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 authors studied on SCC antigen in patients with esophageal carcinoma. Serum SCC antigen was found in 9 (40.9%) of 22 patients with esophageal squamous cell carcinoma and 5 (55.5%) of 9 patients with lung squamous cell carcinoma, but was not found in other malignant diseases, such as gastric cancer, hepatoma, colon cancer, pancreas cancer and biliary try tract cancer. SCC antigen positive cases increased in association with progression of histological invasion, grade of nodal metastasis and clinical stage. However, in early esophageal carcinoma, SCC antigen was rarely positive. There was no positive case in patients with poorly differentiated squamous cell carcinoma regardless of clinical stage. Positive rate of SCC antigen increased in association with progression of clinical stage in patients with moderately and well differentiated squamous cell carcinoma. Immunoreactivity of SCC, which was investigated immunohistologically with TA-4 rabbit serum, was not found in cases with poorly differentiated squamous cell carcinoma, but was found in keratinized portion and cytoplasm of moderately and well differentiated carcinoma. From the above, SCC antigen is intimately related with keratinization of squamous cell carcinoma, and it was thought that it could be useful as a good marker for diagnosis of moderately and well differentiated squamous carcinoma of the esophagus.
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PMID:[Studies on antigen associated with human squamous cell carcinoma (SCC antigen) in patients with esophageal carcinoma]. 274 8

To further define the clinicopathologic features and determinants of survival, we reviewed the cases of 110 patients with primary hepatic malignancy managed surgically between 1975 and 1986. Presenting signs of symptoms were pain (57%), fatigue (48%), abdominal mass (40%), and weight loss (33%). Twenty-six percent of patients had a history of hepatitis or cirrhosis. Histopathologically, tumors were hepatocarcinoma (72%), fibrolamellar variant (7%), cholangiocarcinoma (9%), mixed (7%), and other (5%). Resectability rate with curative intention was 67%. Exploration and biopsy alone was performed in 27% and palliative resection in 6%. Hospital mortality was 9%, and serious morbidity was 22%. Perioperative morbidity and mortality were significantly associated with operative blood loss. Median survival was 12.6 months, with a 5-year survival of 18%. Median survival after curative resection was 22.8 months, and 5-year survival was 27%. Univariate analysis showed that female sex, normal performance status, well-differentiated tumor, and curative resection were associated with increased survival; cholangiocarcinoma, nodal metastases, cirrhosis, hypocalcemia, prolonged prothrombin time, and increased serum transaminase and alkaline phosphatase were associated with decreased survival. Cox multivariate analysis showed that curative resection, normal performance status, and well-differentiated tumors were associated with increased survival, and prolonged prothrombin time and hypocalcemia were associated with decreased survival.
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PMID:Primary hepatic malignancy: surgical management and determinants of survival. 279 50

In the West, Kaposi's sarcoma and non-Hodgkin's lymphoma have been closely associated with HIV-induced immunosuppression. To date, however, there has been no published account of the impact of HIV infection upon malignancies prevalent in Africa where the HIV epidemic is widespread. The authors describe the pattern of malignant disorders among adult indigenous Zambians over the period 1980-89 in the attempt to discern the impact of HIV infection upon the prevailing malignancies. Histopathological and hematology records of 7836 neoplasms seen during 1980-89 at the University Teaching Hospital in Lusaka, Zambia, were analyzed. The crude incidence rate of each malignancy per 100,000 adults per year was calculated and the patterns of malignancies compared for the periods 1980-83 and 1984-89. The latter period corresponds to the advent of the HIV epidemic. Carcinoma of the cervix, Kaposi's sarcoma, bladder carcinoma, hepatoma, lymphoma, and carcinoma of the breast were the six most commonly observed tumors, occurring, respectively, among 19.6%, 7%, 6.3%, 5.8%, 4.6%, and 4.4% of cases. The crude incidence rates of Kaposi's sarcoma and carcinoma of the breast increased significantly during the last six years of the study period, with nodal KS exhibiting the most significant rise from a crude incidence rate of 0.25 per 100,000 adults per year during 1980-83 to 1.11 during 1984-89. In contrast to findings from Europe and the US, no significant increase in non-Hodgkin's lymphoma was detected in Zambia following the arrival of the HIV epidemic.
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PMID:Pattern of adult malignancies in Zambia (1980-1989) in light of the human immunodeficiency virus type 1 epidemic. 763 27

One hundred and fourteen consecutive patients with unresectable hepatocellular carcinoma were treated by chemoembolization using ethiodized oil (Lipiodol), anticancer agents. Ninety patients had concomitant chronic liver disease. Hepatocellular carcinoma (HCC) was diagnosed by US, contrast enhanced CT, fine needle biopsy and alpha-feto-protein level. Admission criteria were as follows: tumor confined to the liver with or without hilar nodal involvement, Child class A or B, white blood cell count above 2.000/mmc and platelet count above 75,000/mmc. All the patients underwent angiographic chemoembolization with Lipiodol and anticancer agents. In 98 patients we performed transcatheter hepatic arterial embolization (TAE) with Gelfoam or for Ivalon sponge. In 16 patients TAE was not performed because of portal thrombosis (7 cases) or technical reasons (9 cases). Mitomycin was used in 40 patients and dihydroxyanthracenedione (DADH) in 58 patients. In the TAE group 83 patients were Child A and 15 Child B. In 27 patients HCC was mononodular whereas in 71 it was multinodular. In 41 patients the tumor was more than 5 cm in diameter (in multinodular tumors only the larger lesion was taken into account). In 56 patients chemoembolization plus TAE was repeated. Seven patients died within one month after treatment: two from myocardial infarction, two from liver failure, two from digestive haemorrhage and one from necrotizing pancreatitis. Long-term survival rates were investigated in relation to prognostic factors: anti-cancer agent, number of nodes, tumor size and Child stage using Kaplan-Meier method. Survival rate at 12, 24 and 36 months are 64%, 38%, and 30% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The treatment of hepatocellular carcinoma by chemoembolization]. 802 66

The western HCC registry comprised data from 322 patients who underwent hepatic resection for HCC over a 50-year period. The majority of patients had lesions > 4 cm and were symptomatic at presentation. Lesions were mostly unicentric. Cirrhosis was not a prevalent problem, unlike the East. In the most recent decade, 1980-1989, we noted a significant decrease in operative mortality from 19% to 10% overall, and 15% to 4% in the noncirrhotic group. We identified four variables that resulted in poorer postresectional outcome: cirrhosis, regional nodal disease, multicentric disease, and tumor-free resectional margin < 1 cm. Although these factors are associated with a poorer outcome after resection, whether they should serve as contraindications to surgery should be determined by individual surgeons, taking into account the patient's overall status, concomitant risk factors, and treatment objectives.
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PMID:Hepatoma registry of the Western world. Repeat Hepatic Resection Registry. 803 52

Twenty patients with either unresectable primary hepatocellular carcinoma or hepatic metastases were entered into a chemoembolization program with cisplatin and lipiodol; 19 patients were evaluable for response. Doses of cisplatin ranged from 40 to 100 mg/m2. Toxicity was tolerable and reversible and included abdominal pain, transient elevation in serum creatinine, serum bilirubin, and serum transaminases. Less common side effects include fever, ascites or pleural effusion, and hiccups. Two of four patients with ocular melanoma had partial responses. Duration of response was 10 and 11 months. Among 8 patients with unresectable hepatoma, 2 patients had partial response for 10+ and 13 months, 2 had minor response for 2 months and 4+ months, 1 patient had stable disease for 5+ months, and 3 patients failed to respond. Of the six colon cancer patients treated, one had a partial response in the liver, but developed progressive nodal disease, and another patient had a partial response for 3 months. Chemoembolization of the liver with cisplatin and lipiodol is feasible and doses of cisplatin at least 100 mg/m2 are tolerable. Antitumor activity in metastatic ocular melanoma is encouraging but requires further study.
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PMID:A phase I study of chemoembolization with cisplatin and lipiodol for primary and metastatic liver cancer. 809 12

Lymph node metastases at presentation are common in PTC and MTC (about one third of patients at presentation), but are rare in other types of thyroid malignancy, though HCC frequently recurs in lymph nodes. Nodal metastases can be detected by a variety of means, but high resolution ultrasonography may be the method of choice. Unlike other epithelial malignancies, in thyroid cancer neither prognostic significance nor optimal treatment of nodal metastasis are known with certainty. For PTC lymph node metastases at presentation do not seem to adversely affect survival, but do increase the risk of locoregional tumor recurrence. By contrast, in FTC nodal metastases at presentation may adversely affect cause-specific mortality, but because of their rarity definite conclusions are impossible. Except for the oxyphilic variant of FTC (HCC) nodal recurrence in FTC is rare. The most firm evidence of prognostic relevance for nodal metastases in thyroid malignancies exists in medullary thyroid cancer, where most studies suggest that survival and recurrence are both adversely affected by node-positive status at presentation. Primary treatment of nodal metastases is removal of macroscopically affected nodes at initial surgery, optionally supplemented with adjuvant radioiodine treatment in an attempt to reduce recurrence risk. The value, however, of postoperative radioiodine in preventing either nodal recurrence or cancer death in patients with papillary and follicular thyroid cancer remains controversial. Extensive lymph node dissection at presentation offers no advantage (and may cause increased morbidity) in papillary carcinoma, but may be useful in medullary thyroid carcinoma, where nodal metastases seem to increase the risk of cause-specific mortality. In all tumor types postoperative nodal recurrences should primarily be treated surgically.
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PMID:Thyroid cancer nodal metastases: biologic significance and therapeutic considerations. 878 93

During a 12-year period (1981-1992), 3,029 patients, including 220 with hepatocellular carcinoma (HCC), received their first orthotopic liver transplantation (OLTX) for various liver diseases. One-, three- and five-year survivals of these 220 patients with HCC were 68%, 46%, and 37%, respectively, and those of the 2,809 patients without HCC were 78%, 71%, and 67.0%, respectively. Among the 220 patients with HCC, the following factors were associated with a poor prognosis: multiple tumors, HCC in two lobes of the liver ("bilobar tumors"), micro- and macroscopic vascular invasion, lymph node metastasis, tumor within the surgical margin, Stage IV HCC, and male gender. Cirrhosis and detection of hepatitis B surface antigen (HBsAg) or antibody to hepatitis C virus (anti-HCV) did not influence the survival rates after OLTX in the presence of HCC. By multivariate analysis, the negative prognostic value of only vascular invasion, bilobar distribution, and lymph node metastasis reached significance. As vascular invasion of HCC was the most significant prognostic factor after OLTX, its incidence was examined according to the following three radiologic measurements of the HCC before operation: (1) size, (2) lobar distribution, and (3) number of HCC nodules. Fifty percent of the HCCs of greater than 5 cm diameter had macroscopic vascular invasion, and 1-, 3- and 5-year survivals of the patients with these HCCs were 60%, 30%, and 18%, respectively, after OLTX. Nearly 50% of the bilobar HCCs also had macroscopic vascular invasion, and 1-, 3- and 5-year survivals were 56%, 29%, and 15%, respectively, after OLTX. One-third of multiple tumors had macroscopic vascular invasion, and 1-, 3- and 5-year survivals were 64%, 38%, and 27%, respectively. However, survival after OLTX in patients with bilobar HCCs of < or = 2 cm diameter (even when these were Stage IV) was as good as in patients without HCC who had OLTX. The 5-year survival rate of the patients with unilobar, multiple HCCs without macroscopic vascular invasion, lymph node invasion and distant metastasis was 60%. These data indicate that HCCs of up to 5 cm diameter without macroscopic vascular invasion and nodal or distant metastasis can be effectively treated by OLTX.
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PMID:Survival after liver transplantation in patients with hepatocellular carcinoma. 887 33

Intrahepatic cholangiocarcinoma is an uncommon neoplasm of liver compared with hepatocellular carcinoma. Hepatic resection seems to provide the only chance for therapeutic success. The records of 77 patients with intrahepatic cholangiocarcinoma treated over a 28-year period were studied to determine demographics, clinical features, laboratory findings, diagnostic tests, operative management, and results of therapy. Survival was analyzed according to three treatment groups: conservative management, palliative operation, and hepatic resection. Conservative management was used for 15 patients, and hepatic resections were performed in 39 patients. The remaining 23 patients had laparotomy alone (10 patients), bile duct intubation (4 patients), hepatic artery ligation (3 patients), bilienteric bypass (3 patients), gastrojejunostomy (1 patient), insertion of a hepatic artery port for regional chemotherapy (1 patient), or open drainage of an abscess (1 patient). The median survival after conservative management, palliative operation, and hepatic resection were 1.8, 2.9, and, 12.2 months, respectively. After hepatic resection, patients without lymphatic permeation (p < 0.02) or hilar nodal metastases (p < 0.0003) survived significantly longer. We concluded that hepatic resection is indicated for intrahepatic cholangiocarcinoma when it is deemed resectable.
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PMID:Intrahepatic cholangiocarcinoma. 901 75

Cumulative recurrence after surgical resection for hepatocellular carcinoma (HCC) is very high. Several retrospective analyses have shown that liver transplantation was more effective than resection for patients with HCC at early tumor stages. Consequently, in January 1990, we decided to prospectively indicate orthotopic liver transplantation (OLT) as the first surgical treatment for small, localized HCC in cirrhotic patients without nodal involvement independently of the degree of liver function. The aim of this prospective cohort study was to analyze prognosis, recurrence rate, and survival after liver transplantation in patients in whom the main indication was HCC with cirrhosis. Thirty-eight patients in whom the main indication for liver transplantation was HCC and hepatic cirrhosis were compared with 136 transplantations because of cirrhosis without tumor, performed in our unit from January 1990 to December 1995. HCC arising in noncirrhotic livers and those incidently discovered after OLT were excluded from the study. Chemoembolization using doxorubicin, lipiodol, and Gelfoam was performed before OLT in 31 patients with good liver function. There were no differences in gender, but HCC patients were older (57 +/- 7 vs. 50 +/- 10 years [P < .001]). Liver function was better in HCC (Child-Pugh score: 6.9 +/- 2 vs. 8.6 +/- 1.8; P < .001), and hepatitis C virus antibody was positive in 31 (82%) vs. 51 (37%) (P < .007). Seven tumors had bilobar involvement (18%). Capsule was present in 22 (58%). The mean size of the tumor was 3.4 +/- 2 cm. Seventeen tumors (45%) were larger than 3 cm, and 4 (11%) were larger than 5 cm. The average number of nodules was 2 +/- 1. The tumor-node-metastasis stage of the tumors was pT1 in 6 patients (16%), 11 were pT2 (29%), 12 were pT3 (31%), and 9 were pT4 (24%). Seven patients were retransplanted in the HCC group (18%) and 19 (14%) in the nontumor group (not significant). Tumor recurrence was detected in three patients (8%). One, 3-, and 5-year survival rates were 82% vs. 79%, 75% vs. 71%, and 63% vs. 68%, respectively, for patients with and without HCC, and no differences were found between the two groups (P = .84). Survival was significantly reduced in patients with a macroscopic vascular invasion and tumors greater than 5 cm in diameter. Recurrence and mortality after liver transplantation in cirrhotic patients with carefully selected HCC are similar to the results in cirrhotic patients without tumor.
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PMID:Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. 918 72


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