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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reported the results of hepatic artery ligation (HAL) and infusion (HAI) with chemotherapy in the treatment of 356 patients with nonresectable primary liver cancer (PLC). A comparison of data between the periods 1958-1977 (81 cases) and 1978-1989 (275 cases) revealed that remarkable improvement in survival in the latter period might be attributed to the accurate site of hepatic artery cannulation, long-term infusion with chemotherapy, and combined treatment with subsequent tumor resection. During 1978-1989, the 5-year survival rates of different treatment modalities were 0% in HAL (n = 36) alone, 7.9% in HAI (n = 67) alone, 24.4% in HAL + HAI (n = 112, with subsequent resection in 10 cases), 36.5% in HAL + HAI + radiation (internal and/or external) (n = 60, with subsequent resection in 19 cases). The results indicate that HAL + HAI + combined treatment might provide a hope for the prolongation of survival or even resection in some patients with nonresectable PLC.
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PMID:[Hepatic artery ligation and intrahepatic arterial chemotherapy for nonresectable primary liver cancer]. 165 Jun 84

The importance of chronic hepatitis B virus (HBV) infection in the development of primary liver cancer has been established by epidemiological studies. However, the evidence for a direct role of the virus in liver carcinogenesis is still tentative. In addition, the findings of HBV DNA sequences in HBsAg-negative subjects with liver cancer has been reported, although it is controversial. Here we report the use of the polymerase chain reaction to detect HBV DNA in the serum and liver of HBsAg-negative patients. This technique allows both for the detection and cloning of HBV variants. In addition, the demonstration of HBV DNA and RNA molecules in HCC of HBsAg-negative individuals as determined by standard techniques reinforces the role of HBV in the pathogenesis of this tumor.
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PMID:The detection of hepatitis B virus (HBV) in HBsAG negative individuals with primary liver cancer. 165 Jun 88

Arterial infusion therapy using implantable reservoirs was used in 44 patients with hepatocellular carcinoma which was unresectable for severe liver dysfunction or advanced tumor. The prognosis for patients with whom the double lumen reservoir developed by our department which can occlude the hepatic artery, was compared with that of patients for whom the conventional reservoir was employed. We also evaluated the reduction surgery previous to infusion therapy for tumor-advanced unresectable HCC. The six-month survival rates (Kaplan-Meier method) of the double lumen reservoir cases were significantly higher than for conventional reservoir cases. The survival rates of the cases of reduction surgery and infusion therapy (within only one year) were higher than for infusion therapy cases. Not only the use of the double lumen reservoir but the reduction surgery for unresectable HCC increases the effectiveness of infusion therapy and improves the prognosis.
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PMID:[Intra-arterial infusion chemotherapy for unresectable hepatocellular carcinoma using an implantable reservoir]. 165 25

Transcatheter arterial chemo-embolization with lipiodol and anticancer agents (LP-TACE) is a highly effective therapeutic method for treating liver cancer. It has been difficult, however, to evaluate how lipiodol, an oil, and anticancer agents dissolved in an aqueous contrast medium are retained in tumors. This paper reports the study on the dynamics of anticancer agents administered in LP-TACE both in vitro and in tumor-bearing animals using emulsions produced by mixing lipiodol and adriamycin (ADM) dissolved in Gd-DTPA. The results were as follows. 1) ADM was dissolved in contrast mediums (60% Urografin and Gd-DTPA) and each solution was emulsified by mixing with lipiodol. The emulsion separated into two distinct layers 5 min. after mixing. From this observation it is guessed that lipiodol and anticancer agents also separate in tumors after administration in LP-TACE. 2) Rabbits with VX2 carcinoma implanted in their lower limbs were treated by chemo-embolization and subjected to serial observations for changes in signals on MRI. The signal intensity markedly increased, persisting until one week after administration, when the tumor was resected. This change may have been owing to Gd-DTPA retained in the tumor, indicating that the anticancer agent is not washed out, even after separating from lipiodol, but is retained in the tumor. 3) When ADM was dissolved in Gd-DTPA and intraarterially infused without being mixed with lipiodol, the intensity of the signal on MRI was the same as that in LP-TACE immediately after the administration, and gradually decreased thereafter. This result indicates earlier washout of the anticancer agent when administered without being combined with lipiodol. Quantitative analysis of the tumor resected one week after the treatment also revealed ADM levels with less than 10% of those in LP-TACE, suggesting the possibility of estimating intratumoral concentration of anticancer agents. This was evaluated on the basis of the signal intensity in the tumor using MRI. 4) A comparison of lipiodol accumulation on CT and signal changes induced by Gd-DTPA on MRI suggested that even after separation from lipiodol, the anticancer agent extends to microvessels in the interior part of the tumor.
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PMID:[Experimental studies on the dynamics of anticancer agents in transcatheter arterial chemo-embolization. Magnetic resonance imaging using emulsions containing lipiodol and Gd-DTPA]. 165 93

From April 1987 to May 1988, right trisegmentectomy was done in 4 primary liver cancer patients under normothermic interruption of porta hepatis. This interruption lasted 22-26 minutes. Two of the 4 cases were associated with mild cirrhosis. No operative complication and mortality occurred. Two patients died of recurrence 5 and 14 months after operation. The other two patients are still alive free of tumor for 14 and 24 months. Detailed technical description and discussion with review of literature are presented.
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PMID:[Right trisegmentectomy for primary liver cancer--a report of 4 cases with review of literature]. 165 89

Anti-tumor activity of cisplatin-capsulated microspheres with ethylcellulose (CDDPmc) was studied in Wistar rat bearing transplantable hepatocellular cancer. Seven days after inoculation into the rat's liver, normal saline, conventional cisplatin, placebo ethylcellulose microsphere and CDDPmc at comparable doses were infused into the proper hepatic artery. The results indicated that the rats treated with CDDPmc had a significantly slower tumor growth, more extensive tumor necrosis and longer survival as compared with the three other groups. It is suggested that the tumoricidal effect of arterial chemoembolization with CDDPmc be superior to arterial chemotherapy or embolization alone in the treatment of liver cancer.
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PMID:[Hepatic arterial infusion of cisplatin microspheres for transplantable hepatocellular carcinoma in rats]. 165 90

A 36-year-old woman was admitted to our hospital because of general fatigue. The physical and laboratory findings on admission revealed splenomegaly, pancytopenia, hypocoagulopathy, liver hypofunction with a hepaplastin test of 55% and ICG Rmax of 0.6 mg/kg/min. Diagnostic imaging showed a hypoechoic mass 1.5 in diameter a low density area on the CT scan and a faint tumor stain on the AAG in the posterior inferior area of the liver. On a diagnosis of hepatocellular carcinoma with liver cirrhosis and hypersplenism, partial hepatectomy and splenectomy were performed. The resected hepatic specimen revealed a small liver cancer of 1.9 x 1.5 x 1.3 cm with liver cirrhosis. The specimen consisted of a firm rubbery mass. Macroscopically, the tumor appeared oval and was lobulated with a thin capsule. A fibrous scar was observed in the central area. Microscopically, malignant hepatocytes showed various shapes, ranging from polygonal to spindle form, with eosinophilic granular cytoplasm and were surrounded by abundant fibrous stroma. Orcein stain, revealed that these malignant hepatocytes contained many black granules of copper-binding protein. Immunoperoxidase staining for alpha 1-antitrypsin was also positive in the malignant hepatocytes. However, within this lamellar fibrous regions, there were many cords of tumor cells in which nucleoli were absent and abortive biliary differentiation was suggested. Consequently this tumor was diagnosed as an atypical fibrolamellar hepatocellular carcinoma. We think that this case is the 3rd case reported in Japan and the 2nd case in a Japanese person.
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PMID:Fibrolamellar carcinoma of the liver--a case report. 165 47

This prospective study was undertaken to evaluate the efficacy of continuous-infusion doxorubicin and cisplatin (CI-DOX/CPPD) for the treatment of children with incompletely resected hepatic cancer. Of the 46 evaluable patients, 32 had hepatoblastoma (70%) and 14 had hepatocellular carcinoma. Ten children had stage II tumors (microscopic residual), 25 were defined as stage III (gross residual), and 11 had distant metastasis (stage IV). Twelve patients underwent initial incomplete resection of their hepatic lesions and in the 34 others tumor biopsy specimens were obtained. Chemotherapy was administered and the majority of the children (70%) had an excellent clinical response with a decrease in both alpha-fetoprotein levels and measured tumor dimensions. The combination of CI-DOX/CPDD clearly facilitated surgical management, allowing for delayed hepatic resections in 20 of the 34 patients (59%) whose tumors were initially biopsied and considered to be unresectable. Overall survival in this study demonstrates a significant improvement in comparison to the historical controls. Twenty-one patients (46%) remain in complete clinical remission an average of 30 months following diagnosis (range, 17 to 40 months). The outcome of the children with hepatoblastoma was much better than those with hepatocellular carcinoma (63% v 17% survival). Survival of the 20 children who underwent delayed hepatic resections was not statistically different from the 12 patients whose hepatic tumors were removed at the initial laparotomy (41% v 58% survival). Although no obvious survival advantage was observed in those patients who underwent initial hepatic resections, there did appear to be an increased risk of postoperative complications in children whose tumors were resected following chemotherapy (8% v 25%).
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PMID:The surgical management of children with incompletely resected hepatic cancer is facilitated by intensive chemotherapy. 165 89

Tumor hemodynamics including arterial vascularity (AV) and portal perfusion (PP) were evaluated in histologically confirmed 55 hepatic nodules associated with cirrhosis using ultrasonographic (US) angiography during intraarterial carbon dioxide microbubbles injection and CT during arterial portography. Tumor hemodynamic patterns were classified into 6 types as follows: Type I (n = 10): PP (+), AV (hypo); Type I' (n = 2): PP (+), AV (iso); Type II (n = 5): PP (-), AV (hypo); Type III (n = 8): PP (-), AV (iso); Type IV (n = 25): PP (-), AV (hyper), Type V (n = 5): PP (partially +), AV (vascular spot in hypovascular). Eight nodules of Type I were diagnosed as benign nodules histologically including adenomatous hyperplasia (AH) (n = 6) and regenerative nodule (n = 2). Hundred percent (5/5) of Type II and 88% (7/8) of Type III nodules were well-differentiated HCC, in contrast to 8% (2/25) of Type IV nodules, typical HCCs. Fatty metamorphosis was observed in 75% (6/8) of Type III nodules, in contrast to 16% (4/25) of typical (classical) HCC nodules (Type IV). We concluded that at the malignant transformation from AH to HCC, reduction of portal blood flow in the nodule precedes the initiation of the increase of the arterial tumor vessel. Moreover, early stage HCC could exhibit hypovascular (Type I, II), isovascular (Type III), or vascular spot in hypovascular pattern (Type V) compared with a typical HCC (Type IV). It was also suggested that the more mature as a neoplasms the HCC becomes, the more the arterial tumor vessel in the nodule increases and fatty metamorphosis of well-differentiated HCC is highly related with tumor hemodynamic condition, i.e., hypoperfusion state from both arterial and portal vessel.
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PMID:[Tumor hemodynamics in hepatic nodules associated with liver cirrhosis: relationship between cancer progression and tumor hemodynamic change]. 165 18

A retrospective analysis of 35 stage IV HCC (26 IV-A case and 9 IV-B cases) which underwent reduction surgery from 1983 suggested a possibility to extend their survival period by decrease in their tumor-mass and subsequent immunochemotherapy for improvement of their depressed immunity. Their operability depended on the clinical stage of accompanying liver cirrhosis and extent of distant organ metastasis. It is of first importance for reduction surgery to select intrahepatic multiple tumors, slow-growing and not rapidly to induce distant organ metastases, among them. Intrahepatic tumors arising from multicentric origins were found in 42% in IV-A cases but 0% in IV-B. DNA ploidy analysis of the multicentric tumors in 8 cases did not show any clear indication of resectable tumors according to DNA index. The present immunochemotherapy is composed of a continuous infusion of IL2 and intermittent one-shot injections of 10mg ADR to the remnant liver by using subcutaneously implanted pump. In patients who could enhance peripheral NK and LAK activities by the immunotherapy, decreases in intra- and extra- hepatic tumors were observed. The 2 year-survival rate was 49% in IV-A, but only one case who is receiving the immunotherapy is surviving over 2 years in IV-B.
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PMID:[Significance of reduction surgery for stage IV hepatocellular carcinoma (HCC) and postoperative immunochemotherapy for extension of survival period]. 165 92


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