Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 177 patients with recurrent colorectal cancer treated at the Massachusetts General Hospital is examined retrospectively. Two thirds of recurrences were observed by the second postoperative year, and 15% of patients were asymptomatic. Pelvic recurrences were usually attributable to rectal or sigmoid tumors, whereas right-sided carcinomas frequently spread to the liver. The commonest methods of clinical discovery of recurrence included findings of abdominal and pelvic masses, hepatomegaly, and positive chest films. The average survival after discovery of recurrence was only eleven months, but 23 patients having reresections for cure lived an average of thirty-three months. Seven patients (30%) undergoing reresection for cure represented probable cures. Chemotherapy with intravenous 5-FU provided poor palliation, but radiotherapy gave satisfactory relief of symptoms in approximately 50% of patients, particularly those with rectal or low colon lesions. A program of follow-up is offered since there is evidence that even the symptomatic patient may be well palliated or even cured by surgical resection of the recurrence or palliative therapy.
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PMID:Detection and treatment of recurrent cancer of the colon and rectum. 63 96

This radomized double-blind study was designed to compare the therapeutic effectiveness of the oral and i.v. routes for 5-FU administered in intensive courses to 100 patients with metastatic adenocarcinoma of the large bowel, treated to equivalent levels of toxicity. An oral dose of 20 mg/kg day times 5 was found to produce comparable G.I., mucocutaneous, and hematologic side effects to a dose of 13.5 mg/kg day times 5 by rapid i.v. injection. Courses were repeated at 5 weeks. Nine of 47, or 19.1%, treated by the oral route have shown objective response, compared to 14 of 53, or 26%, treated by the i.v. route. If malignant hepatomegaly is considered alone, the response rates are 8 of 23, or 34.8%, by the oral route, and 7 of 22, or 31.8%, by the i.v. route. The mean duration of response for the oral group, 11.1 weeks, was shorter than for the i.v. route, 20 weeks, a statistically significant (p less than 0.02) difference. Serial serum 5-FU levels after two doses of 5-FU were determined by microbiological assay in 19 patients. For i.v. administration the curves were comparable among different patients as well as in the same patient. There was striking variability, however, for oral administration.
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PMID:A double-blind comparison of intensive course 5-flourouracil by oral vs. intravenous route in the treatment of colorectal carcinoma. 109 Mar 58

From 1970 to 1987, a total of 112 patients underwent regional chemotherapy as primary treatment of colorectal liver metastases. 68 patients received 250-750 mg 5-FU 2-3 times per week via external devices, 40 patients with port catheters had 5-day courses of Mitomycin C (8 mg/m2/day 1) and 5-FU (600 mg/m2/day 1-5) at 4 week intervals, and four patients were treated with FUDR (0.2 mg/m2/day 1-14/28) using an Infusaid pump. Median and maximum survival were 13.2 and 58 months, respectively. The overall response rate in patients suitable to imaging criteria who underwent treatment for more than three months and was 83% (CR 14%, PR 40%, SD 29%). The influence of various factors on Kaplan/Meier survival was checked the Logrank test. Response to treatment was of superior importance (p = 0.0000016), but hepatomegaly, Karnofski index, the percentage of liver volume replaced by tumour, and various liver related biochemical tests were also highly significant prognostic determinants (p greater than 0.01). There was no difference between external and fully implantable devices. A subgroup of 68 patients without extrahepatic disease, treatment of more than three months was retrospectively compared to 121 untreated patients with a similar stage of disease. There was no obvious effect of regional chemotherapy on survival (p = 0.16). Although the untreated patients consist a historical control group only, this result indicates that regional chemotherapy must continuously be restricted to well prospective clinical trials.
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PMID:[Regional chemotherapy of diffuse liver metastases of colorectal cancer]. 183 15

Twenty Malaysian patients with unresectable primary liver cell cancer were prospectively studied at the General Hospital, Kuala Lampur, and were compared for clinical features with an equal number each of African and American patients being studied by the Eastern Cooperative Oncology Group. The patients received intravenous 5-FU and oral MeCCNU which was used for the first time in an Asian country. Most of the Malaysian patients were Chinese, belonged to younger age groups, and presented with massive hepatomegaly, jaundice, and fever. Toxicity to MeCCNU invariably occurred in the form of leukopenia or thrombocytopenia, but none life threatening. Partial response was seen in 20% of Malaysians as compared to 16% in Americans and none in Africans. Malaysians achieved a median survival of 16 weeks compared to 28 weeks in Americans and only eight weeks in Africans. Malaysian Chinese patients were all HBc Ab + ve. Other factors which may have played an etiologic role in the induction of primary liver cancer included alcohol, Chinese herbal medicines, aflatoxin and habitual use of medicated rubbing oils.
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PMID:Clinical and chemotherapeutic study of hepatocellular carcinoma in Malaysia: a comparison with African and American patients. 628 85

Five-fluorouracil (5-FU) has become the standard chemotherapeutic agent for the treatment of advanced colorectal carcinoma. It has been used as a single agent and in combination with other chemotherapeutic agents for the treatment of advanced disease. Conflicting experiences have been reported with all these therapeutic programs and a review of these studies reveals failure to take into consideration the factors determining survival and response. These factors consist of performance status, weight loss, hepatomegaly, previous chemotherapy treatment, prior radiotherapy treatment, and resected versus unresected primaries. The purpose of this study is to examine the various claims for therapeutic efficacy of drugs used in all stages of colorectal carcinoma. This will consist of a review of single agent systemic chemotherapy for advanced colorectal carcinoma, combination chemotherapy for advanced colorectal carcinoma, regional infusion, and adjuvant chemotherapy following curative resection.
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PMID:An analysis of chemotherapy for colorectal carcinoma. 636 78

A 50-year-old man with gallbladder cancer was treated by extended cholecystectomy and regional lymph node dissection. At 13 months after surgery, CEA showed high serum levels, and an enlarged liver tumor due to recurrence was demonstrated by computed tomography. After arterial infusion chemotherapy consisting of CDDP, epirubicin and 5-FU, the tumor size and serum level of CEA were significantly decreased. After this therapy and transcatheter arterial embolization, the liver tumor markedly responded and became undetectable. It was suggested that this therapy was effective for gallbladder cancer.
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PMID:[A case of recurrent gallbladder cancer with marked response to arterial infusion chemotherapy and transarterial embolization]. 902 Sep 52

A 68 year old Ecuadorian man was investigated for polyuria, polydipsia and weight loss of 3 kg during the previous two months. Insulin dependent diabetes mellitus was diagnosed 10 year before admission and treated with appropriate diet and insulin (35 U/d). 18 months before was diagnosed in El Ecuador of "multiple liver nodes non-suggestive of malignancy". Physical examination showed a large multinodular petrous hepatomegaly. There was no evidence of skin lesions. Results of laboratory studies included a basal plasma glucose level that ranged between 275-367 mg/dl (N=60-100), glycosylated haemoglobin of 8.9% (N<5) and a serum albumin of 2.8 gr./dl (N=3.4-4.8). At admission non-other laboratory alterations were detected. Computed tomography showed a mass on the head of the pancreas with loco-regional lymph nodes and liver metastases. Tumor markers were normal. Fine-needle aspiration cytology of the liver masses revealed the presence of liver metastases of a non-differentiated malignant tumor. A 111In-DTPAOC scintigraphy revealed the presence of somatostatin receptors in the liver metastases, also detecting the presence of multiple bone metastases in the axial and appendicular skeleton. Plasma glucagon level was 678 pg/ml (N<250). A diagnosis of metastatic glucagonoma was established and therapy with streptozocin, 5-FU, insulin and synthetic somatostatin analogs was initiated. Three months after the therapy initiation the patient was symptom free. Some weeks after the patient suffered from left hip pain, and a control 111In-DTPA scintigraphy showed progression of his bone metastases. In conclusion, glucagonoma must be suspected in all diabetic patients with metastatic liver, even in absence of necrotic migratory erythema. In these circumstances, plasmatic glucagon level and somatostatin receptors scintigraphy will be a useful tool for establishing the final diagnosis.
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PMID:[Diabetes mellitus and pancreatic tumor]. 1471 49

This was an extraordinary liver metastasis case with complication when the patient, a 70-year-old male, was diagnosed with stomach cancer for the first time. However, the patient has been in remission and is a long-term survivor due to an active chemotherapy after the operation. His chief complaints were stomachache and a loss of weight. He was diagnosed with stomach cancer by endoscopy. During the surgery, the mass was found to be 3 QFB palpable caused from hepatomegaly. The liver dysfunction was revealed in the blood biochemistry inspection. The abdominal CT revealed that the stomach cancer had spread to the whole liver. Distal gastrectomy was performed on May 22, 1997. In pathological findings, the tumor was diagnosed as a well-differentiated adenocarcinoma. Final findings: M, type3, T3 (SE), N2, H3, P0, CY0, and Stage IVb. The 5-FU based chemotherapy was performed and a complete response was temporarily obtained. However, it has recurred one year later and two or more kinds of chemotherapy have continued. He is alive for more than 7 years and comes to our hospital as an outpatient.
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PMID:[A case of gastric cancer with extraordinary liver metastasis effectively treated by adjuvant chemotherapy]. 1555 82