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

To determine the frequency of cardiovascular systemic invasion by hepatocellular carcinoma (HCC). Eighty-one Nigerian patients who had autopsy examinations were studied. Of these, 36 (44%) had tumour thrombi within the cardiovascular system (CVS) or metastases to the heart itself. Compared with the patients without CVS invasion, no clinicopathologic findings distinguished these two groups from each other. Furthermore, CVS invasion did not worsen the generally bad prognosis of these patients with liver cancer. It is concluded that CVS invasion is frequent and difficult to diagnose by clinical examination. Patients who are selected to undergo hepatic resection must be assessed by imaging techniques to exclude CVS invasion. However, it is unlikely that frequent and routine imaging procedures will affect the generally bad prognosis of the majority of the patients.
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PMID:Cardiovascular systemic invasion by hepatocellular carcinoma: incidence and pattern in a west African population. 783 48

Selective internal radiation therapy (SIR therapy) is a technique whereby metastatic liver cancer is irradiated by embolising microspheres containing the radionuclide yttrium-90 into the hepatic arterial circulation. To date this technique has not been used as an adjuvant therapy, but rather to treat established metastases in the liver. This study evaluated the use of two intrahepatic radiation doses delivered on radioactive microspheres for the treatment of small, growing micrometastases. Three groups of five rats were each inoculated with tumour spheroids into the portal vein. The resultant liver micrometastases were treated with either 10 or 20 MBq of yttrium-90 microspheres or a sham dose of non-radioactive microspheres injected into the portal vein 2 days following tumour inoculation. The livers of each animal were examined for the presence of metastases after a further 21 days and liver function tests were performed. At the time of sacrifice there was no obvious normal liver damage in any of the rats treated with microspheres. The livers of the sham-treated animals contained extensive signs of tumour deposition. A mean of 34 tumours were taken from the livers of each of the sham-treated animals, whereas only a single tumour was found in one animal treated with 10 MBq of yttrium and eight small tumours from two animals treated with 20 MBq. Liver function tests demonstrated a significant short-term increase in alkaline phosphatase levels in the radiation-treated animals compared with shams, but there were no other indications of any effects on liver function. These results indicate a potential role for SIR therapy in an adjuvant setting with colorectal cancer.
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PMID:Adjuvant internal radiation therapy in a model of colorectal cancer-derived hepatic metastases. 784 Oct 48

There have been few studies and case-reports of bone metastases from hepatocellular carcinoma. To determine the characteristics of these metastases, we retrospectively studied 22 patients in whom the diagnosis was established either on the basis of concomitant occurrence of malignant bone lesions and hepatocellular carcinoma in the absence of other detectable malignant disease (n = 15) or on the basis of histological evidence of bone metastasis from an hepatocellular carcinoma (n = 7). There were 21 males and one female. Mean age was 62.5 years. Most patients (88.2%) had chronic alcohol abuse. The bone metastases occurred as the first manifestation of the liver cancer in half the cases (11/22). Time interval between onset of bone symptoms and admission was less than one month in 6 of 11 patients; mean interval was 7.4 weeks. Hepatomegaly was found upon initial physical evaluation in 9 of 11 patients. Pain was the main symptom of bone disease (18/22). Palpable bone masses were found in 6 of 22 patients. Purely osteolytic lesions were seen on roentgenograms in every case; rupture of the cortex and spread to adjacent soft tissues were common findings. The radionuclide bone scan was normal in four of 12 patients. An advanced primary hepatic tumor was found in 84.2% of cases. Histologic examination of bone specimens established the diagnosis of metastasis from a hepatocellular carcinoma in 7 of 9 patients (77.8%). Severe bleeding occurred during one of the nine biopsy procedures. Patients were given symptomatic treatment. Systemic chemotherapy was used in five patients, unsuccessfully. Median survival was three months.
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PMID:[Bone metastasis of hepatocellular carcinoma. Apropos of 22 cases]. 801 16

Localized hyperthermic solidification therapy employs a high temperature of around 65 degrees C to induce biological heat effects for the solidification and inactivation of the cells of visceral cancers without affecting the physiological processes of the body or any of the viscera. This technique was used in combination with surgical resection to treat 39 moderately or far advanced cases of liver cancer and quite satisfactory results were obtained. The FHCL-92B localized hyperthermic solidification apparatus, designed and manufactured under the supervision of the authors, was preliminarily put into clinical use and exhibited its efficiency. It is believed that, if the technique of localized hyperthermic solidification is introduced more widely into the field of cancer surgery for internal organs, it will be of benefit to prevent iatrogenic metastases and to promote the efficacy of cancer surgery.
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PMID:Studies on hyperthermic solidification as a supplement to surgical resection in the treatment of 39 advanced cases of liver cancer. 805 91

From January 1960 to July 1991, 72 patients underwent reoperation for recurrence of liver cancer. Hepatectomy was performed twice in 59 cases, three and four times each in nine and three cases. The 1, 3, and 5-year survival rates after the first operation were 98.6%, 69.9%, and 49.5%, respectively, while after the second operation these rates were 90.8%, 53.5%, and 36.1%, respectively. The 1,2, and 3-year survival rates after the third operation were 100%, 85.6%, and 36.7%, respectively. The preliminary results of rehepatectomy are thus encouraging. The indications for reintervention, types of operation, prophylactic measures against tumor recurrence and metastases, and evaluation of rehepatectomy are discussed.
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PMID:Rehepatectomy of primary liver cancer. 821 Sep 13

With the increasing availability of curative surgical techniques for primary and secondary hepatic neoplasms, the tasks for clinical imaging of patients suspected of having liver cancer have become more exacting. Detection of tumor, differential diagnosis of individual nodules, and mapping the anatomic extensions of malignant disease are now required routinely. The most sensitive imaging techniques are computed tomography and arterial portography and intraoperative sonography, but because of their invasiveness, there are reserved exclusively for cancer staging. For primary screening, magnetic resonance imaging is increasingly preferred over computed tomography because of its superiority in discriminating hemangiomas and cysts from metastases without the need for iodinated contrast material.
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PMID:Liver tumor imaging. Current concepts. 828 60

The results of superselective intra-arterial chemotherapy with Mitomycin C (SIAC) in cases of hepatic neoplasms continue to be poor. Survival time was related to the percentage of hepatic replacement (PHR) but only 19% of the patients with Stage I tumours (PHR < 25%) survived for over 5 years and all the others died within 4 years. The patients with hepatic metastases from colorectal cancer achieved a significantly better cumulative 5-year survival figure than those with hepatocellular cancer (P < 0.05). The median survival times for patients with hepatic metastases from colorectal cancer, hepatocellular cancer and gallbladder cancer were 15 months, 6 months and 13 months, respectively. The overall response rate was only 27% (26/97), that for primary liver cancer 20% (7/35), that for hepatic metastases from colorectal cancer 22% (8/37) and that for gallbladder cancer 44% (11/25) and the patients who responded to SIAC (n = 27) had a significantly better cumulative 5-year survival rate (P < 0.005). Cessation of SIAC was necessary in 74% (72/97) of the cases, because of tumour progression in 53% (51/97), major complications in 19% (18/97) and patient refusal in 3% (3/97). The results of this trial may be regarded as disappointing, and we are going to use SIAC for Stage I tumours only. Resection of the tumour continues to provide the only chance of a permanent cure with these patients.
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PMID:Superselective intra-arterial chemotherapy with mitomycin C in hepatic neoplasms. 839 9

In this study of orthotopic implantation of histologically intact surgical specimens, the authors constructed metastatic models of human hepatocellular carcinoma (HCC) in nude mice. Histologically intact human liver cancer specimens, derived from patients, were implanted directly into the liver of nude mice, and their orthotopic growth and metastases were observed. The transplantability and metastatic rate of two specimen groups (primary and metastatic lesions) were analysed. alpha-Fetoprotein (AFP) was also determined in transplanted tumours by an immunohistochemical method. Orthotopic growth was observed in 14 of 30 transplanted specimens and formation of metastases in 7 cases, which exhibited the variety of clinical behaviours seen in patients with HCC. These behaviours included local growth, regional invasion, spontaneous intrahepatic, lymph node and lung metastasis and peritoneal seeding. In two groups the growth rate of metastatic lesions following implantation was clearly higher than that of primary tumours. Chromosome analysis from locally growing tumours confirmed their morphologically human origin. An immunohistochemical study showed that implanted tumours originating from AFP-positive specimens maintained AFP expression. These results indicated that the animal models should prove valuable for developing new treatment modalities and studying the mechanism of metastasis of human HCC.
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PMID:Metastatic models of human liver cancer in nude mice orthotopically constructed by using histologically intact patient specimens. 869 Jul 49

Liver cryosurgery is a relatively new form of treatment for unresectable liver cancer that involves in situ ablation of liver tumors by freezing them with liquid nitrogen. Cryosurgery has been used mainly to treat liver metastases from colorectal cancer, but other types of metastases and primary liver cancers have been treated as well. Results of liver cryosurgery over the past decade have demonstrated that it is a safe and effective treatment for malignant liver tumors. Because only a small percentage of primary and metastatic liver tumors are resectable, cryosurgery offers a potentially curative treatment option for patients with unresectable disease.
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PMID:Liver cryosurgery. 880 10

Patients with cancer recurrence limited to the liver alone after a first liver resection may be candidates for a repeat resection. Some 191 second and ten third liver resections for recurrent colorectal metastases, and 128 second and ten third liver resections for recurrent hepatocellular carcinoma (HCC), were evaluated after reviewing the literature. The 5-year survival rate after second liver resection for colorectal metastases was 26 per cent with a median survival time of 30 months. Mortality and morbidity rates were 1.2 and 27.4 per cent respectively. The 5-year survival rate after second resection for HCC was 40 per cent with a median survival time of 40 months. The operative mortality rate was 2.3 per cent; morbidity occurred in 13 per cent of patients with HCC. Survival after primary colorectal resection was significantly better for patients with metachronous metastases than for those with synchronous disease; survival correlated with a long interval between the first and second liver resection (in both colorectal liver cancer and HCC). Repeated liver resection may be performed in selected patients and yield a similar survival to that obtained after first liver resection.
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PMID:Repeated liver resection for recurrent liver cancer. 881 71


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