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

Recurrent epistaxis is a common manifestation of patients with a bleeding diathesis. Two patients with epistaxis secondary to a bleeding diathesis managed by local conservative techniques are reviewed. (A case of polycythemia vera and a case of liver failure secondary to hepatoma are reviewed.) Recently bilateral, percutaneous carotid angiography examination was performed on a patient with a bleeding diathesis and intractable epistaxis. At the time of the angiographic examination, embolization of both internal maxillary arteries with Gelfoam particles was accomplished and dramatic control of the epistaxis was achieved. In a patient with severe epistaxis secondary to a bleeding diathesis that is unresponsive to local measures, percutaneous Gelfoam embolization offers substantial advantages over surgical intervention.
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PMID:Percutaneous embolization to control intractable epistaxis. 48 Oct 44

A total of 100 patients with histologically proven hepatocellular carcinoma (HCC) underwent transcatheter arterial chemoembolization (TACE) and were followed for more than 1 year and 10 months. Portal vein branch thrombosis was diagnosed in 14 patients, and extrahepatic metastasis was noted in 11 subjects. The embolization material used was iodized oil (0.1-0.2 ml/cm tumor area at its maximal diameter), which was prepared by pumping with contrast agent and then mixed with anticancer drugs; Gelfoam particles measuring 1-2 mm in size were subsequently injected. The overall cumulative 0.5- 1-, 2-, and 3-year survival rates were 81%, 57%, 31%, and 21%, respectively. Patients with an intact capsule and those with solitary lesions, especially when the tumor diameter was < 5 cm, achieved a higher survival rate. In contrast, incomplete TACE, extrahepatic metastasis, and portal vein thrombosis were associated with the worst outcome. Patients with positive HBsAG and diffuse or multiple tumors also showed a poor outcome. Early diagnosis and early treatment of HCC are the keys for the achievement of better clinical results.
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PMID:Treatment of hepatocellular carcinoma by transcatheter arterial chemoembolization and analysis of prognostic factors. 128 Oct 48

Chemoembolization is an effective treatment for hepatocellular carcinoma, giving results equally as good as surgical therapy for T2 tumours. Survival can be prolonged and side-effects can be reduced by combining Lipiodol and Gelfoam for chemoembolization, employing a modified technique, with repeated procedures, and using appropriate follow-up treatment. The toxicity of the procedure is acceptable, but it requires supportive therapy necessitating an intense interdisciplinary co-operation.
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PMID:[Chemoembolization of hepatocellular carcinoma in cases of isolated liver involvement]. 131

The therapeutic results of Lp-TAE (transcatheter arterial embolization in the presence or absence of Gelfoam particles preceded by the infusion of a mixture of lipiodol and an anticancer drug via the proper hepatic artery) or DSM-TAE (transcatheter arterial embolization with degradable starch microspheres and the arterial injection of anticancer drugs via the hepatic artery) combined with hyperthermia were evaluated in 30 patients with hepatocellular carcinoma (HCC), 5 subjects with hepatic cholangiocarcinoma, and 22 patients with metastatic liver carcinoma. Hyperthermia was performed using an 8-MHz Thermotron RF-8. Tumor temperatures could be measured in 31 patients (54.4%) with malignant lesions of the liver who had undergone hyperthermia. The mean maximal temperature (Tmax) was 41.5 degrees C in the metastatic liver cancers. The efficiency of heating in HCC was unfavorable, i.e., the mean Tmax was only 40.7 degrees C. The rise in tumor temperature was greater in either HCC or metastatic liver carcinoma associated with portal invasion of the lesion. The tumor-temperature elevation was also excellent in HCC that had been subjected to embolization with DSM in combination with hyperthermia. The response rate (complete response plus partial response) was as high as 40% (4/10) in the group in which the tumor temperature could be raised to 42 degrees C or more. Among the 52 patients who had shown a high pretreatment level of tumor marker, that value decreased in 34 cases (65.4%), and the decrease was greater than 50% in 22 cases (42.3%).
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PMID:Effects of multimodal treatment and hyperthermia on hepatic tumors. 133 97

In the present study, we compared the survival of patients with multi tumor hepatocellular carcinoma (HCC) following their treatment with liver resection versus TAE. A total of 336 HCC patients were treated at Osaka University Hospital between 1980 and 1989. Of these, 140 patients underwent liver resection in the presence or absence of TAE and 173 subjects were treated with TAE alone. Our TAE protocol consisted of 50 mg Adriamycin, 3-5 ml lipiodol, and Gelfoam. The 1-, 3-, and 5-year survival values found for the liver resection group were 87.4%, 66.0%, and 47.4%, respectively, whereas the values calculated for the TAE group were 64.6%, 29.9%, and 15.8%, respectively. The survival of patients in the resection group was clearly better than that of subjects in the TAE group. Of the 140 patients who underwent resection, 36 cases were proven to have multiple lesions by histopathological examination. The 1- and 3-year survival values determined for this special group were 67.9% and 33.3%, respectively. Of the TAE cases, 113 were diagnosed as having multiple lesions by imaging examination, and their 1- and 3-year survival values were 59.7% and 24.9%, respectively. No significant differences in survival was found between these two different treatment modalities for these multiple-lesion cases. The results of this study indicate that it is unlikely that surgical resection is superior to TAE alone for the treatment of HCC patients with multiple lesions.
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PMID:Selection of therapeutic modalities for hepatocellular carcinoma in patients with multiple hepatic lesions. 133 7

When lipiodol is injected into the hepatic artery at a dose exceeding a certain level, it flows into the portal vein. On the basis of this feature, an emulsion of Adriamycin with lipiodol was injected into a segmental or subsegmental artery such that it was delivered to the portal vein of the same segment, and the artery was then embolized with Gelfoam. This segmental arterioportal chemoembolization (cement therapy) was performed in 50 patients with localized hepatocellular carcinoma. A posttreatment CT scan showed that almost 100% of the lesions were occupied by lipiodol. The cumulative survival values determined for the 50 patients were very high: 83.4% after 1 year and 62.7% after 2 years.
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PMID:Outcome of localized hepatocellular carcinoma treated with segmental arterioportal chemoembolization. 133 11

The effectiveness of Lipiodol (iodized oil) in transcatheter arterial embolization (TAE) of hepatocellular carcinoma (HCC) was retrospectively evaluated using statistical analysis. A total of 343 HCC patients who underwent TAE at 5 institutions between 1984 and 1989 were divided into 2 groups: the GS-TAE group underwent TAE with Gelfoam sponge alone, whereas the LP-TAE group was given Lipiodol (LP) immediately before GS-TAE. The statistical T value calculated for the LP-TAE group showed that the administration of LP, the tumor size, intrahepatic metastasis, portal vein infiltration, and serum total bilirubin and alpha-fetoprotein levels significantly (P < 0.01) affected the patients' survival. Both the cumulative survival determined using the Kaplan-Meier model and the cumulative hazard calculated using Cox's proportional hazard model differed significantly (P < 0.01) between the GS-TAE group and the LP-TAE group (log-rank test). These results confirmed the effectiveness of LP used in combination with Gelfoam sponge for TAE of HCC.
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PMID:Effectiveness of Lipiodol in transcatheter arterial embolization of hepatocellular carcinoma. 133 13

To investigate therapeutic strategies for hepatoma, it is necessary to have a reproducible animal model with a tumor growth pattern allowing accurate assessment of results. Many techniques of intrahepatic tumor implantation (IHTI) have been devised for intrahepatic tumor models. Most of them, however, have the disadvantage of high rates of artificial tumor dissemination during tumor implantation, which interferes with the evaluation of therapy. To overcome this problem, we have developed a technique of IHTI in which a piece of Gelfoam is placed into a small incision in the liver for the purpose of both hemostasis and formation of a tension-free pocket to accept the tumor implant. In 583 ACI rats receiving IHTI with Morris hepatoma 3924A, the tumor take rate was 100%. Resembling the natural course of human hepatoma, the implanted tumor grows locally early in the course of disease and eventually invades the surrounding organs causing ascites and also metastasizes to the lung. Liver microangiography demonstrated that the tumor received blood supply mainly from the hepatic artery. This IHTI technique was also compared to two other methods of IHTI: insertion of fragments without using Gelfoam and implantation with a tumor cell suspension. A significantly lower rate of early lung metastases was achieved with our technique (0%) in comparison with other two techniques (41 and 80%). We conclude that this rat liver cancer model is reproducible and allows efficient evaluation of treatment modalities for liver cancer without interference from tumor at undesirable sites.
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PMID:A reproducible rat liver cancer model for experimental therapy: introducing a technique of intrahepatic tumor implantation. 153 93

A patient having a large hepatocellular carcinoma with an accompanying tumor thrombus in the right main branch of the portal vein and arterioportal shunting was treated with transcatheter oily chemoembolization with adriamycin emulsion in Lipiodol plus Gelfoam. The whole right hepatic lobe regressed together with the tumor, and the tumor thrombus in the portal vein disappeared. The patient is still alive more than seven years after the treatment, with normal levels of alpha-fetoprotein. The response of this patient is interesting in discussing potential indications for therapy.
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PMID:Transcatheter oily chemoembolization for the treatment of large hepatocellular carcinoma with an accompanying tumor thrombus in the right main branch of the portal vein and arterioportal shunting: report of one patient still surviving after more than seven years. 165 85

Hepatic biloma (bile cyst) developed in a patient after transcatheter oily chemoembolization (TOCE) with Lipiodol for hepatocellular carcinoma. The patient was treated conservatively and underwent the next TOCE uneventfully. An inappropriately large dose of Lipiodol, anticancer agent, and Gelfoam can induce biloma; however, it is not reasonable to abstain from TOCE for hepatocellular carcinoma in fear of biloma.
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PMID:Biloma following transcatheter oily chemoembolization. 165 54


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