Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

150 cases of prostate cancer treated with estrogens at the Urology clinic of the Hotel-Dieu from 1963 to 1974 are presented. The men ranged in age from 50 to 91; the majority were 60-69 years. Their clinical stages were 29% Stage 1, no perceptible mass; 43% Stage 2, nodule felt on rectal exam; 13% Stage 3, tumor extended outside the prostate but not metastases, normal prostatic phosphatases; and 15% Stage 4, elevated prostatic phasphatases and metastases. Diagnosis was by urinary symptoms in Stage 2 or above, rectal palpation, and puncture biopsy under local anesthesia. Estrogen treatment consisted of diethylstilbestrol, stilbelstrol diphosphate or TACE (Chlorotraianisene), or estradiol. Estrogen side effects were loss of libido after 1 month, gynecomastia, and nausea. Other treatments included prostatectomy in Stages 1 and 2, cobalt in 5 cases, castration in 3 cases, 1 endo-uretral resection, and 1 hypophysectomy. 50% died in 1 year and 16% were lost to follow up and presumed dead in 1 year; the mean survival of the others was 3 years. Estrogen therapy improved symptoms and reversed tumor growth temporarily in hormone-dependent cancers, but these tumors all escape hormone control eventually.
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PMID:[Course of prostate cancer under estrogen therapy]. 87 31

Despite remarkable progress of diagnostic imaging and operative procedures radiological interventions play a major role in diagnostic and therapeutic liver tumor interventions. Percutaneous biopsies should be taken by 16-20 g needles. CT control is indicated in cases when sonographically guidance is impossible or of risk. MR guidance is still seldom. Accuracy rates of percutaneous biopsies are high (>90%), and safe with complications (e.g. bleeding) of less than 1%. Palliative percutaneous therapeutic interventions of primary or secondary liver malignancies are thermoablative procedures of laser (LITT), cryoablation or radio-frequency, percutaneous ethanol injection (PEI) and intraarterial chemotherapy via port system or repetitive catheterisation with perfusion or embolization (TACE). For metastatic disease with less than five tumors of less than 4 cm LITT and PEI are recommended, more advanced cases should be treated by intra-arterial port system chemotherapy. For HCC best results are shown for PEI, in cases of UICC stage IIIB and IV only TACE is adequate.
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PMID:[Image-guided interventions in liver tumors]. 1052 32

Patients with advanced Stage IV-A primary liver cancer, hepatocellular carcinoma (HCC) can be divided into subgroups: those with involvement of a major branch of the portal (Vp3) or hepatic (Vv2, Vv3) veins and those having multiple tumors in both lobes without Vp3 or Vv2, Vv3. The prognosis of Stage IV-A patients with Vv2 or Vv3 may be improved by extended hepatectomy with resection and reconstruction of hepatic veins or IVC. In those with Vp3, multidisciplinary treatments consisting of extended hepatectomy and adjuvant chemotherapy, i.e. intra-arterial injection or TACE, are thought to be feasible at the present, but the outcomes are still poor. On the other hand, there are some Stage IV-A patients with multi-centrical tumors who have multiple tumors in both lobes without major vascular invasion, and their prognoses are improved by partial resection of each tumor. However, when there are multiple tumors caused by intrahepatic metastases, multidisciplinary treatments consisting of reduction surgery, microwave ablation, ethanol injection, and intra-arterial chemotherapy might be useful at present.
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PMID:[Up to date of multidisciplinary treatments centering around hepatectomy for advanced liver cancer in stage IV-A]. 1101 91

In the treatment of early and intermediate hepatocellular carcinoma the range of indications for percutaneous ablation techniques is becoming wider than surgery or intra-arterial therapies. Although it is understood that partial resection assures the highest local control, the survival rates after surgery are roughly comparable with those obtained with PEI or RF ablation. The explanation is due to a balance among advantages and disadvantages of the two therapies. Survival curves with percutaneous ablation techniques are better than curves of resected patients who present adverse prognostic factors, and this means that surgery needs a better selection of the patients. Indications for both of therapies are reported. An open question remains the choice among different ablation procedures. In our department we currently use RF ablation in the majority of patients but consider PEI and segmental TACE complementary, and use them according to the features of the disease and the response. In the treatment of colorectal metastases, the initial survival curves of RF ablation are promising. As treatment is size and site dependent, partial resection remains the gold standard. However, on the basis of the studies on "test of time", a possible candidate could be a patient presenting operable lesions with favourable criteria for a complete ablation. An interesting indication seems to be the treatment of breast liver metastases in selected patients.
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PMID:Removal of liver tumours using radiofrequency waves. 1182 Apr 10

Liver transplantation (LT) for malignant tumors should be accepted if, with adequate case selection, long-term results are similar to those in patients transplanted for benign diseases. The aim of the present study was to reexamine selection criteria for LT in malignant diseases with particular emphasis on hepatocellular carcinoma (HCC) in cirrhosis. One hundred-three of 369 patients transplanted in our unit had HCC in cirrhosis (28%), 15 of which were incidental tumors, and 234 patients underwent LT for non-cholestatic cirrhosis. Pretransplant arterial chemoembolization(TACE) was performed in 36 cases (41%) of known HCC. Only early,well-delimited tumors in advanced cirrhosis with no extrahepatic disease were accepted for LT. Hepatocellular carcinoma characteristics included mean tumor size (3.1 cm), multiple (59%), bilobular involvement (31%), and vascular invasion (9.2%). Postoperative mortality was 4%. Median follow-up was 67.5 months. Tumor recurrence rate was 14.5%, 33% (5/15) in incidental tumors and 11.4% (10/88) in known HCC and by tumor stage (pTNM): 7.7% (1/13) in stage I, 16.7%(5/30) in stage II, 15% (3/20) in stage III, and 17% (6/35) in stage IV. Mean time for recurrence was 20.6 months. Tumoral vascular invasion, tumor differentiation, and satellite tumors were significant factors for tumor recurrence in univariate analysis, whereas tumor vascular invasion was the only significant factor for tumor recurrence in multivariate analysis. Actuarial survival rates at 1, 3, and 5 years were 81%, 66%, 58%, respectively, in patients with HCC and were similar to those of cirrhotic patients 76%, 67%, 63%, respectively. In conclusion, patients with early HCC in cirrhosis are good candidates for LT; results are similar when compared with those of cirrhotic patients without tumor. Liver transplantation for other malignancies is admitted only in fibrolamellar hepatoma, hepatoblastoma, epithelioid hemangioendothelioma without extrahepatic disease, and in metastases from carcinoid tumors.
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PMID:Liver transplantation for malignant diseases: selection and pattern of recurrence. 1186 57

The liver is the second only to lymph nodes as the most common site of metastatic disease irrespective of the primary tumor. Up to 50% of all patients with malignant diseases will develop liver metastases with a significant morbidity and mortality. Although the surgical resection leads to an improvement of the survival time, only approximately 20% of the patients are eligible for surgical intervention. Radiofrequency (RF) ablation represents one of the most important alternatives as well as complementary methods for the therapy of liver metastases. RF ablation can lead in a selected patient group to a palliation or to an increased life expectancy. RF ablation appears either safer (vs. cryotherapy) or easier (vs. laser) or more effective (percutaneous ethanol instillation [PEI], transarterial chemoembolisation [TACE]) in comparison with other minimal invasive procedures. RF ablation can be performed percutaneously, laparoscopically or intraoperatively and may be combined with chemotherapy as well as with surgical resection. Permanent technical improvements of RF systems, a better understanding of the underlying electrophysiological principles and an interdisciplinary approach will lead to a prognosis improvement in patients with liver metastases.
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PMID:[Radiofrequency ablation of liver metastases]. 1504 92

Surgical treatment of hepatocellular carcinoma. The therapy of hepatocellular carcinoma (HCC) has got nowadays an important problem of medicine. The five year survival time has increased in the consequences of the last 25 year medical activities. The development of liver surgery, the introduction of aggressive surgical strategy, the prognosis of the disease and the special indication of the operation have had important factors in bettering of the results. The size and number of the tumor, the tumor-free region of the tissue resected, capsule building, and the venous infiltration are the most important factors influencing the survival time. The repeated resection in case of newly developed HCC has got also a result with 19-20 per cent of five year survival time. In cases of non resectable tumors the a la carte chemotherapy, radiofrequency, TACE for down staging produce an opportunity in 10-20% of tumors being resectable. The new combined surgical-oncologic-intervention strategies involve the two step and repeated interventions, the minimal invasive technique (MIT), the TACE and the a la carte chemotherapy. Liver transplantation can be carried out exclusively in tumors less than 3 cm and in those having no more than 3 metastases.
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PMID:[Surgical treatment of hepatocellular carcinoma]. 1549 19

We devised low-output radiofrequency ablation (RFA)combined with transcatheter arterial chemoembolization using iodized oil mixed with anticancer drugs (TACE) for hepatocellular carcinoma (HCC), to reduce the cooling effect of tumoral arterial blood flow, to prevent intraportal disseminations and intrahepatic metastases by sudden ebullition (bumping), and to obtain an adequate margin of safety. We performed low-output RFA on 10 HCC patients. We performed RFA with a lower output of 90W or less within two weeks after TACE. After the ablation, portal venous-phase CT images showed a low-density margin of 5 mm or larger around the site of iodized-oil accumulation, indicating that the necrotic area completely included the tumor. No intrahepatic metastasis or severe complication occurred. Low-output RFA combined with TACE is a safe, effective therapy for HCC.
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PMID:[Low-output radiofrequency ablation combined with transcatheter arterial oily-chemoembolization for hepatocellular carcinoma]. 1592 Sep 73

With the current practice of surveillance programs in high-risk patients, early stage hepatocellular carcinoma HCC is commonly diagnosed. This poses great challenge to clinicians, in terms of prognostic estimation, patient stratification to various treatment modalities and patient management during long-term follow-up. This review focuses on the current trends in the management of HCC, with special attention to tumor staging, treatment algorithm, and outcome of various treatment modalities. According to the American Association for the Study of Liver Diseases AASLD practice guideline, Barcelona Clinic Liver Cancer BCLC staging system has fulfilled the criteria that HCC patients can be stratified into different prognostic subgroups, to which optimal treatments can be offered. Under this management scheme, curative treatments hepatic resection, liver transplantation, and percutaneous ablation would be reserved to the subgroup of patients with relatively good prognosis. For patients with advanced malignancy localized to the liver, local ablation or transarterial chemoembolization TACE may offer effective symptomatic palliation, and prolongation of patients' survival. For patients with distant metastases, no effective therapy can be offered, and symptomatic palliative care is the best option. Until now, favorable survival outcomes have been reported following hepatic resection, liver transplantation, and local ablation for HCC. Although the therapeutic effect of TACE is less pronounced than curative treatments, randomized controlled studies have proven its survival benefit for HCC patients. A comprehensive treatment algorithm involving these treatment modalities is mandatory to ensure optimal care of patients with HCC.
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PMID:Current treatment strategy for hepatocellular carcinoma. 1776 55

In the last two decades image-guided interventional catheterizations and percutaneous ablative regional treatment procedures have revolutionized the therapy of nonresectable primary and secondary liver tumours. A distinction is made between chemoablative procedures and thermo- and radioablative procedures. The main chemoablative interventions are transarterial infusion chemotherapy (HAIC; hepatic arterial infusion chemotherapy) and transarterial (chemo-)embolization (TACE/TAE). The object of the transarterial treatment procedures is to deliver the highest possible concentration of a chemotherapy agent or combination of chemotherapy agents directly into the tumour by way of the blood vessels supplying it, while at the same time keeping the systemic effects of the drugs as small as possible. Transarterial chemoperfusion to the liver can be applied in the treatment of all primary and secondary hepatic tumours, but the main indications are hepatocellular carcinoma (HCC) and metastases from colorectal primary tumours.
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PMID:[Update on chemoinfusion and chemoembolization treatments]. 1799


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