancer Study Group (CCSG) undertook a study (CCG-823F) to test the feasibility of administering continuous infusion doxorubicin (CI DOX) and cisplatin (CDDP) in patients with unresectable or incompletely resected hepatoblastoma (HB) or hepatocellular carcinoma (HCC). Chemotherapy consisted of CI DOX 20 mg/m2/d for days 1 to 4 and CDDP 100 mg/m2 on day 1 followed by a 21-day rest period. Second-look surgery was performed after the administration of four chemotherapy courses. Forty-seven (47) assessable patients were entered on study, 33 with HB and 14 with HCC; of these, 34 (26 HB and eight HCC) completed the initial four courses of chemotherapy. Of the 26 HB patients, 25 were evaluated as responding to chemotherapy before the scheduled second-look procedure and were considered surgically resectable at that time. Surgery was performed on 22 patients; three patients refused the second-look surgery. Nine patients had no evidence of residual malignant disease, seven underwent surgical resection of remaining tumor, four were left with microscopic residual disease, one had a partial resection with gross tumor left behind, and one remained unresectable. Nine HCC patients completed four chemotherapy courses. Eight patients achieved a partial remission and second-look surgery was attempted on seven. Only two had all malignant disease removed at the second procedure. Data from 225 courses of chemotherapy were evaluated for toxicity. Neutropenia (absolute granulocyte count less than 500/mL) was observed in 68 courses, and five of these episodes were associated with sepsis. Severe mucositis was documented in 21 courses, and hypomagnesemia (magnesium less than 1.2 mg) was noted in 30 patients. Two patients developed decreased left ventricular shortening fraction, which resolved when chemotherapy was discontinued. In summary, CI DOX plus CDDP is a well-tolerated and effective regimen in inducing surgical resectability in HB patients who are unresectable at diagnosis and significantly improves survival for this group of patients to 66.6%.
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PMID:Effective treatment of unresectable or metastatic hepatoblastoma with cisplatin and continuous infusion doxorubicin chemotherapy: a report from the Childrens Cancer Study Group. 172 Apr 52

Purified monoclonal mouse or polyclonal horse antibodies (Ab) to rat alpha-fetoprotein (AFP) were conjugated with daunomycin via a dextran bridge. The therapeutic effect of these Ab-daunomycin conjugates on an AFP-producing rat hepatoma which was inoculated s.c. in Donryu rats was studied. Tumors (s.c.) and distant metastases were present by 14 days after tumor inoculation and the serum AFP level was 35 micrograms/ml. The injection of the Ab-daunomycin conjugate, started on day 14, significantly prolonged host survival with inoculated controls having a median survival of 25 days compared to 57 and 60 days for the treated groups. In a second study the Ab-daunomycin conjugates were injected i.v. every other day for five times after the surgical resection of the s.c. tumor. There was a slight therapeutic effect with either antibody or daunomycin alone but treatment with the AFP Ab-daunomycin conjugates significantly prolonged survival and 60% of these treated animals were "tumor free" when sacrificed on day 100. Serial quantitation of the concentration of AFP in the serum of the treated tumor-bearing or in the tumor-resected rats correlated with the therapeutic effectiveness of the Ab-daunomycin conjugates. These experiments show that the optimal treatment with specific antibody-drug conjugates will be in hosts where there is a small residual tumor burden such as may exist following resection of a primary tumor mass. They further show that the serial quantitation of serum AFP can be utilized to determine if residual tumor is present following treatment with Ab-daunomycin conjugates.
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PMID:Therapeutic effect of treatment with polyclonal or monoclonal antibodies to alpha-fetoprotein that have been conjugated to daunomycin via a dextran bridge: studies with an alpha-fetoprotein-producing rat hepatoma tumor model. 244 May 63

Twenty patients with hepatic malignancy were treated with transcatheter arterial embolization (TAE) under examination by intra-arterial digital subtraction angiography (IA-DSA) and conventional angiography (CA). Comparison of these two angiographies revealed that the time required for confirmation of the embolized portion of the artery was about four-and-a-half times shorter with IA-DSA than CA. Moreover, IA-DSA revealed the obstructed portion more readily and accurately than CA. In particular, confirmation could not be made by CA in 35% of cases because of residual Gelform sponge containing contrast medium in the artery. The visualization of residual tumor stain after TAE was 40% better on IA-DSA than CA, because of residual Gelform sponge containing contrast medium and overlapping shadow with calcified costal cartilage, excretory pyelography, and original tumor stain. However, CA was better than IA-DSA in visualizing accidental obstruction of nonobjective arteries such as the cystic artery because of the poor spatial resolution and misregistration artifacts of IA-DSA. CA was better than IA-DSA in visualizing surrounding nonembolized hepatic parenchyma because of the misregistration artifacts of IA-DSA. For effective TAE without severe complication, we concluded that TAE for HCC should be performed under a combination of IA-DSA and CA.
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PMID:Comparison of intra-arterial digital subtraction angiography with conventional angiography after transcatheter arterial embolization for hepatic malignancy. 256 Aug 38


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