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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Primary Liver Cancer - August 2002
National Cancer Institute®
Last Modified: August 1, 2002
- A Phase II trial of nolatrexed dihydrochloride in patients with advanced hepatocellular carcinoma.
- A multi-centre randomized phase II study of nolatrexed versus doxorubicin in treatment of Chinese patients with advanced
- Effect of nimesulide on proliferation and apoptosis of human hepatoma SMMC-7721 cells.
- Effector mechanisms of norcantharidin-induced mitotic arrest and apoptosis in human hepatoma cells.
- [Construction of a hepatoma-targeting vector of adeno-associated virus containing human alpha-fetoprotein promoter and wild p53 gene in gene
- Mechanism of Impila (Callilepis laureola)-induced cytotoxicity in Hep G2 cells.
- [Perioperative management of focal liver diseases by ofloxacin]
- [The protective effect and mechanism of ischemic preconditioning for hepatic resection under hepatic blood inflow occlusion in hepatocellular
- [Resection of right or total hepatic caudate lobe including paracaval portion]
- Redox-sensitive interaction between KIAA0132 and Nrf2 mediates indomethacin-induced expression of gamma-glutamylcysteine synthetase.
- Multimodality treatment for patients with hepatocellular carcinoma: analysis of prognostic factors in a single Western institution series.
- External beam radiation therapy for inoperable hepatocellular carcinoma with portal vein thrombosis.
- Radiofrequency ablation for multiple hepatic metastases.
- Liver fibrosis increases the risk of intrahepatic recurrence after hepatectomy for hepatocellular carcinoma (Br J Surg 2002; 89: 57-62).
- Therapeutic radiological interventional procedures in hepatocellular carcinoma.
- Neoadjuvant and adjuvant therapies for resectable hepatocellular carcinoma (HCC) and palliation strategies.
- The effect of virtual reality and training on liver operation planning.
- Survival benefit of cirrhotic patients with hepatocellular carcinoma treated by percutaneous ethanol injection as a salvage therapy.
- Clinicopathological prognostic factors and impact of surgical treatment of mass-forming intrahepatic cholangiocarcinoma.
- Surgical results in patients with hepatitis virus-related hepatocellular carcinoma in Taiwan.
Table of Contents
1
UI - 10430248
AU - Stuart K; Tessitore J; Rudy J; Clendennin N; Johnston A
TI -
A Phase II trial of nolatrexed dihydrochloride in patients with advanced
hepatocellular carcinoma.
SO - Cancer 1999 Aug 1;86(3):410-4
AD - Boston Center for Liver Cancer, Beth Israel Deaconess Medical Center,
Harvard Medical School, Massachusetts 02215, USA.
BACKGROUND: Inoperable hepatocellular carcinoma is an incurable
malignancy with no accepted standard therapy. Chemotherapy has
demonstrated occasional responses and the need is great for a new and
effective agent. Therefore the authors conducted this Phase II trial of
a novel thymidylate synthase inhibitor, nolatrexed dihydrochloride
(designed using structure-based computer modeling), in patients with
advanced hepatocellular carcinoma. METHODS: Forty-one patients with
unresectable or metastatic hepatocellular carcinoma were treated with
nolatrexed, which was administered as a 24-hour outpatient intravenous
infusion for 5 days at a dose of 795 mg/m2/day as free base (1000
mg/m2/day as salt) during each 21-day cycle. Prophylactic treatment was
given for emesis and rash. RESULTS: Twenty-eight patients received at
least 2 courses of treatment and 26 patients were evaluable. Two
patients (8%) achieved a partial response and 2 additional patients
achieved a minor response that was significant enough to allow surgical
resection with curative intent. Fourteen patients (54%) achieved stable
disease. The overall median survival was 7 months (10 months among
patients who completed 2 cycles) and 1 patient remained free of disease
at last follow-up, 37 months after surgery. Toxicity was modest and
generally was comprised of stomatitis, nausea, malaise, and rash.
CONCLUSIONS: Nolatrexed appears to have modest biologic activity in
hepatocellular carcinoma. Due to the lack of alternative treatments,
further study of this drug or an oral equivalent may be warranted.
2
UI - 10447578
AU - Mok TS; Leung TW; Lee SD; Chao Y; Chan AT; Huang A; Lui MC; Yeo W; Chak
TI -
K; Johnston A; Johnson P
A multi-centre randomized phase II study of nolatrexed versus
doxorubicin in treatment of Chinese patients with advanced
hepatocellular carcinoma.
SO - Cancer Chemother Pharmacol 1999;44(4):307-11
AD - Department of Clinical Oncology, The Chinese University of Hong Kong,
Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
mok206551@cuhk.eu.hk
PURPOSE: A multi-centre randomized phase II study of single agent
nolatrexed dihydrochloride versus doxorubicin was undertaken in Chinese
patients with advanced hepatocellular carcinoma (HCC) to study and
compare the clinical efficacy of the two drugs. METHODS: Fifty-four
patients with clinical or histological diagnosis of HCC were randomized
in a 2:1 ratio to receive nolatrexed or doxorubicin. Nolatrexed 725
mg/m(2)/day was given by continuous infusion via a central venous device
for 5 days and doxorubicin 60 mg/m(2) was given as a rapid intravenous
infusion every 3 weeks. RESULTS: No objective responses were observed in
either treatment arm. Two patients in the nolatrexed arm and none in the
doxorubicin arm had >50% decline in serum alpha-fetoprotein. The median
survival for the patients in the nolatrexed and doxorubicin arms was 139
days and 104 days, respectively. Moderate toxicities including
leukopenia, thrombocytopenia, mucositis and skin rash were observed in
both treatment arms. CONCLUSION: Nolatrexed and doxorubicin are
minimally active in the treatment of advanced HCC. Given the small
sample size, no difference is observed between the two drugs.
3
UI - 12046075
AU - Tian G; Yu JP; Luo HS; Yu BP; Yue H; Li JY; Mei Q
TI -
Effect of nimesulide on proliferation and apoptosis of human hepatoma
SMMC-7721 cells.
SO - World J Gastroenterol 2002 Jun;8(3):483-7
AD - Gastroenterology department. Renmin hospital of Wuhan university, 238
Jie-fang Road,Wuhan 430060,Hubei Province,China.
AIM: Cyclooxygenase-2 (COX-2) has been suggested to be associated with
carcinogenesis. We sought to investigate the effect of the selective
COX-2 inhibitor, Nimesulide on proliferation and apoptosis of SMMC-7721
human hepatoma cells.METHODS: This study was carried out on the culture
of hepatic carcinoma SMMC-7721 cell line. Various concentrations of
Nimesulide (0, 200 micromol/L, 300 micromol/L, 400 micromol/L) were
added and incubated. Cell proliferation was detected with MTT
colorimetric assay, cell apoptosis by electron microscopy, flow
cytometry and TUNEL.RESULTS: Nimesulide could significantly inhibit
SMMC-7721 cells proliferation dose-dependent and in a dependent manner
compared with that of the control group. The duration lowest inhibition
rate produced by Nimesulide in SMMC-7721 cells was 19.06%, the highest
inhibition rate was 58.49%. After incubation with Nimesulide for 72 h,
the most highest apoptosis rate and apoptosis index of SMMC-7721 cells
comparing with those of the control were 21.20%+/-1.62% vs 2.24%+/-0.26%
and 21.23+/-1.78 vs 2.01+/-0.23 (P<0.05). CONCLUSION:The selective COX-2
inhibitor, Nimesulide can inhibit the proliferation of SMMC-7721 cells
and increase apoptosis rate and apoptosis index of SMMC-7721 cells. The
apoptosis rate and the apoptosis index are dose-dependent. Under
electron microscope SMMC-7721 cells incubated with 300 micromol and 400
micromol Nimesulide show apoptotic characteristics. With the
clarification of the mechanism of selective COX-2 inhibitors, These
COX-2 selective inhibitors can become the choice of prevention and
treatment of cancers.
4
UI - 12115564
AU - Chen YN; Chen JC; Yin SC; Wang GS; Tsauer W; Hsu SF; Hsu SL
TI -
Effector mechanisms of norcantharidin-induced mitotic arrest and
apoptosis in human hepatoma cells.
SO - Int J Cancer 2002 Jul 10;100(2):158-65
AD - School of Chinese Medicine, China Medical College, Taichung, Taiwan.
NCTD is a demethylated form of cantharidin with antitumor properties,
which is now in use as a routine anticancer drug against hepatoma.
However, there is limited information on the effect of NCTD on human
cancer cells. In the present study, NCTD inhibited proliferation, caused
mitotic arrest, then progressed to apoptosis within 96 hr in 3 human
hepatoma cell lines: HepG2, Hep3B and Huh-7. NCTD treatment (5
microg/ml) enhanced the expression of Cdc25C and p21(Cip1/Waf1),
increasing the phosphorylation of these 2 proteins. In addition, NCTD
treatment induced an earlier increase in cyclin B1-associated histone H1
kinase activity within 48 hr, but an approximately 70% reduction of both
protein level and kinase activity of cyclin B1 was observed at 72 hr.
Treatment with NCTD significantly decreased the expression of p53
protein but did not affect the expression of Cdk1 and p27(Kip1).
Moreover, NCTD treatment also increased the phosphorylation of Bcl-2 and
Bcl-X(L) but did not affect the expression of Bax or Bad. Bcl-2
phosphorylation appears to inhibit its binding to Bax since less Bax was
detected in immunocomplex with Bcl-2 in NCTD-treated HepG2 cells. In
addition, NCTD treatment caused activation of caspase-9 and caspase-3,
preceding DNA fragmentation and morphologic features of apoptosis.
Pretreatment with the broad-spectrum caspase inhibitor z-VAD-fmk
markedly inhibited NCTD-induced caspase-3 activity and cell death. These
results suggest that phosphorylation of p21(Cip1/Waf1) and Cdc25C and
biphasic regulation of cyclin B1-associated kinase activity may
contribute to NCTD-induced M-phase cell-cycle arrest. Furthermore, the
increase of p21(Cip1/Waf1), phosphorylation of Bcl-2 and Bcl-X(L),
activation of caspase-9 and caspase-3 may be the molecular mechanism
through which NCTD induces apoptosis. Copyright 2002 Wiley-Liss, Inc.
5
UI - 11798803
AU - Cheng J; Leng X; Peng J
TI -
[Construction of a hepatoma-targeting vector of adeno-associated virus
containing human alpha-fetoprotein promoter and wild p53 gene in gene
therapy of liver cancer]
SO - Zhonghua Yi Xue Za Zhi 2000 Jun;80(6):461-3
AD - Department of Surgery, People's Hospital, Beijng Medical University,
Beijing 100044, China.
OBJECTIVE: To construct plasmids that express target genes in hepatoma
cell line using adeno-associated virus (AAV) vectors containing human
AFP promoter. METHODS: Primers containing specific enzyme-cutting sites
were designed to amplify the alpha-fetoprotein promoter (AFP promoter)
from human genome. The promoter was cloned into pTR-UF5, a plasmid
containing GFP reporter gene, resulting in the recombinant AAV plasmid
containing the reporter gene (rAAV-AFP-GFP). Blunted ligation was used
to construct the recombinant AAV vector plasmid containing human wild
p53 gene (rAAV-AFP-53). The plasmid rAAV-AFP-GFP was used to transfect
the AFP-expressing Hep G(2) and non-AFP-expressing 293 cell lines,
respectively, to measure the function of the cloned AFP promoter. Flow
cytometry was used to measure the effect of rAAV-AFP-53 on hepatoma cell
line HLE. RESULTS: rAAV-AFP-53 and rAAV-AFP-GFP were verified by DNA
sequencing and enzyme digestion to carry human AFP promoter. Cell
transfection of rAAV-AFP-GFP showed selective expression in AFP-positive
hepatoma cell lines with a transfection rate of 36.5%; rAAV-AFP-53
induced apoptosis rate was 73.88%. CONCLUSION: Two adeno-associated
virus plasmids are successfully constructed that carry p53 gene and
reporter gene, respectively, guided by AFP promoter. The former one
shows a hepatoma-specific apoptosis-inducing effect.
6
UI - 11937079
AU - Popat A; Shear NH; Malkiewicz I; Thomson S; Neuman MG
TI -
Mechanism of Impila (Callilepis laureola)-induced cytotoxicity in Hep G2
cells.
SO - Clin Biochem 2002 Feb;35(1):57-64
AD - Division of Clinical Pharmacology, Sunnybrook and Women's College Health
Sciences Centre, Toronto, Ontario, Canada.
OBJECTIVES: To determine the mechanism(s) of Impila (Callilepis
laureola)-induced toxicity in human hepatoblastoma Hep G2 cells in vitro
and the possible prevention of this toxicity by N-acetylcysteine (NAC).
DESIGN AND METHODS: Cells were treated with an aqueous extract of Impila
(10 mg/mL) for up to 24 h. NAC (5 mM) was administered either
concomitantly with Impila or one hour post Impila treatment.
Cytotoxicity was quantitated spectrophotometrically by the metabolism of
the tetrazolium dye MTT. Total glutathione (GSH) was measured using the
Tietze assay. RESULTS: Impila produced cytotoxicity and depleted GSH in
a concentration- and time-dependent manner. A significant depletion in
GSH was observed after 15 min (p < 0.0001 vs. control), whereas
significant cytotoxicity was only observed after at least 3 h (p <
0.0001 vs. control). Both concomitant and posttreatment with NAC
prevented Impila-induced GSH depletion and resulted in a significant
decrease in Impila-induced cytotoxicity (p < 0.001 vs. NAC-untreated
cells). CONCLUSION: Our results suggest the mechanism of Impila-induced
cytotoxicity in Hep G2 cells in vitro involves depletion of cellular
GSH. Preventing GSH depletion by supplementing cells with NAC reduces
cytotoxicity.
7
UI - 12087720
AU - Khlebnikov EP; Elagina LV; Vishnevskii VA; Kybyshkin VA; Izotova GN;
TI -
Pavlova MV; Ikramov RZ
[Perioperative management of focal liver diseases by ofloxacin]
SO - Antibiot Khimioter 2002;47(2):24-8
AD - A.V. Vishnevsky Institute of Surgery, Russian Academy of Medical
Sciences, Moscow.
Perioperative use of ofloxacin for prophylaxis was investigated in 20
patients with focal hepatic formations (hemangioma, adenocarcinoma,
echinococcosis). First dose of ofloxacin (200 mg) was given
intravenously 15 min before operation. After operation ofloxacin was
used intravenously (400 mg daily) for 5 days. Pharmacokinetic
investigation demonstrated that perioperative intravenous use of
ofloxacin provided concentrations in blood and hepatic tissue
satisfactory for potential microflore inhibition. Immunological
monitoring demonstrated positive dynamics on 5-7 days after operation.
dynamics depended on nosology of the focal hepatic formation. Ofloxacin
use for prophylaxis in the operated patients with focal hepatic
formations was efficient for profilaxy of postoperation infective
complications.
8
UI - 12133355
AU - Liang L; Li S; Huang J
TI -
[The protective effect and mechanism of ischemic preconditioning for
hepatic resection under hepatic blood inflow occlusion in hepatocellular
carcinoma patients with cirrhosis]
SO - Zhonghua Wai Ke Za Zhi 2002 Apr;40(4):265-7
AD - Department of Hepatobiliary Surgery, First Affiliated Hospital, Sun
Yet-sen University of Medical Sciences, Guangzhou 510080, China.
OBJECTIVE: To investigate the protective effect of ischemic
preconditioning (IPC) for hepatic resection under hepatic blood inflow
occlusion (HBIO) in hepatocellular carcinoma patients with cirrhosis and
its possible mechanism. METHODS: 29 consecutive patients resectable HCC
were randomized into two groups. IPC group: before HBIO, IPC with 5 min
of ischemia and 5 min of reperfusion was given; control group: simple
HBIO. The liver function, hepatic caspase-3 activity, and apoptotic cell
were compared between the two groups. RESULTS: The AST, ALT levels of
POD 1, POD 3 and POD 7 in the IPC group were significantly higher than
those of the control group, respectively (t = 4.238, P < 0.05). The TBIL
levels of POD 3 and POD 7 in the IPC group were significantly higher
than those of the control group, respectively (t = 2.296, P < 0.05). The
ALB of POD 1 in the IPC group was higher than in the control group (t =
2.029, P > 0.05). After 1 h of reperfusion, the hepatic caspase-3
activity and apoptotic sinusoidal endothelial cell were significantly
higher than those of in the control group (t = 2.349, P < 0.05).
CONCLUSIONS: IPC has the a protective effect in hepatic resection under
HBIO in HCC patients with cirrhosis. Its mechanism is that sinusoidal
endothelial cell apoptosis is inhibited by inhibiting caspase-3
activity.
9
UI - 12133356
AU - Wang Y; Chen H; Wu M; Jian X; Wei G; Sun Y
TI -
[Resection of right or total hepatic caudate lobe including paracaval
portion]
SO - Zhonghua Wai Ke Za Zhi 2002 Apr;40(4):268-70
AD - Eastern Hepatobiliary Hospital, Second Military Medical University,
Shanghai 200438, China.
OBJECTIVES: To evaluate the surgical techniques and feasibility for
resecting the hepatic caudate lobe including the paracaval portion.
METHODS: Right posterior approach for right caudate lobectomy and left
lateral approach for total caudate lobectomy were taken with or without
some kinds of preparatory segmentectomies. RESULTS: Seven right and 6
total caudate lobectomies, all including paracaval portion, ware
accomplished without operative death. The mean intraoperative blood loss
was 896.15 (250 - 2 000) ml and the mean portal triad clamping time was
25.4 (10 - 83) min. The postoperative course was uneventful for all the
cases, and the mean hospital stay was 12 (9 - 22) days. CONCLUSIONS:
Although being complicated anatomically, resection of the hepatic
caudate lobe including the paracaval portion is feasible with a high
safety.
10
UI - 11909699
AU - Sekhar KR; Spitz DR; Harris S; Nguyen TT; Meredith MJ; Holt JT; Guis D;
TI -
Marnett LJ; Summar ML; Freeman ML
Redox-sensitive interaction between KIAA0132 and Nrf2 mediates
indomethacin-induced expression of gamma-glutamylcysteine synthetase.
SO - Free Radic Biol Med 2002 Apr 1;32(7):650-62
AD - Dept of Radiation Oncology, Vanderbilt University School of Medicine,
Nashville, TN 37232, USA.
Exposure of HepG2 cells to nonsteroidal anti-inflammatory drugs (i.e.,
indomethacin and ibuprofen; NSAIDs) as well as resveratrol, caused
increased expression of the mRNAs coding for the catalytic (Gclc) and
modifier (Gclm) subunits of the glutathione synthetic enzyme,
gamma-glutamylcysteine synthetase. In addition, indomethacin exposure
increased intracellular glutathione content as well as inhibited
glutathione depletion and cytotoxicity caused by diethyl maleate.
Indomethacin-induced increases in the expression of
gamma-glutamylcysteine synthetase mRNA were preceded by increases in
steady state levels of intracellular pro-oxidants and glutathione
disulfide accumulation. Simultaneous incubation with the thiol
antioxidant N-acetylcysteine (NAC) inhibited indomethacin-mediated
increases in GCLC mRNA, suggesting that increases in GCLC message were
triggered by changes in intracellular oxidation/reduction (redox)
reactions. Indirect immunofluorescence using intact cells demonstrated
that indomethacin induced the nuclear translocation of Nrf2, a
transcription factor believed to regulate GCLC expression.
Immunoprecipitation studies showed that indomethacin treatment also
inhibited Nrf2 tethering to KIAA0132 (the human homolog of Keap1
accession #D50922), which is believed to be a negative regulator of
Nrf2. Consistent with this idea, over-expression of Nrf2 increased GCLC
reporter gene expression and over-expression of KIAA0132 inhibited GCLC
reporter gene activity as well as inhibited indomethacin-induced
increases in the expression of GCLC. Finally, simultaneous treatment
with NAC inhibited both indomethacin-induced release of Nrf2 from
KIAA0132 and indomethacin-induced nuclear translocation of Nrf2. These
results demonstrate that NSAIDs and resveratrol cause increases in the
expression of gamma-glutamylcysteine synthetase mRNA and identify these
agents as being capable of stimulating glutathione metabolism. These
results also support the hypothesis that indomethacin-induced
transcriptional activation of GCLC involves the redox-dependent release
of KIAA0132 from Nrf2 followed by the nuclear translocation of Nrf2.
11
UI - 12086903
AU - Medina-Franco H; Sellers MT; Eckhoff DE; Bynon JS; Urist MM; Heslin MJ
TI -
Multimodality treatment for patients with hepatocellular carcinoma:
analysis of prognostic factors in a single Western institution series.
SO - J Gastrointest Surg 2001 Nov-Dec;5(6):638-45
AD - Department of Surgery, Section of Surgical Oncology, University of
Alabama at Birmingham, USA.
There are few Western studies evaluating prognostic factors for survival
in patients with hepatocellular carcinoma (HCC) and the influence on
survival of various therapeutic options including orthotopic liver
transplantation (OLT). A retrospective analysis was performed of 122
patients with HCC treated at the University of Alabama at Birmingham
factors were analyzed with overall survival as the main outcome
variable. Median age was 62 years. Most patients were male (74%) and
white (79%). Eighty patients (66%) had associated cirrhosis. Sixty-three
percent of patients presented with American Joint Committee on Cancer
(AJCC) stage III or IV tumors. The median follow-up for survivors was 22
months. The 1-, 3-, and 5-year actuarial survival rates for the entire
cohort were 46%, 24%, and 17%, respectively. On multivariate analysis,
ablative surgery (P = 0.003), AJCC stages I and II (P = 0.0012), and
absence of vascular invasion (P = 0.0001) were found to be independent
favorable characteristics. Forty-four patients underwent surgical
resection (including OLT, n = 20) or a surgical ablative procedure. All
but two nonsurgical patients died of disease. The actuarial 1-, 3-, and
5-year survival rates for this group were 80%, 71%, and 61%,
respectively. On multivariate analysis of the surgical group, only
vascular invasion was associated with poor prognosis (P = 0.001). OLT
was associated with a favorable prognosis on univariate analysis (P =
0.02). Forty percent of patients who received transplants underwent
local/regional treatment before transplantation and the outcome in these
patients was no different from that in other transplant patients.
Surgical treatment is the only potential curative option for HCC, and
qualifying for liver transplantation may be a favorable prognostic
factor in surgical patients. Local/regional therapy prior to
transplantation may provide a bridge to OLT without an increase in
tumor-related mortality.
12
UI - 12168494
AU - Huang CJ; Lian SL; Chen SC; Wu DK; Wei SY; Huang MY; Ho YH
TI -
External beam radiation therapy for inoperable hepatocellular carcinoma
with portal vein thrombosis.
SO - Kaohsiung J Med Sci 2001 Dec;17(12):610-4
AD - Department of Radiotherapy, Kaohsiung Medical University Hospital, No.
100, Shih-Chuan 1st Rd., Kaohsiung 807, Taiwan.
Portal vein thrombosis (PVT) in patients with hepatocellular carcinoma
(HCC) has a poor impact on prognosis. Many of these tumors may cause
1996, 41 unresectable HCC patients with PVT underwent transcatheter
arterial chemoembolization (TACE) and external beam radiation therapy
(EBRT) to the portion of PVT. The irradiated field, with a mean
equivalent field size of 6.6 x 7.1 cm2, was localized and simulated by
abdominal sonography, angiography and computed tomography. Radiation
dose ranged from 36 to 66 Gy (mean dose: 51.4 Gy), in a daily fraction
of 1.8 to 2 Gy. The response of EBRT was evaluated by abdominal
sonography within 3 months of completion of EBRT. The response rates of
the PVT after treatment were 39% for complete response (CR), 41% for
partial response (PR), and 19% for no response (NR), respectively. The
median overall survival time from start of radiotherapy was 10 months
for all patients, 17 months for CR patients, 8 months for PR patients
and 4 months for NR patients. By multivariate analysis, response of PVT
resulted in a significant improvement in survival. (P = 0.001) There was
no occurrence of severe complication of radiation-induced liver disease.
The results obtained with combined treatment modality of EBRT and TACE
in the treatment of HCC patients with PVT are encouraging.
13
UI - 11352313
AU - Machi J
TI -
Radiofrequency ablation for multiple hepatic metastases.
SO - Ann Surg Oncol 2001 May;8(4):379-80
14
UI - 12081752
AU - Esnaola N; Vauthey JN; Lauwers G
TI -
Liver fibrosis increases the risk of intrahepatic recurrence after
hepatectomy for hepatocellular carcinoma (Br J Surg 2002; 89: 57-62).
SO - Br J Surg 2002 Jul;89(7):939-40; discussion 940
15
UI - 12118934
AU - Srivastava DN; Thulkar S; Sharma S; Pandey GK; Sahni P; Julka PK;
TI -
Acharya SK
Therapeutic radiological interventional procedures in hepatocellular
carcinoma.
SO - Indian J Gastroenterol 2002 May-Jun;21(3):96-8
AD - Department of Radiodiagnosis, All India Institute of Medical Sciences,
Ansari Nagar, New Delhi. deepsrivastava@vsnl.net
BACKGROUND: To improve the survival rate of patients with hepatocellular
carcinoma (HCC) in whom surgery is not possible, various methods have
been developed employing angiographic and percutaneous techniques. We
analyzed our experience with various percutaneous therapeutic
interventional techniques done for HCC in our center. METHODS: Sixty-one
patients with inoperable HCC (mean age 48.9 [SD 13.8] y; 47 men) were
chemoembolization (TACE) alone (22), TACE with percutaneous alcohol
injection (PEI) (20), transcatheter arterial embolization (TAE) with
steel coils and gel foam for gastrointestinal bleed (7), percutaneous
radiofrequency ablation (1), percutaneous preoperative right portal vein
embolization (3) and percutaneous preoperative tumor embolization to
reduce blood loss at surgery (8). RESULTS: In 42 patients treated by
TACE and PEI and TACE alone, tumor necrosis was scored; over 50%
necrosis was seen only after six and nine months in both treatment
groups. The survival rates after six and nine months and the median
survival were similar in the two groups. Of 7 cases treated with TAE
with steel coils and gel foam, the gastrointestinal bleeding stopped in
four; in the other three, bleeding did not stop completely although less
transfusion was required. In the patient treated by radiofrequency
ablation, follow-up contrast-enhanced CT did not show enhancing tumor
mass. We noted left lobe enlargement after percutaneous preoperative
right portal vein embolization, prior to right hepatectomy. CONCLUSION:
In patients with HCC not amenable to surgical intervention, a variety of
percutaneous therapeutic interventional techniques may be used.
16
UI - 12013692
AU - Wildi S; Kadry Z; Clavien PA
TI -
Neoadjuvant and adjuvant therapies for resectable hepatocellular
carcinoma (HCC) and palliation strategies.
SO - Swiss Surg 2002;8(2):61-6
AD - Department of Visceral and Transplantation Surgery, University Hospital
of Zurich, Switzerland.
Hepatocellular carcinoma (HCC) is the most common primary malignancy in
the liver worldwide. The incidence of the tumor varies geographically.
Thus, in the eastern area (China, Taiwan, and Japan) there are more than
20 cases per year per 100'000 population compared to less than 5 cases
per 100'000 in most western countries [1]. The etiology of HCC is
multifactorial. The two most important factors are the presence of
cirrhosis and chronic hepatitis [2]. Early detection of HCC still
remains a challenge. At the time of diagnosis, only 20-30% of all
patients have tumors that are surgically resectable. Survival after
curative resection is 30%-50% at five years. The poor outcome of the
disease led to the development of different adjuvant and neoadjuvant
therapies. There are numerous studies dealing with the treatment of HCC.
Unfortunately, only few randomized controlled trials exist. In addition,
there is no consensus on staging of HCC and no standardization of the
outcome in the literature, which makes it difficult to compare the
different procedures. This paper summarizes the current strategies in
the treatment of HCC.
17
UI - 12013693
AU - Herfarth C; Lamade W; Fischer L; Chiu P; Cardenas C; Thorn M; Vetter M;
TI -
Grenacher L; Meinzer HP
The effect of virtual reality and training on liver operation planning.
SO - Swiss Surg 2002;8(2):67-73
AD - Department of Surgery, University of Heidelberg, Germany.
OBJECTIVE: The three-dimensional relation of a liver tumour to the
intrahepatic vascular trees is basis of operation planning in liver
surgery. Yet it has not been proven whether 3D reconstruction and
further computerised processing will enhance precision of operation
planning in liver surgery which has been based on the liver segment
classification of Couinaud up to now. DESIGN: Our interdisciplinary
group (department of Surgery, German Cancer Research Center and
Department of Radiology) has developed a new interactive computer-based
quantitative 3D operation planning system for liver surgery which is
being introduced into the clinical routine. The system quantifies the
organ structures semiautomatically, defines resection planes depending
on safety margins and the vascular trees, and presents the data in
digital movies as well as in quantitative reports. We conducted a
clinical trial to evaluate whether 3D reconstruction will lead to an
improved operation planning. Data of 7 virtual patients were presented
to a total of 81 surgeons in different levels of training. The tumours
had to be assigned to a liver segment and subsequently drawn together
with the operation proposals into a liver model. The precision of both
was measured quantitatively for each surgeon and stratified concerning
2D and different types of 3D presentations. RESULTS: The 3D anatomy can
be visualised in high quality which results in good perception of the
third dimension (depth). Tumour assignment to liver segments was
significantly correlated to the level of training (p < 0.05). There was
a significant increase (p < 0.001) in the precision of tumour
localisation by 51% and resection proposal from 2D through 3D
reconstructions by 13%-21%. Quantitative differences of the simplified
Couinaud's classification of the liver segments compared to the true
vascular anatomy of up to 40% were found. CONCLUSION: The impact of
individual 3D-reconstruction on surgical planning has been proven to be
significant and increases precision quantitatively. The merit of
Couinaud's classification may be enhanced by individualisation of the
segment borders in future.
18
UI - 11916199
AU - Huo TI; Huang YH; Wu JC; Lee PC; Chang FY; Lee SD
TI -
Survival benefit of cirrhotic patients with hepatocellular carcinoma
treated by percutaneous ethanol injection as a salvage therapy.
SO - Scand J Gastroenterol 2002 Mar;37(3):350-5
AD - Dept. of Medicine, Taipei Veterans General Hospital and National
Yang-Ming University School of Medicine, Taiwan, Republic of China.
tihuo@vghtpe.gov.tw
BACKGROUND: The therapeutic strategy for cirrhotic patients with
hepatocellular carcinoma (HCC) who cannot tolerate surgery or
transcatheter arterial chemoembolization (TACE) is uncertain. The safety
and efficacy of percutaneous ethanol injection (PEI) as a salvage
therapy in such patients is not clear. METHODS: A total of 63 (49 men)
HCC patients (mean age 67 +/- 11 years), for whom surgery or TACE was
not indicated because of the coexistence of various medical conditions,
were enrolled and prospectively studied. Fifty-six (89%) were treated
with PEI and 7 were treated with conservative measures. The outcome and
the factors that may affect survival were evaluated. RESULTS: During a
mean follow-up period of 16 +/- 9 months, 17 (30%) of the patients
treated with PEI and 5 (71%) of those treated with conservative measures
died (P = 0.045). A total of 16 patient-related and tumor-related
variables that may influence the outcome were analyzed. Survival
analysis showed that female gender, small (< or = 3 cm) solitary tumor
and PEI were associated with a better prognosis (P < 0.05). When using
the Cox proportional hazard model, PEI was the only significant
independent factor predicting survival (relative risk: 0.3, 95%
confidence interval: 0.11-0.86, P = 0.024). The 1- and 2-year survival
rates were 85% and 65% for patients treated with PEI compared to 57% and
29% for conservative measures (P = 0.016). CONCLUSIONS: PEI may be a
treatment option for cirrhotic patients who have HCC and coexisting
contraindications that preclude surgery and TACE. Careful pre-treatment
patient selection may effectively prolong the survival.
19
UI - 12053220
AU - Suzuki S; Sakaguchi T; Yokoi Y; Okamoto K; Kurachi K; Tsuchiya Y;
TI -
Okumura T; Konno H; Baba S; Nakamura S
Clinicopathological prognostic factors and impact of surgical treatment
of mass-forming intrahepatic cholangiocarcinoma.
SO - World J Surg 2002 Jun;26(6):687-93
AD - Department of Surgery II, Hamamatsu University School of Medicine,
1-20-1 Handayama, Hamamatsu 431-3192, Japan. shohachi@hama-med.ac.jp
The clinicopathological characteristics relevant to prognosis after
surgical treatment of intrahepatic cholangiocarcinoma (ICC) remain
unclear. In this study, the clinicopathological features of 19 patients
with mass-forming ICC, the most common form of the disease, were
reviewed to analyze prognostic determinants. Two or more segmentectomies
of the liver with systematic lymphadenectomy were performed in 18
patients. Resection of the extrahepatic bile duct was performed in 14
patients, and reconstruction of the portal vein was accomplished in 5
patients. Stage IVA or IVB tumors were seen in 13 patients, and lymph
node (LN) metastasis was present in 14 patients. The estimated 5-year
survival rate after surgery for mass-forming ICC was 28%, with median
survival time of 18 months. In univariate analysis, five variables were
determined to be significantly correlated with poor survival of patients
with mass-forming ICC after surgery. These variables include
mass-forming ICC with periductal infiltration, perineural invasion,
portal vein invasion, presence of intrahepatic metastasis, and two or
more LN metastases. Survival rates of 5 patients without LN metastasis
and 6 patients with a single LN metastasis were 80% and 33% at 5 years,
respectively, while 8 patients with two or more LN metastasis failed to
survive beyond 2 years. Multivariate analysis revealed the presence of
intrahepatic metastasis to be an independent prognostic factor of poor
survival. Hepatectomy with resection of the extrahepatic bile duct and
systematic lymphadenectomy yields a good chance for prolonged survival
for patients with mass-forming ICC when the lesion is singular and LN
metastasis is limited to a regional LN. Because the presence of
intrahepatic metastasis was closely related to a poor prognosis in
patients with mass-forming ICC, efficacious chemotherapy would be needed
to control development of the lesion.
20
UI - 12053231
AU - Chen MF; Jeng LB; Lee WC
TI -
Surgical results in patients with hepatitis virus-related hepatocellular
carcinoma in Taiwan.
SO - World J Surg 2002 Jun;26(6):742-7
AD - Department of General Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsing
Street, Kwei-Shan, Taoyuan, Taiwan. chenmf@adm.cgmh.org.tw
To investigate the surgical results of hepatectomy for hepatocellular
carcinoma in relation to hepatitis virus status in Taiwan, 252 patients
patients were divided into four groups: 30 patients (11.9%) seronegative
for both hepatitis B surface antigen (HBsAg) and antihepatitis C
antibody (HCVAb) (N-HCC group); 133 patients (52.8%) seropositive for
HBsAg and seronegative for HCVAb (B-HCC group); 66 patients (26.2%)
seronegative for HBsAg and seropositive for HCVAb (C-HCC group); and 23
patients (9.1%) seropositive for both HBsAg and HCVAb (BC-HCC group).
Patients in group C-HCC were older (p = 0.001) and had a higher
incidence of diabetes mellitus (p = 0.004). Also, they had a higher
indocyanine green retention rate at 15 minutes (p = 0.021), longer
international normalization ratio for the prothrombin time (p = 0.049),
and smaller tumor (p = 0.006). Postoperative complications and hospital
mortality were significantly higher in patients in the C-HCC and BC-HCC
groups (p = 0.046, 0.021). All patients were followed 12 to 76 months
after hepatectomy (mean 23.5 +/- 16.3 months). The 1-, 3-, and 5-year
overall cumulative survival rates of the 252 patients in this series
were 80%, 54.3%, and 34.2%, respectively. The cumulative intrahepatic
recurrence rates were 46.5%, 64.9%, and 72.9% at 1, 3, and 5 years,
respectively. The mean disease-free survival time was longest in group
C-HCC and shortest in group BC-HCC (p = 0.020). The overall survival
time and cumulative survival rates in the four groups were not
significantly different (p = 0.146).
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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