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)

Fifteen to 20 years ago, the natural history of HCC demonstrated approximately 1.5 months median survival after diagnosis with rare cases of one-year survival. Ten to 15 years ago, one shot intraarterial (IA) injection of mitomycin C (MMC) or doxorubicin (ADR) became the prevailing treatment and prolonged median survival to 3-5 months. Ten years ago, transcatheter arterial embolization was introduced and improved the survival rate dramatically. In the earlier period, TAE was performed with gelatin sponge (GS) plus ADR or MMC and showed shrinkage of HCC in the well-capsulated case. Combined use of Lipiodol (LPD) with anticancer drug and GS in later period showed further progress in antitumor response and survival. The one year survival rate obtained from our 100 cases was 53.8%, and the 2 year one was 36.5%. We speculate that the effective response of LPD plus drug to intrahepatic daughter nodules contributed to this improvement because we clarified the efflux of LPD to peripheral portal vein clinically and experimentally. Since the metastatic liver tumor originating from colon or gastric cancer is usually hypovascular and shows limited response to intra-arterial chemotherapy, a special device is needed for improvement. We introduced an S.C. implanted port for injection route and long-term intermittent IA combination therapy with ADR or MMC and degradable starch microspheres (DSM), which embolise arteries temporarily for 20-30 minutes. These new methods achieved a favorable response rate with better quality of life, and would be expected to prolong the life span of patients with metastatic liver tumor.
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PMID:[Recent progress in multidisciplinary treatment of hepatic cancer]. 254 1

The liver involvement by tuberculosis in the macronodular form is quite rare and one must know their clinical features and actual imaging to have precise diagnosis. We present a case of the solitary hepatic tuberculosis, of which angiographic findings originally suggested hepatocellular carcinoma (HCC) given Lipiodol Ultra Fluid (LUF). On angiogram the tuberculoma showed marked hypervascularity in a capillary phase. Histological examination of the biopsy specimen disclosed granulomas with central coagulation necrosis. A good clinical response was achieved with a course of Isoniazid and Rifampicin. Angiographic findings of one year later showed hypovascularity. Meanwhile LUF remained long in the tuberculoma marginally, presenting nodular opacities on lipiodolized CT. This finding was different from that of HCC. We also discussed those clinical actual imaging and pathological findings.
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PMID:A case of solitary tuberculosis of the liver. 254 55

The surgical treatment of cancers in cirrhotic liver has two main objectives: 1) to remove the cancer with low mortality and mobility rate; 2) to carry out a radical operation with a survival index of 50% three years after the operation. For this purpose, five queries may contribute to programming the most suitable surgery. 1) What patients can be operated? a) those without abdominal ascitic effusion; b) anicteric patients; c) those with fairly well preserved liver function. 2) What liver cancers can be resected? Mainly those with a single localisation. 3) What investigations offer a picture of the extent of tumoral invasion? a) ultrasonography; b) arteriography with simultaneous injection of Lipiodol and later echography; c) intraoperative echography. 4) What surgical operation should be carried out? Liver resection as "economical" as possible (cirrhotic liver) but at the same time as "radical" as possible (hepatocarcinoma). 5) What results can be expected? a) 5% mortality; b) 30% survival 3 years after operation. As the prognosis of liver cancers in cirrhotic livers is better the more limited are the dimensions of the tumour at the time of operation, only systematic screening of cirrhotic patients by repeated ultrasonography permits their treatment at an earlier stage.
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PMID:[Recent advances in surgical therapy of hepatocarcinomas. 5 questions on the exeresis of carcinomas of the cirrhotic liver]. 254 35

To evaluate the usefulness of intraarterial digital subtraction angiography (IADSA) in hepatocellular carcinoma, IADSA was prospectively performed, combined with conventional film-screen angiography, in 40 patients in whom the tumor was histologically proven or highly suspected. Of the 16 main tumors less than 2 cm, IADSA detected 7 that were missed by film-screen angiography; 6 of these were less than 1 cm in size. With other diagnostic modalities including ultrasound, routine CT study, and CT after intraarterial Lipiodol injection, the detection rate of these tumors was low. IADSA's contribution is important in the detection of small hepatocellular carcinomas.
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PMID:Intraarterial digital subtraction angiography in detection of hepatocellular carcinoma. 254 68

Intraarterial injection of Lipiodol has been recommended to differentiate hepatocellular carcinoma from benign lesions such as cavernous hemangioma, because uptake and prolonged retention of the contrast medium is a characteristic of the malignant tumors. In two cases of cavernous hemangioma of the liver in which we injected Lipiodol, uptake and retention up to 3 months was demonstrated. We conclude that the intraarterial injection of Lipiodol may not be reliable in differentiating hepatocellular carcinoma from cavernous hemangioma of the liver.
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PMID:Lipiodol retention within hepatic cavernous hemangioma. 254 69

Between 1982 and 1987, selective regional cancer chemotherapy using Lipiodol plus an anticancer drug (lipiodolization) was prescribed for 200 patients with hepatocellular carcinoma. One hundred forty-nine patients were given lipiodolization alone, and the remaining 51 underwent hepatic resection following lipiodolization. The grades of deposits of the oily contrast medium in the neoplastic tissue seen on the plain X-ray correlated well with the antitumor effect. In the resected specimens of 17 patients treated with lipiodolization prior to surgery, concentrations of adriamycin in the malignant liver tissues were 13.2 +/- 18.2 micrograms per gm, whereas the adjacent liver parenchyma contained 1.4 +/- 2.0 micrograms per gm of adriamycin; the difference was statistically significant (p less than 0.05). In the 149 patients treated with lipiodolization, 1-, 2-, 3- and 4-year survival rates were 56.1, 28.9, 17.3 and 7.4%, respectively. Thus, lipiodolization was considerably more effective, compared to the results achieved by hepatic artery ligation and cannulation into the hepatic artery for patients in Stages I and II. In this sequential nonrandomized study, the survival rates for patients undergoing hepatic resection were superior to those for patients in Stage I and treated with lipiodolization. The significant difference appeared to depend on incomplete killing of tumor cells, which are most often present in the fibrous capsule, by lipiodolization. We conclude from these data that lipiodolization is an effective treatment for hepatocellular carcinoma when the tumor is not curatively resectable. When the clinical status is good, then surgery is warranted.
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PMID:A 5-year experience of lipiodolization: selective regional chemotherapy for 200 patients with hepatocellular carcinoma. 254 99

Fifty patients with HCC associated with hepatic cirrhosis underwent intra-arterial injection of Lipiodol UltraFluid (LUF) during diagnostic DSA of liver parenchyma, 42 of them for a complete chemotherapeutic treatment, 8 for an isolated diagnostic control. LUF is known to be specifically captured by HCC neoplastic tissue, with long-term persistence in the lesion if injected in the arterial hepatic tree; this is not the case with other focal hepatic masses. Therefore LUF opacification can be used to demonstrate small daughter tumors not shown by CT or US in cases with evidence of HCC, or to diagnosis HCC in clinically positive patients with no evidence of tumor at non-invasive screening. In our series of patients, accumulation of LUF in the HCC was observed in 100% of the cases, with no false negatives. Two false positives (4%) were observed, due to CT being performed too early (it should be performed not sooner than 10 days after the injection). Overall DSA accuracy was 78%, with 22% false negatives. In 14% of the cases DSA was positive for HCC in patients with aspecific noninvasive screening. CT, performed 10 days after LUF injection, demonstrated HCC daughter tumors not depicted by US, conventional CT, and angiography, in 34% of the cases, and in 9% of the patients only CT/LUF was able to show HCC in clinically positive cases with no evidence of tumor on other imaging techniques. Specificity, sensitivity and over-all accuracy were thus 100% in our series; LUF was well tolerated by the patients, and no technical complications were observed. In our opinion, the diagnostic DSA and CT/LUF is justified only for the typification of suspected focal nodules unsuitable for biopsy: in other instances, especially in case of HCC with positive biopsy/clinical findings and focal nodular mass, the technique should be directly employed as a therapeutic approach, with the injection of lipiodolized agents to treat both primary and daughter nodules after surgery in operable patients, and to begin chemoembolization treatment in patients with intrahepatic polyfocal diffusion. DSA and LUF are therefore of primary importance in the diagnosis and therapeutic flow-chart of HCC associated with hepatic cirrhosis.
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PMID:[Lipiodol UltraFluid in the imaging diagnosis of hepatocarcinoma with cirrhosis]. 255 Sep 98

Hepatectomy has been a treatment of choice for hepatocellular carcinoma and metastatic liver carcinoma. Recurrence in residual liver after hepatectomy is clinically a serious problem. Since 1987, postoperative hepatic arterial infusion chemotherapy using subcutaneously implanted reservoir has been undertaken to improve the prognosis after hepatectomy in hepatocellular carcinoma and liver metastasis of colorectal carcinoma. The indications for reservoir implantation were determined for high-risk cases in hepatocellular carcinoma and all cases in liver metastasis. The tip of a catheter was placed at the root of the common hepatic artery via gastroduodenal artery. Lipiodol-ADM was injected for hepatocellular carcinoma every 2 months and MMC-5-FU was injected for liver metastasis of colorectal carcinoma every one or two weeks. Complications of this procedure in every 2 cases of reservoir infection proved to be catheter obstruction and hepatic artery obstruction. In the process of this treatment, we observed 3 recurrences in residual liver of hepatocellular carcinoma and one case of peritoneal dissemination and 3 recurrences in residual liver of liver metastasis of colorectal carcinoma. All are still alive.
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PMID:[Usefulness of subcutaneously implanted reservoir for postoperative therapy in hepatocellular carcinoma and liver metastases of colorectal carcinoma]. 255 Dec 21

In 24 cases of unresectable hepatocellular carcinoma, we performed hepatic arterial catheterization and intra-arterial infusion chemotherapy. Adriamycin (ADM), Mitomycin C (MMC), 5-FU and Lipiodol (LPD) were administered an average of 13.5 times over a mean period of 106 days. Except for 5 unevaluable cases, there were 0 CR, 5 PR, 4 MR, 7 NC and 2 PD cases, for an efficiency rate of 27.8%. Complications thought to be due to the catheter included catheter blockade in 1 case (4.3%) and dermal infection of insertion site in 3 cases (13.0%). As for the results of follow-up study, one-year survival rate with this therapy was 47.8%, which compares favorably with a one-year survival rate of 30.0% in 30 cases treated only with TAE. From the above results, hepatic arterial infusion chemotherapy can be repeatedly performed on an outpatient basis, and it is considered to be a useful therapeutic method for treating unresectable hepatocellular carcinoma.
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PMID:[Hepatic arterial infusion chemotherapy of hepatocellular carcinoma]. 255 Dec 22

We report a long-term survival case of recurrent hepatocellular carcinoma (HCC). A 40-year-old woman suffering advanced HCC underwent right hepatic tri-segmentectomy. After the surgery, HCC recurred in the remnant liver and lung. An arterial infusion of Lipiodol emulsion of anti-cancer agents and regional hyperthermia therapy were repeatedly performed. Administration of FT and PSK were also started. After this combined therapy, AFP levels decreased and recurrent lesions in the liver as well as pulmonary metastases disappeared on image studies. The patient is doing well 4 and half years later with no evidence of recurrence.
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PMID:[A case of recurrent hepatocellular carcinoma successfully treated by arterial chemoembolization in combination with local hyperthermia]. 255 Dec 34


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