Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We performed a clinical evaluation of repeated arterial infusion chemotherapy using an implantable drug delivery system for 41 patients with inoperable hepatocellular carcinoma (HCC). About half of our patients could not undergo transcatheter arterial embolization (TAE) because of extreme tumor extension and/or accompanying advanced cirrhosis. In most patients we implanted a 5 Fr. catheter non-surgically and connected it to an implanted injection port through a subcutaneous tunnel. The treatment schedule was weekly or biweekly intrahepatic one-shot administration of mitomycin C, adriamycin, 5-fluorouracil and epirubicin. The response rate (CR + PR) was 24.4%. The median survival period was 401.1 days. The 6 month, 1-year and 2-year survival rates were 73%, 48% and 24%, respectively. There were no severe side effects nor complications. The implantable drug delivery system will contribute not only to improved therapeutic efficacy for inoperable HCC but also improve the quality of life for patients.
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PMID:[Repeated arterial infusion chemotherapy for inoperable hepatocellular carcinoma using implantable drug delivery system]. 133 26

Of the 692 patients with hepatocellular carcinoma (HCC) who were admitted to our hospital between 1976 and 1990, 60 (8.8%) had small HCC with a maximal diameter of below 2 cm. The outcome of these 60 cases was analyzed after they had been divided into 4 groups based on the therapeutic method used: operation group (17 cases), percutaneous ethanol injection therapy (PEIT) group (20 cases), transcatheter arterial embolization (TAE) group (13 cases), and oral anticancer drug therapy (per os) group (10 cases). The 1-, 2-, 3-, 4-, and 5-year survival values obtained for the operation group (100%, 87.5%, 87.5%, 87.5%, and 87.5%, respectively) were significantly higher than those found for the per os group (P < 0.01). The best therapeutic results were achieved in the operation group. Although the follow-up period for the PEIT group was short, the 2-year survival of this group was nearly equal to that of the operation group. Whereas the duration of survival tended to increase in inverse proportion to the severity of the underlying liver cirrhosis, the survival values did not differ between solitary and multiple tumors or among the different histological grades of HCC. In this series, 20 patients died; 9 deaths (45.0%) were due to progressive disease and 3 deaths (15.0%) were attributed to hepatic failure. Because the operation group included many patients who displayed relatively good liver function, we cannot rule out the possibility that their excellent outcome may have been associated with this background factor. Therefore, further prospective investigation is necessary to compare the efficacy of various therapies in patient groups with a homogeneous background.
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PMID:Treatment of small hepatocellular carcinoma. 133 4

A 69-year-old woman was diagnosed as having hepatocellular carcinoma (HCC) with liver cirrhosis in October, 1984 and treated by transcatheter arterial embolization (TAE). In June, 1990 she was found to have a huge mass in the left hypochondrium which ultrasonography and computed tomography (CT) scan revealed to be a lett adrenal mass. A 99mTc pyridoxyl-5-methyl tryptophan (99mTC-PMT) hepatobiliary scintigraphy was positive and confirmed metastatic HCC. Although the adrenal mass was large, the HCC itself was controlled well with TAE. The adrenal mass was removed surgically in July, 1990 and the histological findings were compatible with HCC metastasized to the adrenal gland.
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PMID:Establishing a diagnosis of adrenal metastasis from hepatocellular carcinoma by 99mTc-PMT hepatobiliary scintigraphy. 133 13

In 40 patients with small hepatocellular carcinoma, the lesions were less than 5 cm in diameter, with a mean diameter of 3.4 +/- 1.1 cm. The smallest was 1.1 x 1.3 cm. 39 patients were first detected by ultrasonic scanning, and one was discovered during emergency operation because of spontaneous tumor rupture. 36 patients were treated by means of hepatic resection. One (2.7%) died within 30 days after operation. Four patients with severe hepatic cirrhosis and significant prolongation of prothrombin time (4 seconds over control) were subjected to selective transcatheter arterial embolization combined with transcatheter arterial infusion of chemotherapeutic agent. The diagnosis and treatment of small hepatocellular carcinoma was discussed.
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PMID:[Small hepatocellular carcinoma. Diagnosis and treatment of 40 cases]. 133 11

Total hepatic blood flow and portal blood flow were measured separately using a modified xenon 133 clearance method during angiography in 71 patients with chronic liver diseases, including 40 with proven hepatocellular carcinoma, and in 12 patients without detectable chronic liver injury who served as controls. Total hepatic and portal blood flow rates in controls were 805 +/- 149 ml/min and 667 +/- 206 ml/min, respectively. Total hepatic blood flow was significantly decreased in patients with compensated and decompensated liver cirrhosis (519 +/- 156 ml/min and 317 +/- 153 ml/min, respectively; P less than 0.01), as was portal blood flow (399 +/- 134 ml/min and 271 +/- 134 ml/min, respectively; P less than 0.01). Following transcatheter arterial embolization or hepatic resection (in 35 and 13 patients, respectively), hepatic failure occurred in 3 cases each. Embolization appeared contraindicated when hepatic portal blood flow was under 125 ml/min, and safe hepatic resection required an anticipated residual hepatic portal blood flow of at least 250 ml/min.
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PMID:Clinical significance of the measurement of hepatic blood flow using xenon 133 and balloon catheter in patients undergoing treatment for hepatocellular carcinoma. 164 53

The results of hepatectomy, percutaneous ethanol injection therapy and transcatheter arterial embolization for small hepatocellular carcinoma (HCC) of 3 cm or less in diameter from the published literature were compared with the authors' experiences with surgical treatment. The survival rates for those treated by hepatectomy and ethanol injection were almost the same, being more than 90% at 1 year and 70% at 3 years. The overall results achieved by embolization were inferior to those achieved by the other two therapeutic modalities, although the 1 year survival rate was not worse. The cancer-free survival rates after hepatectomy and ethanol injection were also similar. Most of the patients with small HCC had associated liver cirrhosis or chronic active hepatitis, but the degree of liver dysfunction and the level of hepatic reserve varied. Anatomically, the number, size, and location of the cancer also varies. Choice of treatment for small HCC should be made based upon the degree of liver function and the anatomic status of the cancer. For example, a patient with multiple (more than four) cancer nodules is a good candidate for embolization. Ethanol injection is indicated for a small HCC, deeply seated in a severely diseased liver. Hepatectomy is the first choice for a small HCC situated near the surface of a liver with relatively good liver function.
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PMID:Choice of treatments for small hepatocellular carcinoma: hepatectomy, embolization or ethanol injection. 165

One hundred fifty-eight patients with hepatocellular carcinoma (HCC) were treated by transcatheter arterial embolization (TAE) as repeatedly as possible. Survival rates at the end of the first, second, and third year were 76.5%, 54.5%, and 41.1%, respectively. In 142 patients with repeated TAE, a significantly increased number of patients with complete necrosis of tumor was observed after repetition of the therapy. Adjusting the imbalance in prognostic factors among patients by using Cox proportional hazard model, it proved that the best response during the repeated therapy, rather than the first response, was significantly associated with survival period of the patients. Aside from the factor of response to the treatment, tumor size was the worst prognostic factor at the time when diagnosis was made. Other significant factors were portal vein invasion by HCC and bilirubin. The survival period of patients with HCC treated by repeated TAE was, therefore, affected by cancer factors, liver cirrhosis factors, and therapy-responsiveness factors. It is concluded that even if complete necrosis of tumor is not obtained after the first trial, repetition of TAE is an effective measure for prolonging of survival time in patients with HCC.
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PMID:Effect of repeated transcatheter arterial embolization on the survival time in patients with hepatocellular carcinoma. An analysis by the Cox proportional hazard model. 165 2

The changes in the plasma level of PIVKA-II (Protein Induced by Vitamin K Absence or Antagonist-II) following the treatment or progress of the disease was studied in 60 patients with hepatocellular carcinoma. The positivity rate determined by the changes in PIVKA-II was 58.4 percent (35/60 cases) and was about the same as those reported so far, all of which were obtained by a single determination of PIVKA-II. Plasma PIVKA-II was elevated in 61.9 percent (13/21 cases) of alpha-fetoprotein negative patients and it was almost identical with the overall positivity rate. In parallel with serum alpha-fetoprotein, the plasma level of PIVKA-II was decreased after the surgery or transcatheter arterial embolization and was increased when the recurrence or progress of the disease was observed. Furthermore, the nonspecific elevation of PIVKA-II due to the associated liver cirrhosis or chronic hepatitis was infrequent compared with that of alpha-fetoprotein. In 18 cases positive with both PIVKA-II and alpha-fetoprotein, a close correlation (R = 0.91) was observed between the changes of these markers during the progress or treatment of the disease. Thus, it was suggested that determination of PIVKA-II in blood might be useful not only in the diagnosis but in monitoring the progress or the effectiveness of treatments in hepatocellular carcinoma.
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PMID:[The clinical significance of PIVKA-II determination in patients with hepatocellular carcinoma: a comparative study with alpha-fetoprotein]. 169 80

Detection of hypercoagulable state might be helpful in the diagnosis of primary hepatocellular carcinoma (HCC) complicating liver cirrhosis (LC). Plasma levels of thrombin-antithrombin III complex (TAT) were determined in 50 patients of LC with or without HCC. The levels were above 2 ng/ml in 80% of 25 HCC patients, but only in 12% of 25 non-HCC patients (P less than 0.01). The levels over 2 ng/ml occurred even in five of six HCC patients whose serum alpha-fetoprotein levels were below 20 ng/ml as well as in two of three patients with HCC less than 2 cm in diameter. Those levels in HCC patients were significantly decreased within 8 days after treatment with transcatheter arterial embolization or infusion of antitumor agents, without affecting plasma antithrombin III levels. These results suggest that plasma TAT levels may be useful in the diagnosis of HCC complicating LC.
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PMID:Plasma thrombin-antithrombin III complexes in the diagnosis of primary hepatocellular carcinoma complicating liver cirrhosis. 184 49

A 63-year-old male patient with compensated cirrhosis underwent transcatheter arterial embolization (TAE) and percutaneous ethanol injection therapy (PEIT) for a minute hepatocellular carcinoma (HCC). Although the HCC was successfully treated, esophageal varices worsened and refractory ascites developed 3 months after the TAE and PEIT. Liver atrophy progressed rapidly compared to the natural course of liver cirrhosis.
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PMID:Liver atrophy after transcatheter arterial embolization and percutaneous ethanol injection therapy for a minute hepatocellular carcinoma. 184 52


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