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)

The indications for tumor-mass reduction surgery and subsequent immunotherapy in patients with stage IV hepatocellular carcinoma (HCC) were elucidated in this study. About 42% of the resected specimens from stage IV-A patients (n = 26) contained well-differentiated multicentrically occurring HCC, which was not found in any of the stage IV-B patients (n = 9). The 2-year survival rate after reduction surgery was 49% for the stage IV-A patients and only 13% for the stage IV-B patients, while 6 of the stage IV-A patients who survived for more than 2 years had no vascular invasion or distant organ metastases. Some of the stage IV patients maintained normal peripheral natural killer (NK) activity and were also able to tolerate surgical insults immunologically, provided that appropriate postoperative immunotherapy was given. Thus, stage IV-A HCC has a greater possibility of containing slow-growing intrahepatic tumor clusters, and the removal of any rapidly growing tumors from among these should be undertaken by reduction surgery followed by subsequent multidisciplinary treatment for residual tumor cells, including appropriate immunotherapy.
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PMID:The indications for tumor mass reduction surgery and subsequent multidisciplinary treatments in stage IV hepatocellular carcinoma. 840 Jun 70

An increasing number of hepatic resections are being performed as potentially curative surgery for malignant liver neoplasms. Hepatectomy and subsequent liver regeneration produce a local environment that enhances growth of microscopic residual tumor. To determine if pretreatment with murine interferon gamma (IFN-gamma) can protect against such enhanced tumor growth, Buffalo rats were randomized to receive a 3-day treatment of IFN-gamma (50,000 U/qD intraperitoneally) or saline. Groups then underwent intrasplenic injection of 10(6) Morris hepatoma cells, followed 1 hour later by sham (control) or partial hepatectomy (PH) of 70%. PH significantly enhanced tumor growth within the liver (control, 8 +/- 3 nodules per liver; PH, 73 +/- 12 nodules per liver; P < .001). This enhancement was attenuated by prior administration of IFN-gamma IFN-gamma/PH, 16 +/- 3; P < .001 vs. PH). Growth factor release and liver regeneration were not affected significantly by pretreatment with IFN-gamma. The effect of IFN-gamma on tumor growth is associated with a significant enhancement of Kupffer cell (KC)-mediated tumoricidal activity (percentage of specific lysis, 55 +/- 10% control, 78 +/- 11% IFN-gamma, P < .01) but not lymphocyte-mediated tumoricidal activity. Because microscopic residual disease may be present after hepatectomies for cancer, IFN-gamma may be useful agent in retarding growth of residual tumors.
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PMID:Interferon gamma protects against hepatic tumor growth in rats by increasing Kupffer cell tumoricidal activity. 869 Apr 7

MRI was performed in 13 patients who had microwave coagulation therapy (MCT) for hepatocellular carcinoma. Six of them underwent surgery after MRI. The area (including tumor) treated by MCT showed low to high intensity on T1WI, and low to isointensity on T2WI. No enhancement was obtained on dynamic MRI. Histologically, this area was supposed to be coagulation necrosis. On T1WI, only tumor showed high intensity within the MCT area in 8 patients, and nearly uniform intensity was observed in 5 patients. Histologically, residual cell nuclei were observed in the former, and nearly uniform coagulation necrosis in the latter. The marginal part of the MCT area exhibited low intensity on T1WI, and high intensity on T2WI. Strong enhancement was obtained on dynamic MRI, and histologically, granulation tissue was noted. In the hepatic parenchyma around the MCT area, a ring-or wedge-shaped high intensity part was observed in 7 patients on T2WI, and that part was enhanced on dynamic MRI. This finding was considered to reflect changes such as hepatic hyperperfusion. In terms of the capability of visualizing residual tumor after MCT, MRI was superior to CT. Furthermore, a clear distinction was seen between the MCT area and non-MCT area on T2WI and dynamic MRI. Thus, MRI was useful in the determination of additional therapy.
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PMID:[MR imaging of hepatocellular carcinoma following microwave coagulation therapy]. 896 57

Color and power Doppler are now widely used to monitor treatment response because of the latest technologic advances and of the increasing use of echo-enhancing agents. The assessment of treatment response is based on the amount of necrosis obtained and changes in local vascularization indicate a successful treatment. To date, clinical experiences have mainly concerned the treatment of hepatocellular carcinomas, hyperfunctioning nodules of the thyroid and parathyroid glands and the neoadjuvant chemotherapy of breast cancer. Aim of this review is to describe the role and potentials of color and power Doppler in this field. Hepatocellular carcinomas are currently treated with surgery or percutaneous ethanol injection and/or chemoembolization. Treatment response can be monitored with color Doppler: after a successful treatment, color signals are no longer detectable on color Doppler images. Conversely, the presence of arterial signals indicates persistent viable tumor. Unfortunately, color Doppler is limited when the hepatocellular carcinoma is hypovascular, small or deep. Echo-enhancing agents may help overcome these limitations, although spiral computed tomography or dynamic magnetic resonance imaging cannot be replaced yet in the definitive assessment of tumor necrosis. Color and power Doppler are well-established tools in the study of functioning thyroid and parathyroid adenomas after percutaneous ethanol injection. Echo-enhancing agents may improve Doppler sensitivity in the detection of residual viable tissue. Other interesting applications of color and power Doppler in this field are secondary hyperparathyroidism and hyperfunctioning thyreopathies (Graves' disease) treated with mercaptoimidazole. The evaluation of systolic flow velocity in the inferior thyroid artery is more reliable than the quantitative analysis of color signals in monitoring treatment response in Graves' disease. In our experience, systolic velocity in the inferior thyroid artery decreased from 150-250 to 60-80 cm/s after medical therapy. Finally, Doppler studies have provided good results in the follow-up of breast cancers after neoadjuvant therapy. In our experience on 18 patients treated with local parenteral repeated administration of antiblastic drugs, sonography showed no more signals within the lesion in 16 patients at the end of therapy. In the remaining two cases with persistent tumor at ultrasound, some color spots were still present and histopathology confirmed residual tumor cells. In conclusion, the results of color and power Doppler are encouraging. Thus, we believe that Doppler will be increasingly used in monitoring treatment response.
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PMID:Monitoring treatment response with color and power Doppler. 965 15

The aim of the study was to evaluate the usefulness of the magnetic resonance (MR) perfusion maps in the detection of liver tumor perfusion following transcatheter arterial chemoembolization (TACE). MR dynamic susceptibility contrast-enhanced imaging was performed in 12 patients with 10 confirmed hepatocellular carcinoma and 2 confirmed hepatic metastasis using single-shot echoplanar pulse sequence. Time-intensity curves for all hepatic tumors showed a transient signal drop and the hepatic blood volume (HBV) maps were reconstructed. On the HBV maps, most tumors (80%) demonstrated hyperperfusion before TACE and hypoperfusion following TACE. The site and the degree of residual hyperperfusion within the tumor on the HBV maps correlated well with the areas of hypervascularity on the angiograms. In conclusion, the MR perfusion maps can be a promising technique for detecting the perfusion of the residual tumor tissue following TACE.
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PMID:Detection of hepatic tumor perfusion following transcatheter arterial chemoembolization with dynamic susceptibility contrast-enhanced echoplanar imaging. 1050 16

As a strategy for treating advanced hepatocellular carcinoma (HCC), cytoreductive surgery was studied comparing to transcatheter arterial chemoembolization (TACE). Patients who had curatively unresectable intrahepatic multiple HCC with the main tumor 30 mm or more in size were selected for this study. The patients were classified into two groups; i) cytoreductive surgery group (CRS group): 28 patients in whom the main tumor was resected but other cancer nodules remained in the remnant liver, ii) TACE group: 25 patients at Child A grade who underwent TACE, and in whom it was also evaluated retrospectively that the main tumor had been resectable. The cumulative 5-year survival rate was significantly higher in CRS (48.7%) than TACE (17.1%) group. Multivariate analysis revealed that performing cytoreductive surgery was a significant and independent factor to prolong survival. However, 6 of 28 patients died within one year of surgery. Residual tumor thrombus, and the absence or non-effectiveness of adjuvant therapy were significant high risk factors for postoperative death within one year. Conclusively, cytoreductive surgery contributes to a significant lengthening of survival in patients with advanced HCC. To reduce the risk of early postoperative death, the importance of postoperative adjuvant therapy is also recognized.
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PMID:Prognostic benefit in cytoreductive surgery for curatively unresectable hepatocellular carcinoma - comparison to transcatheter arterial chemoembolization. 1056 17

Right ventricular heart involvement of an otherwise unknown hepatocellular carcinoma is presented and the cytologic differential diagnosis is discussed. This tumor displays classic cytologic features of hepatocellular carcinoma, including trabecular arrangements with prominent endothelial cells and numerous intracytoplasmic hyaline bodies. The background contains many "naked nuclei" and extracellular hyaline bodies. The patient is alive with residual disease 4 months after surgical extirpation of the cardiac mass.
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PMID:Metastatic hepatocellular carcinoma to the heart. 1107 47

Dendritic cells (DCs) are potent antigen-presenting cells that are capable of priming systemic antitumor immune response. Here, we evaluated the combined effectiveness of tumor lysate-pulsed DC immunization and interleukin (IL)-12 administration on the induction of antitumor immunity in a mouse hepatocellular carcinoma (HCC) model. Mouse DCs were pulsed with lysate of BNL 1ME A.7R.1 (BNL), a BALB/c-derived HCC cell line, and then injected into syngeneic mice in combination with systemic administration of IL-12. Lymphocytes from mice treated with BNL lysate-pulsed DCs and IL-12 showed stronger cytolytic activity and produced higher amounts of IFN-gamma than those from mice treated with BNL lysate-pulsed DCs alone. Although immunization with BNL lysate-pulsed DCs alone did not lead to complete regression of established tumors, it significantly inhibited tumor growth compared with vehicle injection. Importantly, the combined therapy of BNL lysate-pulsed DCs and IL-12 resulted in tumor rejection or significant inhibition of tumor growth compared with mice treated with BNL lysate-pulsed DCs alone. In vivo lymphocyte depletion experiments demonstrated that this combination was dependent on both CD8+ and CD4+ T cells, but not natural killer cells. These results demonstrated that IL-12 administration enhanced the therapeutic effect of immunization of tumor lysate-pulsed DCs against HCC in mice. This combination of IL-12 and DCs may be useful for suppressing the growth of residual tumor after primary therapy of human HCC.
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PMID:Administration of interleukin-12 enhances the therapeutic efficacy of dendritic cell-based tumor vaccines in mouse hepatocellular carcinoma. 1160 95

The incidence of hepatocellular carcinoma (HCC) is increasing in the United States. Although liver transplantation is an effective means of treating selected patients, pretransplantation tumor progression may preclude some patients from undergoing transplantation. The aim of this study is to determine the safety and efficacy of percutaneous radiofrequency thermal ablation (RFA) in 33 consecutive patients with nonresectable HCC and advanced cirrhosis. Mean subject age was 57.2 +/- 10.6 years, mean Child-Turcotte-Pugh score was 7.0 +/- 1.4, and mean maximal tumor diameter was 3.6 +/- 1.1 cm. Using contrast-enhanced computed tomography and magnetic resonance imaging, 22 patients (66%) had a complete radiological response at 3 months post-RFA, whereas 11 patients (33%) had an incomplete radiological response. During follow-up, 18 patients (54%) experienced tumor progression and 9 subjects underwent repeated ablation for either residual disease or tumor progression. The overall actuarial patient survival rate of the 33 patients was 58% at 2 years, whereas the transplantation-free patient survival rate was 34% at 2 years. Fifteen of 23 transplant candidates were successfully bridged to liver transplantation after a mean post-RFA follow-up of 7.9 +/- 6.7 months. The extent of tumor necrosis in the explant varied, but no subjects had evidence of tumor seeding on post-RFA imaging, at liver transplantation, or in the explant. The 3-year actuarial posttransplantation patient survival rate was 85%. Two patients have developed posttransplantation recurrence, and both had microscopic vascular invasion in their explants. In summary, our data show that RFA is a safe and effective treatment modality for patients with advanced cirrhosis and nonresectable HCC. Although the ability of RFA to prevent or delay tumor progression requires further prospective study, its favorable safety profile and promising efficacy make it an attractive treatment option for liver transplant candidates with nonresectable HCC.
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PMID:Percutaneous radiofrequency thermal ablation of hepatocellular carcinoma: a safe and effective bridge to liver transplantation. 1247 57

Contrast material-enhanced Doppler or gray-scale harmonic ultrasonography (US) may help determine the completeness or long-term therapeutic efficacy of radio-frequency (RF) ablation of hepatocellular carcinoma (HCC). Successfully treated HCC is devoid of vascularity at color or power Doppler US. When the tumor is not completely treated, residual viable tumor can be detected. These contrast-enhanced US techniques may also help identify residual tumor when performed during repeat RF ablation, when accurate localization of viable tumor is needed. To date, contrast-enhanced computed tomography (CT) has been the most widely used imaging modality in the evaluation of therapeutic response after RF ablation of HCC. At follow-up CT, successfully ablated lesions appear as low-attenuation areas with no foci of contrast enhancement either within or at the periphery of the treated lesion, whereas any foci of enhancement indicate residual or recurrent tumor. Reactive hyperemia in tissue surrounding the ablated lesion, iatrogenic arterioportal shunting, and small intralesional air pockets are frequently seen at immediate follow-up CT. Gadolinium-enhanced dynamic magnetic resonance imaging is also useful in assessing therapeutic response following RF ablation of HCC, particularly when CT findings are inconclusive. Familiarity with these imaging findings is helpful in this setting.
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PMID:Hepatocellular carcinoma treated with radio-frequency ablation: spectrum of imaging findings. 1253 46


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