Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0345904 (liver cancer)
 15,188 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

15 cancer specimens resected after hepatic arterial chemoembolization (TCE) were studied pathologically. It was found that residual tumor tissue was present in three forms: failure of complete tumor necrosis; tumor emboli in small portal veins; and multiple cancer foci in adjacent liver parenchyma. It is believed that presenting residual tumor tissue after TCE may be attributed to one of the following conditions: low drug concentration in residual tumor tissue; the larger tumor size after TCE; more residual cancer tissue in ASCCL than in HCC, collaterals formed soon after hepatic arterial occlusion.
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PMID:[Residual liver cancer after transcatheter hepatic arterial chemoembolization in patients with large primary hepatic carcinoma]. 133 15

Twenty patients with hepatic malignancy were treated with transcatheter arterial embolization (TAE) under examination by intra-arterial digital subtraction angiography (IA-DSA) and conventional angiography (CA). Comparison of these two angiographies revealed that the time required for confirmation of the embolized portion of the artery was about four-and-a-half times shorter with IA-DSA than CA. Moreover, IA-DSA revealed the obstructed portion more readily and accurately than CA. In particular, confirmation could not be made by CA in 35% of cases because of residual Gelform sponge containing contrast medium in the artery. The visualization of residual tumor stain after TAE was 40% better on IA-DSA than CA, because of residual Gelform sponge containing contrast medium and overlapping shadow with calcified costal cartilage, excretory pyelography, and original tumor stain. However, CA was better than IA-DSA in visualizing accidental obstruction of nonobjective arteries such as the cystic artery because of the poor spatial resolution and misregistration artifacts of IA-DSA. CA was better than IA-DSA in visualizing surrounding nonembolized hepatic parenchyma because of the misregistration artifacts of IA-DSA. For effective TAE without severe complication, we concluded that TAE for HCC should be performed under a combination of IA-DSA and CA.
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PMID:Comparison of intra-arterial digital subtraction angiography with conventional angiography after transcatheter arterial embolization for hepatic malignancy. 256 Aug 38

Between November 1973 and December 1996, the in situ freezing of tumor, i.e., cryotherapy, was performed with liquid nitrogen (-196 degrees C) on 235 patients with primary liver cancer (PLC). There were no operative mortalities or severe complications. The 5-year survival was 39.8% for the 235 PLC patients, and 55.4% for the 80 patients with small PLC (< or = 5 cm). When analyzed with respect to treatment modalities without considering the size of the tumor, the 5-year survival was 26.9% for 78 PLC patients treated by cryotherapy alone; 39.6% for 58 PLC patients treated by cryotherapy plus hepatic artery ligation and perfusion; 46.0% for 27 PLC patients treated by cryotherapy for residual tumor plus resection of the main tumor; and 60.4% for 72 PLC patients treated by cryotherapy followed by resection of the frozen tumor. These results indicate that cryotherapy is a safe and effective treatment for PLC.
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PMID:Cryotherapy for primary liver cancer. 949 87

Surgical resection has been accepted as the only curative therapy for primary liver cancer (PLC). Unfortunately, most patients are surgically unresectable when they seek treatment. An alternative therapeutic approach for some of these patients is transcatheter arterial chemoembolization. However, this is not curative by itself, and additional therapy is required to eradicate residual disease. This study investigates the approach of preoperative hepatic arterial chemoembolization followed by the combination of oral Furtulon (5'-deoxy-5-fluorouridine) as a radiosensitizer and external beam radiotherapy (RT). From July 1997 to December 1998, 25 patients with unresectable PLC were treated with hepatic arterial chemoembolization followed by limited-field radiotherapy plus oral Furtulon as a radiosensitizer. Hepatic arterial chemoembolization was performed with 5-fluorouracil 1 g, cisplatin 80 mg (DDP), mitomycin C (MMC) 10 mg, and arterial embolization with iodized oil-10 ml mixed with 10 mg MMC. Hepatic arterial chemoembolization was performed at regular intervals of 6 weeks, and the patients then received limited-field RT. Mean tumor dose was 4,600 cGy (range, 4,100-5,200 cGy) in daily 1.8-Gy fractions, 5 times a week. The toxicity and responses between RT and surgery were assessed. After surgical evaluation, resection was performed. The histopathologic study was also performed in the specimens of both normal and radiation-injured liver tissues from the patients who underwent resection. Seventeen of 25 patients (68%) showed an objective response. One patient with cholangiocarcinoma involving the portal lymph nodes attained a complete response. Eight patients (32%) underwent sequential resection. The most common toxicity was an increase in liver enzymes, which were less than twofold of the upper limit of normal. Follow-up computed tomography studies after treatment showed a low-attenuation area adjacent to the hepatic tumor in the target volume. On pathologic evaluation, the low-attenuation area revealed hyperemia, distended hepatic sinusoids packed with erythrocytes, and hepatic cell loss when examined with microscopy; "new-born" hepatocytes, hepatic cords in the process of forming, and endothelial cells have appeared on electronic microscopic examination. The combination of hepatic arterial chemoembolization and external radiotherapy is efficacious and a safe modality for unresectable primary liver cancers. Furtulon offers the potential for use as a clinical radiosensitizer. Radiation can significantly damage the liver tissue between 41 Gy and 52 Gy, but the new hepatocytes were forming within the radiation-injured liver after RT.
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PMID:Phase I clinical trial of oral furtulon and combined hepatic arterial chemoembolization and radiotherapy in unresectable primary liver cancers, including clinicopathologic study. 1103 2

For unresectable primary liver cancer, transcatheter arterial chemoembolization is the most effective method in reducing the size of tumor and become the most popular forms in Asia, but, it is not a curative approach and additional therapy is needed to kill the residual tumor cells. In this paper, we report a case in which a patient with a single very large liver cancer has been successfully treated by chemoembolization combined with radiotherapy. The results suggest that this is a very promising therapeutic approach for single large primary liver cancer.
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PMID:Large primary liver cancer treated by chemoembolization combined with radiotherapy successfully. 1274 62

A 57-year-old man was found to have elevated levels of HCC markers during an observation of chronic hepatitis C. Diffused hepatoma was involved in the posterior lobe, and tumor thrombus extended into the main portal vein (Vp4). Posterior segmentectomy and tumor thrombectomy were performed. But, CT scan 45 days after the operation showed an enhancement at the residual tumor thrombus in the posterior branch. The patient received a hepatic arterial infusion of 5-FU, followed by hepatic arterial embolization. Then, we chose radiation therapy to the tumor thrombus. The most recent CT showed no enhancement at the reduced tumor thrombus. There have been almost no reports of treatment for residual portal thrombus. Careful observations are necessary in such patients.
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PMID:[A case report of hepatocellular carcinoma (Vp4)--an attempt to reduce residual tumor thrombus using combination therapy (hepatic arterial infusion, hepatic arterial embolization and radiation)]. 1631 49

Radiofrequency ablation has emerged as a minimally invasive option for liver cancer treatment, but local tumor recurrence is common. To eliminate residual tumor cells in the ablated tumor, biodegradable polymer millirods have been designed for local drug (e.g., doxorubicin) delivery. A limitation of this method has been the extent of drug penetration into the tumor (<5 mm), especially in the peripheral tumor rim where thermal ablation is less effective. To provide drug concentration above the therapeutic level as needed throughout a large tumor, implant strategies with multiple millirods were devised using a computational model. This dynamic, 3-D mass balance model of drug distribution in tissue was used to simulate the consequences of various numbers of implants in different locations. Experimental testing of model predictions was performed in a rabbit VX2 carcinoma model. This study demonstrates the value of multiple implants to provide therapeutic drug levels in large ablated tumors.
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PMID:Model simulation and experimental validation of intratumoral chemotherapy using multiple polymer implants. 1852 17

Percutaneous ablative methods guided by imaging techniques are considered nowadays curative treatment for early HCC in patients who are not candidates for liver transplantation and surgical resection. The final goal of all ablative treatments is to achieve complete destruction of neoplastic tissue by disruption of tumor vascularity. The best way to demonstrate the efficacy of any ablative methods noninvasively is to demonstrate that the blood supply has been disrupted both inside and at the periphery of the tumor by means of imaging methods. Contrast-enhanced ultrasound (CEUS) with second generation contrast agents is almost as sensitive as CT (considered to be the gold standard) in depicting the residual tumor after an ablation. Moreover, CEUS can be used before ablation to plan the treatment, during the procedure to guide the needle insertion, or immediately after to determine whether the tumor has been ablated or needs additional treatment which can be performed in the same session.
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PMID:Contrast enhanced ultrasound in assessing therapeutic response in ablative treatments of hepatocellular carcinoma. 1956 61

The success rate of percutaneous radiofrequency (RF) ablation for hepatocellular carcinoma (HCC) depends on correct targeting via an imaging technique. However, RF electrode insertion is not completely accurate for residual HCC nodules because B-mode ultrasound (US), color Doppler, and power Doppler US findings cannot adequately differentiate between treated and viable residual tumor tissue. Electrode insertion is also difficult when we must identify the true HCC nodule among many large regenerated nodules in cirrhotic liver. Two breakthroughs in the field of US technology, harmonic imaging and the development of second-generation contrast agents, have recently been described and have demonstrated the potential to dramatically broaden the scope of US diagnosis of hepatic lesions. Contrast-enhanced harmonic US imaging with an intravenous contrast agent can evaluate small hypervascular HCC even when B-mode US cannot adequately characterize tumor. Therefore, contrast-enhanced harmonic US can facilitate RF ablation electrode placement in hypervascular HCC, which is poorly depicted by B-mode US. The use of contrast-enhanced harmonic US in ablation therapy for liver cancer is an efficient approach.
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PMID:Contrast-enhanced harmonic ultrasound imaging in ablation therapy for primary hepatocellular carcinoma. 2116 Jul 24

The mammalian target of the rapamycin (mTOR) pathway, which drives cell proliferation, is frequently hyperactivated in a variety of malignancies. Therefore, the inhibition of the mTOR pathway has been considered as an appropriate approach for cancer therapy. In this study, we examined the roles of mTOR in the maintenance and differentiation of cancer stem-like cells (CSCs), the conversion of conventional cancer cells to CSCs and continuous tumor growth in vivo. In H-Ras-transformed mouse liver tumor cells, we found that pharmacological inhibition of mTOR with rapamycin greatly increased not only the CD133+ populations both in vitro and in vivo but also the expression of stem cell-like genes. Enhancing mTOR activity by over-expressing Rheb significantly decreased CD133 expression, whereas knockdown of the mTOR yielded an opposite effect. In addition, mTOR inhibition severely blocked the differentiation of CD133+ to CD133- liver tumor cells. Strikingly, single-cell culture experiments revealed that CD133- liver tumor cells were capable of converting to CD133+ cells and the inhibition of mTOR signaling substantially promoted this conversion. In serial implantation of tumor xenografts in nude BALB/c mice, the residual tumor cells that were exposed to rapamycin in vivo displayed higher CD133 expression and had increased secondary tumorigenicity compared with the control group. Moreover, rapamycin treatment also enhanced the level of stem cell-associated genes and CD133 expression in certain human liver tumor cell lines, such as Huh7, PLC/PRC/7 and Hep3B. The mTOR pathway is significantly involved in the generation and the differentiation of tumorigenic liver CSCs. These results may be valuable for the design of more rational strategies to control clinical malignant HCC using mTOR inhibitors.
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PMID:Transient mTOR inhibition facilitates continuous growth of liver tumors by modulating the maintenance of CD133+ cell populations. 2214 42


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