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Query: UMLS:C0345904 (liver cancer)
 15,188 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

HCC in Japan has very different characteristics from that in other Asian countries. Because, among the Japanese HCC patients approximately 80% of the patients are HCV positive and they are aged over 60 years old. On the other hand, in many Asian countries HBVpositive HCC patients are dominant and their age is younger than the Japanese patients. Early diagnosis of HCC is mainly performed by means of imaging diagnostic technique such as abdominal ultrasonography, dynamic CT, dynamic MRI and CT angiography. If small HCC less than 3 cm in diameter is found and liver function is well preserved, local ablation therapy or surgical treatment promises better than 5 years survival (over 60%). While, TAE or TACE is performed in cases of HCC larger than 3 cm in size, if liver failure is not complicated. In advanced HCC cases with multiple tumors, arterial infusion of anticancer drug has been applied. However, its efficacy is not estimated. Chemoprevention is another modality for HCC. Eradication of HCV with an antiviral agent has proven to prevent hepatocarcinogenesis. As for chemoprevention of HCC, some trials are on going in Japan.
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PMID:Clinical aspects of hepatocellular carcinoma in Japan. 1659 85

This article aims to review the state of the art in ablation techniques for hepatic lesions. In addition to discussing the indications, outcomes, and potential complications of the technique, we illustrate the spectrum of imaging findings after treatment. Recent years have seen the development of a wide variety of minimally invasive techniques to treat liver cancer. These include ethanol injection, and thermal ablation using radiofrequency, laser, microwaves, or cryosurgery. Percutaneous radiofrequency ablation is one of the most promising non-surgical treatments for hepatic neoplasms. The results of several studies show that radiofrequency ablation enables adequate local control of tumors with few complications, achieving acceptable survival rates. Radiofrequency ablation can be performed using any imaging technique, although it is most commonly performed under ultrasound guidance. CT and MRI show the degree of tumor necrosis better and are more frequently employed in follow up. This article reviews the indications and contraindications for the procedure, potential complications, long-term outcome, and imaging findings for percutaneous radiofrequency ablation of hepatic tumors.
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PMID:[Radiofrequency ablation of hepatic tumors]. 1705 70

Hepatocellular carcinoma will continue to be one of the most common malignancies worldwide. Improved survival occurs following resection or liver transplantation. The appropriate pre-operative stratification and staging of these patients is essential. CT and MRI will undoubtedly continue to play a major role in the detection and diagnosis of HCC. These imaging techniques should be optimized for the evaluation of suspected HCC. The radiology report from the CT or MRI examination should include a comprehensive review of key diagnostic information for appropriate staging. This includes lesion size and number. Also to be noted are segmental and vascular involvement, regional and distant adenopathy as well as metastases, and finally, the presence of ascites, varices and cirrhosis.
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PMID:Hepatocellular carcinoma: MRI and CT examination. 1740 24

Cholangiocarcinoma (CC) is rare malignant tumors composed of cells that resemble those of the biliary tract. It is notoriously difficult to diagnose, and is associated with a high mortality. Traditionally, CC is divided into intrahepatic and extrahepatic disease according to its location within the biliary tree. Intrahepatic cholangiocellular carcinoma (IH-CCC) or peripheral cholangiocellular carcinoma (CCC) appears within the second bifurcation of hepatic bile duct, and is the second most common primary liver cancer following hepatocellular carcinoma (HCC), IH-CCC or peripheral CCC often presents with advanced clinical features, and the cause for this cancer rise is still unclear. MRI, CT and PET provide useful diagnostic information in those patients. Surgical resection is the only chance for cure, with results depending on selected patients and careful surgical technique. Liver transplantation could offer long-term survival in selected patients when combined with chemotherapy. Chemotherapy, radiation therapy or combination therapies remain as the only treatment for inoperable patients. However, these are uniformly ineffective in patients' survival.
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PMID:Multi-disciplinary treatment for cholangiocellular carcinoma. 1746 40

We report two rare cases of hepatocellular carcinoma with invasion into the right atrium. In both our cases, the patients had liver cirrhosis and were admitted to our department due to symptoms such as worsening of the jaundice, ascites and edema of the lower extremities. The diagnosis of the HCC was established when we found high levels of alpha-fetoprotein, and the patients underwent MRI and CT-scan that were indicative of HCC. The clinical suspicion of invasion of the RA by the tumor emerged from the presence of heart-related symptoms, such as dyspnea and chest discomfort. The patients underwent two-dimensional transthoracic echocardiogram, which revealed from the sub-costal view a mobile atrial mass protruding from the inferior vena cava. In conclusion, when a patient with a history of chronic hepatic disease presents with symptoms of right heart failure one must be cautious and should bear in mind that right heart involvement from a malignant tumor may be present.
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PMID:Hepatocellular carcinoma with invasion into the right atrium. Report of two cases and review of the literature. 1825 Nov 69

Hepatocellular carcinoma (HCC) is a malignant tumor which is becoming more prevalent worldwide. Patients at high risk of developing HCC, namely hepatitis B- and C-related liver cirrhosis patients, should be entered into surveillance programs, which should be performed using both ultrasonography and 3 tumor markers (AFP, PIVKA-II, AFP-L3). The surveillance interval needs to be shortened for patients at higher risk of HCC. Therefore, super-high-risk patients should be screened at 3- to 4-month intervals based on their risk of developing HCC. Sonazoid-enhanced US is extremely useful to characterize hepatic tumors when compared with multidetector-row computed tomography (MDCT). Moreover, Sonazoid-enhanced US with defect reperfusion imaging is a breakthrough approach in the treatment of HCC. This technique will markedly change the therapeutic strategy for liver cancer. Furthermore, diagnostic capability using the new imaging technique Gd-EOB-DTPA MRI is promising. A reduced uptake (low intensity) in the hepatobiliary phase of Gd-EOB-DTPA MRI strongly suggests HCC (including early-stage HCC) or a high-grade dysplastic nodule with high malignant potential. Empirically, intrahepatic arterial infusion chemotherapy using implanted reservoir port is known to be effective for advanced HCC with vascular invasion; however, no randomized study exists to prove its efficacy. Further controlled study is necessary to establish this treatment option as a standard of care in a treatment algorithm for HCC. In contrast, sorafenib was established as the first choice of treatment as a standard of care in advanced HCC patients with preserved liver function and vascular invasion/extrahepatic spread. Furthermore, global clinical trials are now ongoing using sorafenib as an adjuvant setting after resection, ablation or TACE. Efficacy of combined use of sorafenib with TACE or intra-arterial infusion chemotherapy is not clear. In order to clarify this issue a randomized clinical trial for intermediate and advanced HCC comparing sorafenib alone versus sorafenib combined with maintenance TACE/intra-arterial infusion chemotherapy and/or intra-arterial infusion chemotherapy is scheduled to be initiated in Japan in 2009. If positive results are obtained by these trials, its impact on treatment strategy for HCC will be drastically changed.
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PMID:Hepatocellular carcinoma 2009 and beyond: from the surveillance to molecular targeted therapy. 1909 66

The purpose of this study was to evaluate the accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) in differentiating HCC from benign cirrhotic lesions compared with conventional dynamic contrast-enhanced MRI. Fifty-five patients with cirrhosis underwent conventional and DW-MRI at 1.5 Tesla. Signal intensity ratios (SI(ratio)) of solid liver lesions to adjacent hepatic parenchyma were measured for b0, b100, b600 and b1000, and the apparent diffusion coefficients (ADC) were calculated. In 27 patients, imaging results were compared to histopathology, and in 28 patients, to imaging follow-up. Based on predetermined thresholds, sensitivity and specificity of DW-MRI and conventional MRI were compared. SI(ratio) was significantly different between malignant and benign lesions at all b-values (P < 0.0001). No significant difference in ADC was seen (P = 0.47). For detection of malignant lesions, DW-MRI with b600-SI(ratio) yielded a sensitivity of 95.2% compared to 80.6% for conventional MRI (P = 0.023) and a specificity of 82.7% compared to 65.4% (P = 0.064). The improved accuracy was most beneficial for differentiating malignant lesions smaller than 2 cm. DW-MRI with b600-SI(ratio) improved the detection of small HCC and the differentiation of pseudotumoral lesions compared with conventional MRI.
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PMID:Diffusion-weighted MRI provides additional value to conventional dynamic contrast-enhanced MRI for detection of hepatocellular carcinoma. 1944 Jul 18

New interventional options especially for patients with HCC and BCLC scores B and C give rise to disputes about the optimal therapeutic management. CT-guided brachytherapy complements established interventional techniques like RFA and TACE since it may also be used successfully in tumors much greater than 5 cm in diameter. In addition, unlike thermal ablation, the brachytherapy technique may be applied in tumors located nearby risk structures such as liver hilum or gallbladder and it is independent of cooling effects such as through large blood vessels or strong tumor perfusion. Depending on tumor size, geometry and visibility, MRI or CT guidance may be used. 15 Gy minimal target dose can be applied safely in a single or--in case of very large tumors--a sequential approach targeting different tumor portions. Local recurrence rates will be very low, and the rate of complications is moderate despite the fact that most patients present with underlying cirrhosis and related comorbidities. Preliminary data suggest a positive impact on overall survival. Randomized controlled trials are on their way to assess combination schemes with systemic treatments such as sorafenib.
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PMID:Image-guided interstitial high-dose-rate brachytherapy in hepatocellular carcinoma. 1954 56

Although hepatocellular carcinoma (HCC) is the liver cancer that requires repeated treatments because of a high tendency for recurrence, few data have been available about whether repeated treatments, including those to reduce tumor mass, are effective in prolonging survival. We retrospectively analyzed the effectiveness of tumor-mass-reduction therapy for the prognosis of patients with recurrent HCC. To analyze the effectiveness of various modalities of therapies with a single criterion, we defined a tumor-mass-reduction grade (TMRG), which was retrospectively evaluated by dynamic CT or MRI. Grade A: no evident HCC remains untreated; Grade B1: more than 50% of lesions are treated; and Grade B2: less than 50% of lesions are treated. Subjects were stratified by Child-Pugh classification and the number of admissions for HCC treatment. In those classified as Child-Pugh A, a better survival rate was obtained, depending on the degree of TMRG from the first to the fifth admission (P < .01), suggesting that these patients are endurable for repeated therapies and benefit from the many sessions of treatment. In those classified as Child-Pugh B, on the second to the fifth admissions, survival rates showed statistical difference depending on the TMRG (P < .01), which may suggest that only a few sessions of treatment are meaningful. In those classified as Child-Pugh C, any number of mass-reduction treatment sessions did not improve the survival rate. In conclusion, repeated tumor-mass-reduction therapies for recurrent HCC are most beneficial in Child-Pugh A patients. Patients with Child-Pugh B who experience several recurrence episodes and any patients with Child-Pugh C may benefit more from modalities other than tumor-mass-reduction therapies.
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PMID:Retrospective evaluation of tumor-mass-reduction therapy for the prognosis of recurrent hepatocellular carcinoma. 1966 43

To develop a drug delivery system with enhanced efficacy and minimized adverse effects, we synthesized a novel polymeric nanoparticles, (YCC-DOX) composed of poly (ethylene oxide)-trimellitic anhydride chloride-folate (PEO-TMA-FA), doxorubicin (DOX) and superparamagnetic iron oxide (Fe(3)O(4)) and folate. The efficacy of the nanoparticles was evaluated in rats and rabbits with liver cancer, in comparison with free-DOX (FD) and a commercial liposome drug, DOXIL. YCC-DOX showed the anticancer efficacy and specifically targeted folate receptor (FR)-expressing tumors, thereby increasing the bioavailability and efficacy of DOX. The relative tumor volume of the YCC-DOX group was decreased two- and four-fold compared with the FD and DOXIL groups in the rat and rabbit models, respectively. Furthermore, YCC-DOX showed higher MRI sensitivity comparable to a conventional MRI contrast agent (Resovist), even in its lower iron content. In the immunohistochemical analysis, YCC-DOX group showed the lower expression of CD34 and Ki-67, markers of angiogenesis and cell proliferation, respectively, while apoptotic cells were significantly rich in the YCC-DOX group in terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. These results indicate that YCC-DOX is a promising candidate for treating liver cancer and monitoring the progress of the cancer using MRI.
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PMID:Multifunctional doxorubicin loaded superparamagnetic iron oxide nanoparticles for chemotherapy and magnetic resonance imaging in liver cancer. 2034 38


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