Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1864663 (HCC)
 2,985 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ethanol injection into HCC tumors is an effective therapy and percutaneous ethanol injection therapy (PEIT) is performed on many HCC patients. However, there are cases in which PEIT becomes difficult because the HCC could not be detected by ultrasonography or the tumor is located in an area where it is impossible to perform PEIT. Nine patients with HCC underwent laparoscopic ethanol injection therapy (LEIT) in our institution. Their tumors were located on the liver surface and could be visualized by laparoscopic examination. Ethanol injection was performed under laparoscopic direct visualization. The total injected ethanol volume required ranged from 4 to 15 ml and in most cases both tumor size and alpha-fetoprotein (AFP) levels decreased after LEIT. Three cases showed a transient complication of abdominal pain or/and portal vein damage. Other severe complications were not observed. All cases required additional therapies, including transcatheter arterial chemoembolization (TAE) or PEIT to complete the tumor necrosis. In conclusion, LEIT is a safe and effective therapy for HCC located on the liver surface, but should be combined with other therapies to facilitate its effect against HCC.
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PMID:Laparoscopic ethanol injection therapy for hepatocellular carcinoma. 1178 87

The prognosis of patients with HCC still remains dismal. The life expectancy of HCC patients is hard to predict because of the high possibility of postoperative recurrence. Many factors, such as patient's general conditions, macroscopic tumor morphology, as well as tumor histopathology features, have been proven of prognostic significance. Female HCC patient often has a better prognosis than male patient, which might be due to the receptor of sex hormones. Younger patients often have tumors with higher invasiveness and metastatic potentials, and their survival and prognosis are worse than the older ones. Co-existing hepatitis status and hepatic functional reserve have been confirmed as risk factors for recurrence. Serum alpha-fetoprotein (AFP) is useful not only for diagnosis, but also as a prognostic indicator for HCC patients. AFP mRNA has been proposed as a predictive marker of HCC cells disseminated into the circulation and for metastatic recurrence. Many pathologic features, such as tumor size, number, capsule state, cell differentiation, venous invasion, intrahepatic spreading, and advanced pTNM stage, are the best-established risk factors for recurrence and important aspects affecting the prognosis of patients with HCC. Marked inflammatory cell infiltration in the tumor could predict a better prognosis. Clinical stage is still the most important factor influencing on the prognosis. Extratumor spreading and lymph nodal metastasis are independent predictors for poor outcome. Some new predictive systems have recently been proposed. Different strategies of treatment might have significant different effects on the patients' prognosis. To date, surgical resection is still the only potentially curative treatment for HCC, including localized postoperative recurrences. Extent of resection, blood transfusion, occlusion of porta hepatis, and blood loss affect the survival and prognosis of HCC patients. Regional therapies provide alternative ways to improve the prognosis of HCC patients who have no opportunity to receive surgical treatment or postoperative recurrence. The combination of these treatment modalities is hopeful to further improve the prognosis. The efficacies of neoadjuvant (preoperative) or adjuvant (postoperative) chemotherapy or chemoembolization in preventing recurrence and on the HCC prognosis still remain great controversy, and deserve further evaluation. Biotherapy, including IFN-alpha therapy, will play more important role in preventing recurrence and metastasis of HCC after operation.
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PMID:The prognostic significance of clinical and pathological features in hepatocellular carcinoma. 1192 90

Cirrhosis of the liver has to be regarded as a premalignant condition independent of its etiology. The annual risk of developing HCC in cirrhosis is between 1% and 6%. Surveillance-programs have been introduced to detect early stages of HCC in order to improve mortality. However, only controlled trials will answer the question of the efficacy of such programs. Studies on the potential benefit of surveillance-programs comparing survival in surveilled and unsurveilled patients are so far lacking. It seems clear, however, that surveillance-programs can detect small tumors, often unfocal and potentially treatable by a curative approach. Moreover, the etiology (HBV, HCV, genetic hemochromatosis) and activity of liver cirrhosis as measured by serum-transaminases, liver histology (small-cell dysplasia and atypical regenerative nodules), Child-Pugh-stage and the concentration of alpha-fetoprotein at the beginning of a surveillance-program--all these factors reflect a high risk of developing HCC in an individual patient. Until programs are introduced on the basis of randomized, controlled trials of surveillance vs. usual care (with liver-related, specific deaths and all-cause-mortality as end-points) it seems reasonable to screen high-risk patients semi-annually by liver ultrasound and determination of AFP-concentration in the serum.
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PMID:[Hepatocellular carcinoma: risk groups--screening]. 1223 79

1,25-dihydroxycholecalciferol [1,25-(OH)2 D3] has been shown to have antiproliferative effects in a wide variety of cancer cell lines. In vivo studies, although often limited by the development of hypercalcemia, have also shown the potential usefulness of 1,25-(OH)2 D3 in inhibiting tumor growth. The potential usefulness of the drug has been hampered by the development of hypercalcemia. This pilot clinical study was designed to evaluate the preclinical results that have shown, locoregional administration of 1,25-(OH)2 D3 in lipiodol can prevent the development of hypercalcemia. Eight patients with refractory HCC were given a single intrahepatic arterial dose (50, 75 or 100 microg) of 1,25-(OH)2 D3 dissolved in 5 ml of lipiodol. Following this, for 4 weeks serum calcium, 1,25-(OH)2 D3, alpha-fetoprotein and a range of biochemical indices were monitored. While, in 3 patients the calcium levels exceeded the normal range, even at these extremely high doses, non of the patients developed grade 3 hypercalcemia. 1,25-(OH)2 D3 administration also led to transient stabilization of serum alpha-fetoprotein in these patients. The data obtained support the hypothesis that, in patients with HCC, locoregional delivery of 1,25-(OH)2 D3 in lipiodol can allow administration of supra-pharmacological doses of the drug without the development of hypercalcemia.
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PMID:Hepatic intra-arterial injection of 1,25-dihydroxyvitamin D3 in lipiodol: Pilot study in patients with hepatocellular carcinoma. 1223 33

A 76-year old female patient with chronic B type hepatitis had HCC expanding into the extra-hepatic space. In July 2001, we safely performed partial hepatic resection under hand-assisted laparoscopic surgery (HALS). Three months after the treatment, computed tomography of the liver revealed HCC close to the first branch of right portal vein and bile duct. Although we performed transcatheter arterial chemoembolization (TACE) for the tumor, this treatment was not effective. So we treated percutaneous ethanol injection therapy (PEIT) for the tumor area neighboring Glisson's capsule and radiofrequency ablation therapy (RFA) for the tumor. After this treatment the tumor showed no viability on dynamic CT, and there was no liver infarction or damage to the bile duct. Four months after the final treatment, enhanced CT revealed no viable lesion, and serum alpha-fetoprotein level was declining toward the normal range. We conclude that selection of an applicable treatment and approach is of importance for safe and effective therapy.
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PMID:[Treatment of hepatocellular carcinoma--partial hepatic resection under hand-assisted laparoscopic surgery and local ablation therapy with ethanol and radio frequency]. 1248 91

Arterial chemoembolization with subsequent systemic chemotherapy was assessed prospectively. Of 94 consecutive patients with HCC, 31 patients were considered to have inoperable disease and were selected for chemoembolization. Twenty-two of the 31 patients underwent chemoembolization. In eight patients, technical problems with catheterization prevented the application of therapy, and one patient rejected further treatment. Regimen: Three monthly cycles of chemoembolization with cisplatin 20 mg/m(2) mixed with lipiodol delivered intraarterially with Gelfoam or collagen on day 1, followed by intravenous chemotherapy with cisplatin 60 mg/m(2) on day 2; interferon alpha-2c 30 microg (10 M IU) subcutaneously on days 2, 5, 9, and 12. Three percent of the patients (1/31) (CI 95% 0.08; 16.7) experienced a partial clinical response, in 53% alpha-fetoprotein levels decreased by more than 50%. On univariate analysis, performance status, Child score, Okuda stage, albumin levels, and lactate dehydrogenase were found to have an effect on survival. Postchemoembolization syndrome occurred in 68% of the patients, nausea/vomiting grades 3/4 (according to the World Health Organization WHO) in six patients, anemia grade 3 in three patients, leukopenia grade 3 in one patient and thrombocytopenia grade 3 in one patient. This treatment regimen is a very selective procedure. Because of the low response rate it is not recommended for routine clinical use.
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PMID:Chemoembolization with cisplatin, lipiodol and Gelfoam and subsequent systemic chemotherapy with cisplatin and interferon in patients with hepatocellular carcinoma: a non-randomized prospective study. 1288 22

Segmental liver resection is generally considered the treatment of choice for small HCC in cirrhotic livers. Although in selected patients with small encapsulated nodules and low alpha-fetoprotein levels long-term survival can be expected after resection, Western experience is still limited, and follow-up studies too short so that the data presently available cannot be considered satisfactory. The true value of alcoholization as a possible alternative therapy in these patients is still to be ascertained. When using these treatment modalities, the major problem is the high tumour recurrence within the liver. Three main reasons could explain these clinical observations: 1. inadequate resection of the original tumor; 2. unrecognized multifocal HCC; 3. newly generated tumours in the remnant cirrhotic parenchyma. The rationale for liver transplantation is the oncological accuracy of the ablation of the liver, and the possibility of a simultaneous cure of the associated cirrhosis. In our programme of liver transplantation, begun in 1985, we accepted as an indication small HCC in cirrhotic livers. We present here our initial experience with 19 cases.
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PMID:Liver transplantation for small HCC in cirrhosis. 1462 82

Combined hepatocellular-cholangiocarcinoma (HCC-CC) with sarcomatoid features is an extremely rare primary liver cancer, of which only four cases have been reported. We report a case of sarcomatoid combined HCC-CC in a 60-year-old woman who complained of right upper quadrant pain and presented with a 7 cm mass in the S4 region of the liver in abdominal CT. Ultrasonography-guided needle biopsy diagnosed it as HCC, and left lobectomy of the liver followed. Microscopically, the tumor consisted of two portions: HCC portion showing trabecular pattern, which had partially sarcomatous area with spindle-shaped tumor cells, and CC portion with glandular pattern. Immunohistochemically, HCC portion reacted positively with alpha-fetoprotein while CC portion demonstrated positive reactivity with carcinoembryonic antigen and mucicarmine. Sarcomatoid cells reacted positively for cytokeratin. She died of tumor recurrence and hepatic failure 12 months after the operation. Combined HCC-CC has poor prognosis, and sarcomatoid HCC has high metastatic potential and poor prognosis compared with ordinary HCC.
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PMID:[A case of sarcomatoid combined hepatocellular-cholangiocarcinoma]. 1474 54

Brain metastases from hepatocarcinoma are exceptional and only a few cases have been reported in the literature, mainly from Far-Eastern countries. Clinical diagnosis in asymptomatic patients with preserved liver function is difficult and usually late. In some cases, cerebral metastasis is the initial manifestation of HCC and patients may develop intracerebral hemorrage and have a stroke-like presentation. We report on the first Italian case of cerebral metastases from multifocal hepatocellular carcinoma in an asymptomatic HbsAg negative patient with unknown HCV related chronic hepatitis and no evidence of liver cirrhosis. For many years he had a mild liver enzyme elevation and the presence of multiple misinterpreted hypoechogenic hepatic lesions. The hepatic tumor spread to the lungs and the brain and the patient developed two major episodes of intracranial hemorrage. He had two nodular lesions in the brain and alpha-fetoprotein levels were more than 10,000 ng/ml. He died from neurologic causes, without major signs of liver failure.
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PMID:Intracranial hemorrage due to brain metastases in an Italian HCV patient with hepatocellular carcinoma. 1505 9

The theoretical possibility that exposure of a solid malignancy to high-intensity focused ultrasound (US), or HIFU, could lead to an increased rate of metastasis still remains. Using reverse transcriptase polymerase chain reaction (RT-PCR), the potential risk of hematogenous dissemination was assessed in HIFU-treated patients with solid malignancy. RT-PCR can demonstrate the presence or absence of specific RNA fragments. On the day before HIFU ablation, 5-mL peripheral blood samples were collected, and again 5 to 7 days after HIFU, from 26 enrolled patients (hepatocellular carcinoma, HCC: 10; osteosarcoma: 16). Total RNA was isolated and RT-PCR was performed to analyze the mRNA expression of (alpha-fetoprotein (AFP) and bone-specific alkaline phosphatase (BALP) genes. Positive AFP mRNA expression was preoperatively detected in 8 of 10 patients with HCC. In the postoperative specimens, positive expression was also detected in 8 of 10 patients. In 2 patients, circulating tumor cells were found preoperatively, but not postoperatively. Conversely, 2 patients with no circulating tumor cells preoperatively were found to have circulating tumor cells after HIFU. Of 16 osteosarcoma patients, 12 patients had circulating tumor cells and 4 had none. After HIFU treatment, 2 of the 12 patients had converted from presence to absence of circulating cells and the remaining 4 patients remained negative. It is concluded that patients undergoing complete HIFU ablation may demonstrate conversion from presence to absence of circulating tumor-specific marker mRNA, and that HIFU would not enhance the potential risk of metastasis in patients with malignant diseases.
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PMID:Circulating tumor cells in patients with solid malignancy treated by high-intensity focused ultrasound. 1512 Dec 53


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