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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

39 patients with metastases to the liver from colorectal cancer were treated with liver resection. The average survival time was 25 months. 11 patients are alive after 10 to 102 months. 18 patients had liver resection for primary liver cancer. The average survival time was 27 months. 4 patients are alive after 27 to 84 months. 16 patients had temporary dearterialisation for carcinoid. All the surviving patients were free from symptoms for at least 6 months.
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PMID:[New principles in liver surgery]. 712 51

During the past decade, one of the major changes in the field of oncology has been in the surgical approach to primary and secondary cancer of the liver. As a result of data and experience gained in liver transplantation programs and with the application of vascular surgical principles, resectability rates have been increased. The present rate of 32% has been achieved with an overall 30-day operative mortality rate of 9%. More sophisticated intraoperative and postoperative supports have been essential in achieving these results. The median operating time is now 4 3/4 hours in length. Complications are minimal. The median postoperative hospital stay is now 13 days. During the past decade, 436 patients with liver tumors were treated by the authors. It has become apparent in this experience and in that reported by others that an increasing number of patients with primary liver cancer or metastatic cancer in the liver can be cured by surgery with minimal operative risk. Adjuvant chemotherapy may increase the salvage rate. Current therapeutic results are best evaluated after staging of the liver disease: Stage I (no involvement of margins of resection, hepatic vascular structures or bile ducts; all gross disease removed): 85% three-year survival estimate, using the Kaplan-Meier method, for individuals with primary liver cancer; 71% for those with metastatic colorectal cancer. Stages II and III (regional or extrahepatic spread): 22% three-year survival for individuals with primary liver cancer but no survivors at two years with metastatic colorectal cancer. These data permit better selection of patients who are most likely to benefit from surgery.
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PMID:The seventies evolution in liver surgery for cancer. 722 10

In cases of metastatic cancer of the liver in rats, the effect of ligation of the hepatic artery (HAL) or portal vein (PVL) with or without intraportal chemotherapy with Mitomycin C (MMC) was studied in Experiment I. HAL or PVL alone and chemotherapy alone induced only a slight anti-cancer effect. The most striking effect was found in the group treated with HAL plus MMC. PVL plus MMC produced intermediate results. To evaluate which route, via the hepatic artery or portal vein, is more effective for the adjuvant chemotherapy after HAL, Experiment II was conducted on the rats with a minute and/or a rather advanced metastatic cancer of the liver. Chemotherapy with MMC by either route alone and HAL alone did not substantially prolong the survival time, irrespective of the tumor size. HAL plus chemotherapy via both routes produced a statistically longer survival time compared with the control, however, better results were obtained by intraarterial chemotherapy. When compared with the two groups treated by the same procedures but at the different times, the earlier treatments produced better results. In the light of the present studies, it can be concluded that if cytocidal drugs with dose independent effects are given in a single bolus, HAL in connection with intra-arterial chemotherapy is a beneficial modality for the treatment of nonresectable liver cancer.
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PMID:Experimental studies on the treatment of nonresectable liver cancer. 731 Nov 91

The results of treatment of metastatic brain tumours by radiosurgery are reported. Twenty cases including lung (11), colon (5), breast (1), ovary (1), liver cancer (1) and malignant melanoma (1) were involved. Seven cases had single and 13 had multiple brain metastases. In total 55 lesions were evaluated after radiosurgery with the gamma-knife. Following localization with MR1 and dose planning, radiosurgery with marginal doses between 12 to 25 Gy (mean 18.9 Gy) was delivered. In the follow-up studies with MRI after 3 months, 29 out of 55 (52.7%) lesions showed significant shrinkage. In contrast 25 showed either no change (17) or central necrosis (8), and one was enlarged. Thus the tumour control at 3 months was 98.2%, and subsequently 96.6% at 6 months. Clinical symptoms and signs were improved in most cases, but were aggravated in four cases either by tumour recurrence or by radiation-induced oedema. Although the tumours treated with radiosurgery were well controlled, tumour recurrence in another sites occurred in 4 case, of which 3 were treated by 2nd radiosurgery with 2 successful tumour control. Complications were generally mild and transient. In summary stereotactic radiosurgery is valuable new treatment not only for solitary metastases, but also for multiple or recurrent ones.
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PMID:Radiosurgery of the metastatic brain tumours with gamma-knife. 750 36

Case 1 was a 55-year-old male with multiple pulmonary metastases after two operations to excise hepatocellular carcinoma. Treatment consisted of initial administration of 5'-DFUR (po), followed by frequent administration of low-dose epirubicin (20 mg/body once every 2 weeks iv). This resulted in disappearance of the pulmonary metastases and a striking decrease in the AFP level. Case 2 was a 68-year-old male with multiple pulmonary metastases after surgery for hepatocellular carcinoma. Treatment with 5-FU (iv; once a week) and epirubicin (20 mg/body once every 2 weeks iv) resulted in disappearance of the pulmonary metastases and a marked decrease in the AFP level. It was concluded that administration of epirubicin in frequent, low doses is a useful method for the treatment of pulmonary metastasis after surgery for liver cancer, and it can be safely performed even on an outpatient basis.
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PMID:[Efficacy of treatment with frequent and low-dose epirubicin in two cases of pulmonary metastases after surgery of liver cancer]. 757 17

Hepatic malignancy accounts for a large number of cancer-related deaths worldwide. Radiologic evaluation of the liver is critically important in the selection of patients for surgical treatment and newer modalities including computed tomographic arterial portography and intraoperative sonography show promise in the detection of small lesions. Advances in our understanding of the segmental anatomy of the liver, studies of intraoperative hepatic ischemia, and improved care of patients following major hepatic resections have extended the limits of surgical treatment of liver lesions, especially in cirrhotic patients with limited functional reserve. Along with hepatitis B, new data suggest that hepatitis C is also important as an agent causing hepatocellular carcinoma. In addition, the tumor suppressor gene p53 is frequently mutated in aflatoxin-induced hepatoma. In endemic regions, mass screening for early hepatocellular carcinoma appears to increase the surgical cure rate. Resectional surgery remains the best treatment for primary liver cancer and, in selected cases, liver transplantation is worthwhile. Liver resection for some patients with metastases of colorectal origin is now considered standard therapy and studies of regional chemotherapy for liver cancer are beginning to show promise. It remains to be seen whether adjuvant chemotherapy after liver resection will increase cure rates.
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PMID:Primary and secondary hepatic malignancies. 758 84

A high-efficiency hepatic cryosurgical unit has been developed and evaluated. It is capable of simultaneously driving three implantable insulated cryoneedle probes. The system has been used to treat 18 patients with secondary and 4 patients with primary liver cancer: open (n = 12), total laparoscopic (n = 6), laparoscopic assisted (n = 4). In three patient laparoscopic cryotherapy was repeated inside 6 months. Intraoperative bleeding was encountered in three patients undergoing high-volume hepatic freezing but the bleeding was easily controlled. A fall in the core body temperature was encountered in 10 out of 22 patients and averaged 0.4 degree C. There was one postoperative death from liver failure in an 80-year-old patient in whom a large hepatoma was frozen. The most consistent postoperative biochemical change was hyperbilirubinaemia (n = 3). A right-sided pleural effusion developed in two patients after freezing of lesions on the superior surface of the right lobe. A survival benefit was encountered in three patients, one with central cholangiocarcinoma and the other two with large solitary secondary deposits (melanoma, colon cancer). Seven patients with multiple metastases and two patients with large hepatomas developed recurrence at the frozen site or elsewhere in the liver inside 12 months of follow-up and no clinical benefit could be demonstrated by cryotherapy in this group. In nine patients, the follow-up has been too short (< 18 months) to permit any conclusion on outcome. The current limitations of hepatic cryotherapy are largely due to incomplete tumor destruction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hepatic cryotherapy for liver tumors. Development and clinical evaluation of a high-efficiency insulated multineedle probe system for open and laparoscopic use. 767 67

Short-term chronic exposures of rats to furan were recently found by us to preferentially induce a unique liver lobe pattern of development of small intestinal metaplasia and subsequent cholangiofibrosis, being essentially localized to the caudate and right liver lobes (L. W. Elmore, and A. E. Sirica, Cancer Res., 51: 5752-5759, 1991). We now demonstrate the preferential development of primary hepatic adenocarcinomas exhibiting small intestine mucosal cell differentiation, which have arisen at 70 to 90% incidences from the right/caudate liver lobes of Fischer 344 adult male rats by 16 months after their receiving furan by gavage at a daily dose of 30 mg/kg of body weight, five times a week, for 9, 12, and 13 weeks, respectively. In contrast, the incidences of primary hepatocellular carcinomas that developed in the furan-treated rats ranged from 0 to 20%, with the two hepatocellular carcinomas observed to be originating from the median/left liver lobes. Twenty-six of 27 hepatic adenocarcinomas analyzed exhibited glands containing on average 30.2% goblet cells, 2.1% Paneth cells, and 0.5% serotonin-positive neuroendocrine cells. Phenotypically, the glandular epithelial cells of the furan-induced intestinal-type adenocarcinomas were immunohistochemically positive for cytokeratin 19, but exhibited a heterogeneous pattern of immunohistochemical staining for gamma-glutamyl transpeptidase and showed no detectable immunostaining for transforming growth factor alpha. In addition, many of the glandular structures within these primary hepatic adenocarcinomas showed evidence of basement membrane disruption, as demonstrated by both electron microscopy and immunohistochemical staining for basement membrane laminin. While these intestinal-type adenocarcinomas appeared to have spread intrahepatically, none showed evidence of extrahepatic metastases. However, six of eight randomly selected adenocarcinomas grew progressively and retained their intestinal pattern of differentiation following serial transplantation into the fat pads of young adult Fischer 344 recipient rats. In this study, we also observed one primary hepatic cholangiocarcinoma that was characterized by a more native biliary rather than intestinal-type of differentiation. Interestingly, this was the only primary liver cancer observed by us to exhibit extrahepatic metastasis. In conclusion, our current findings clearly indicate that the small intestinal metaplasia and subsequent cholangiofibrosis developing early in the right/caudate liver lobes of furan-treated rats do not simply reflect reactive changes, but strongly correlate with the high incidences of intestinal-type of primary hepatic adenocarcinoma that occurs in the right/caudate liver lobes of rats after long-term exposures to furan.
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PMID:"Intestinal-type" of adenocarcinoma preferentially induced in right/caudate liver lobes of rats treated with furan. 767 71

Mortality and cancer incidence among 999 neurological patients exposed to chronic alpha-particle irradiation from 232ThO2 (Thorotrast) administered for cerebral angiography in 1935-1947 was compared to that of 1480 similar patients examined with cerebral angiography without Thorotrast in 1946-1963 (controls). The ratio of standardized mortality/morbidity ratios (SMRs) for patients exposed to Thorotrast and controls was the relative risk, which was analyzed by multiplicative regression (RRREG). For mortality from all causes, RRREG was significantly increased mainly due to cancer, benign and unspecified tumors and benign liver conditions, while RRREG for all other causes combined was not significantly increased. The RRREG was significantly associated with the injected amount of Thorotrast for cancer and for benign liver conditions, while no other dependence on the amount of Thorotrast was seen. Cancer incidence was significantly increased, caused mostly by liver cancer, leukemia, metastases and cancer at unspecified sites. The risk for cancer other than liver, hematological, brain, metastases and cancer at unspecified sites combined was also significantly increased, but the temporal trend of RR for this category of sites did not indicate a radiation effect. A significant association between relative risk of cancer and injected amount of Thorotrast was largely accounted for by liver cancer. Thus increased mortality among patients exposed to Thorotrast is due mainly to cancer and benign liver diseases, and increased cancer incidence is caused by high risks of liver cancer, leukemia and ill-defined types (metastases, etc.). The time trend and dependence of the amount of Thorotrast injected do not support that cancer at most other sites is related to radiation from Thorotrast.
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PMID:Mortality and cancer incidence after cerebral arteriography with or without Thorotrast. 776 81

The objectives were to compare the role of CT during arterial portography (CTAP) and intraoperative ultrasound (IOUS) in the management of patients with primary or metastatic liver tumors; to study the ability of CTAP to define resectability before laparotomy in these patients; and to study whether the omission of CTAP in the imaging algorithm resulted in a diminished resectability rate. Eighty-eight consecutive patients with primary or metastatic liver cancer who underwent CTAP and/or IOUS between January 1990 and December 1993 were reviewed. Thirty patients had both CTAP and IOUS and underwent 31 laparotomies (Group I). The sensitivity of these two tests to detect liver tumors was compared. Twenty-eight explorations were performed for hepatic metastases and three for hepatocellular carcinoma. Fifty-three patients, including those in group I, underwent CTAP before laparotomy and were studied to assess the sensitivity of CTAP in determining unresectability (Group II). Thirty-five patients (Group III) had IOUS only and were studied to determine whether the omission of CTAP decreased the resectability rate. In Group I, 52 hepatic lesions were found by a combination of imaging studies, operative exploration, and pathologic examination. The sensitivity of CT, CTAP, IOUS, and exploration were 67 per cent, 65 per cent, 100 per cent, and 75 per cent, respectively. IOUS was more sensitive than any other modality in detecting liver tumors (P < 0.001). It added new information in 7/31 cases (23%). The false positive rate of CTAP was 4/31 (13%). In one case (3%), a false positive result would have precluded a curative resection. CTAP changed management of 4/53 patients (7.5%) by showing unresectable disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Is CT portography (CTAP) really useful in patients with liver tumors who undergo intraoperative ultrasonography (IOUS)? 779 34


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