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  • 1
    Electronic Resource
    Electronic Resource
    A case of splenic vein occlusion caused by the intravenous tumor thrombus of nonfunctioning islet cell carcinoma (1992)
    Springer
    Surgery today 22 (1992), S. 62-65 
    Details
    ISSN: 1436-2813
    Keywords: nonfunctioning islet cell carcinoma ; left-sided portal hypertension ; tumor thrombus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein a case of successfully treated advanced, nonfunctioning islet cell carcinoma associated with left-sided portal hypertension. The splenic vein was obstructed by a huge intravenous tumor thrombus developing from the main pancreatic tumor. Direct invasion to adjacent organs such as the spleen, colon, left kidney and stomach was also observed, although liver metastasis was not present. Radical resection was carried out with removal of these five involved organs and the patient is alive without recurrence more than 5 years after surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00326127
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  • 2
    Electronic Resource
    Electronic Resource
    Multiple colorectal carcinomas and colorectal carcinoma associated with extracolonic malignancies (1992)
    Springer
    Surgery today 22 (1992), S. 99-104 
    Details
    ISSN: 1436-2813
    Keywords: multiple primary colorectal cancers ; associated extracolonic cancer ; metachronous cancer ; synchronous cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study, we analyzed 149 surgical cases of colorectal cancer between January 1983 and August 1989. Thirteen cases (8.7 per cent) of colorectal primary cancer associated with extracolonic primary malignancy of 14 lesions and 10 cases (6.7 per cent) of multiple primary colorectal cancers were included. Among the 14 lesions of extracolonic primary malignancy, there were 6 gastric carcinomas, 2 endometrial carcinomas, 2 urinary bladder carcinomas, and one each in the esophagus, liver, bile duct and jejunum. The second tumor was not detected preoperatively in 3 of 4 cases of synchronous multiple primary colorectal carcinoma. A curative resection was done in 10 (77 per cent) out of 13 cases of colorectal cancer associated with extracolonic malignancy, while 7 (88 per cent) out of 8 cases of multiple colorectal cancers had a curative resection. Nine patients (69 per cent) with colorectal cancer associated with extracolonic malignancy were disease-free for 2 months to 14 years. Seven patients (88 per cent) with multiple colorectal cancers were disease-free for one to 22 years. We recommend, therefore, that in any patient with colorectal cancer, the entire large bowel should be thoroughly searched for any other primary tumors, by taking the existence of extracolonic tumors into account. A curative resection should be performed, and the follow-up period should be life-long.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00311331
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  • 3
    Electronic Resource
    Electronic Resource
    Selection of therapeutic modalities for hepatocellular carcinoma in patients with multiple hepatic lesions (1992)
    Springer
    Cancer chemotherapy and pharmacology 31 (1992), S. S38 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In the present study, we compared the survival of patients with multi tumor hepatocellular carcinoma (HCC) following their treatment with liver resection versus TAE. A total of 336 HCC patients were treated at Osaka University Hospital between 1980 and 1989. Of these, 140 patients underwent liver resection in the presence or absence of TAE and 173 subjects were treated with TAE alone. Our TAE protocol consisted of 50 mg Adriamycin, 3–5 ml lipiodol, and Gelfoam. The 1-, 3-, and 5-year survival values found for the liver resection group were 87.4%, 66.0%, and 47.4%, respectively, whereas the values calculated for the TAE group were 64.6%, 29.9%, and 15.8%, respectively. The survival of patients in the resection group was clearly better than that of subjects in the TAE group. Of the 140 patients who underwent resection, 36 cases were proven to have multiple lesions by histopathological examination. The 1- and 3-year survival values determined for this special group were 67.9% and 33.3%, respectively. Of the TAE cases, 113 were diagnosed as having multiple lesions by imaging examination, and their 1- and 3-year survival values were 59.7% and 24.9%, respectively. No significant difference in survival was found between these two different treatment modalities for these multiple-lesion cases. The results of this study indicate that it is unlikely that surgical resection is superior to TAE alone for the treatment of HCC patients with multiple lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00687103
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  • 4
    Electronic Resource
    Electronic Resource
    Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma—a comparison between L-TAE with Farmorubicin and L-TAE with Adriamycin: preliminary results (second cooperative study) (1994)
    Springer
    Cancer chemotherapy and pharmacology 33 (1994), S. S97 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A randomized controlled clinical trial was conducted to compare the use of Farmorubicin (FARM) and Adriamycin (ADR) in Lipiodol transcatheter arterial chemoembolization (L-TAE) as a treatment of hepatocellular carcinoma. In all, 192 hospitals participated, and 415 patients were enrolled in the study during the period from October 1989 through December 1990, and their data were collected. The patients were randomly allocated to group A (FARM) or group B (ADR) by a central telephone registration. Several clinical characteristics were slightly worse in group A than in group B, but there was no statistically significant difference. The actual doses of FARM and ADR were 72 mg/body and 48 mg/body, respectively. Additional treatments, including repeated TAE or surgery, were given to 248 patients. The 1- and 2-year survival rates were 69% and 44% for group A and 74% and 57% for group B, respectively. The difference was marginally significant (P value in the log-rank test, 0.038). When each group of patients was classified into two subgroups, i.e., high-risk and low-risk categories, based on the severity index calculated by the Cox regression model from significant prognostic factors, the ADR subgroup was significantly superior to the FARM subgroup in the low-risk category, but there was no significant difference between the subgroups in the high-risk category. The change in the serum alpha-fetoprotein level, the extent of Lipiodol accumulation in the tumor, and the extent of tumor reduction did not show any significant difference between the groups. At the above-mentioned doses, ADR seemed to have efficacy almost the same as or slightly superior to that of FARM in L-TAE for the treatment of hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00686677
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  • 5
    Electronic Resource
    Electronic Resource
    Follow-up study of combination treatment (TAE and PEIT) for unresectable hepatocellular carcinoma (1994)
    Springer
    Cancer chemotherapy and pharmacology 33 (1994), S. S119 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The subjects were 35 patients with unresectable hepatocellular carcinoma. The patients were divided into a transcatheter arterial embolization group (TAE group, 18 cases) and a combination therapy group receiving both TAE and percutaneous ethanol injection therapy (TAE+PEIT group, 17 cases). The 50% survival period was 21.1 months for the TAE group and 37.8 months for the TAE+PEIT group (P〈0.05). The longest survival period in the TAE group was 89 months. In the TAE+PEIT group, one patient has survived for 59 months. The actuarial 1-, 2-, and 3-year survival rates for the TAE group were 82%, 45%, and 22%, respectively. For the TAE+PEIT group the rates were 83%, 64%, and 64%, respectively. The TAE+PEIT group showed a significantly higher survival rate in the 895-to 1.074-day period as compared with the TAE groupP〈0.05). Overall, the survival rate tended to be higher in the TAE-PEIT group (P〈0.1). The therapeutic responses of tumors were measured by the maximal reduction rate within 6 months of TAE and PEIT. In the TAE group, a PR was seen in only four cases. In the TAE+PEIT group, CRs and PRs were achieved significantly more frequently than in the TAE group. When the patients were divided into a responder group (CR, PR, and MR) and a nonresponder group (NC and PD), survival was significantly longer in the responder group. The findings of the present study suggest that the combination therapy was useful for improving the survival of patients with unresectable hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00686682
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  • 6
    Electronic Resource
    Electronic Resource
    Efficacy of combination treatment — (TAE with adriamycin and ethanol) — for hepatocellular carcinoma (1992)
    Springer
    Cancer chemotherapy and pharmacology 31 (1992), S. S30 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among 44 patients with hepatocellular carcinoma (HCC), combination treatment with both transhepatic arterial embolization (TAE) and ethanol injection therapy (EIT) was performed in 10 patients. Only two had tumors measuring less than 3 cm in diameter. In all, eight patients had solitary tumors and two had multiple tumors. The tumor was classified as stage I in one patient, stage II in six subjects, stage III in two patients, and stage IV in one subject prior to TAE, but one stage II case was changed to stage III after laparotomy. The clinical stage was I in two patients, II in six subjects and III in two patients. Five patients with tumors of stages I and II achieved either a complete response (CR) or partial response (PR). However, three patients with tumors of stages III and IV showed progressive disease (PD). Thus, the response rate (CR+PR) was 50%. For tumor stages I and II, the 1-, 2-, and 3-year survival values were 100%, 100%, and 83%, respectively. For tumor stages III and IV, the 1- and 2-year survival values were 75% and 25%, respectively. Combination treatment of HCC appears to be efficacious for tumor stages I and II.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00687101
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  • 7
    Electronic Resource
    Electronic Resource
    Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma — a comparison of lipiodol-transcatheter arterial embolization with and without Adriamycin (first cooperative study) (1992)
    Springer
    Cancer chemotherapy and pharmacology 31 (1992), S. S1 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A randomized, controlled clinical trial comparing the use of lipiodol-transcatheter arterial embolization (L-TAE) in the presence versus the absence of Adriamycin (ADR) for the treatment of hepatocellular carcinoma was conducted from August 1988 through September 1989. In all, 125 Japanese hospitals participated in this study and 289 patients were entered in the trial. The patients were randomly allocated into group A (L-TAE) or group B (L-TAE+ADR) by telephone registration. There was no significant difference in background factors between group A and group B. Additional treatment, including repeated TAE or hepatic resection, was given to 189 patients. Among the four endpoints analyzed, the rate of tumor reduction and lipiodol accumulation in the tumor did not significantly differ between the two groups. The 3-year survival values for groups A and B were 33.6% and 34.9%, respectively; the difference was not significant. The serum alpha-fetoprotein level, however, decreased to a significantly greater extent in the group that received ADR than in the group that did not (P〈0.05). This result suggests that ADR has some favorable additional effect in L-TAE for the treatment of hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00687096
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  • 8
    Electronic Resource
    Electronic Resource
    New development of transarterial immunoembolization (TIE) for therapy of hepatocellular carcinoma with intrahepatic metastases (1994)
    Springer
    Cancer chemotherapy and pharmacology 33 (1994), S. S48 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The prognosis of patients with multiple hepatocellular carcinoma (HCC) remains disappointing. In this study, we devised a new therapeutic modality for HCC consisting of transarterial immunoembolization (TIE) using OK-432 and fibrinogen and then analyzed the preliminary results. In the first series, we applied the treatment to 19 patients with advanced HCC who had proved to be insensitive to several previous conventional treatments. In all, 14 patients (74%) with unresected HCC have currently survived for between 2 and 16 months after TIE. The remaining 5 patients died at 17, 14, 8, 7, and 4 months after TIE. The serum levels of tumor markers decreased in all of the patients, and a marked reduction in tumor size was observed in six patients after TIE. A high fever occurred in all cases, and abdominal pain and loss of appetite were also observed after TIE. However, deterioration of liver function was negligible. After confirmation of the safety of this method, we started a second study series in which this TIE treatment was selected as the first choice. Six patients have been treated to data. All patients in this group underwent hepatic resection at 6–48 days following TIE. Histological examination of the resected specimens following TIE showed massive infiltration of mononuclear cells around tumor cell nests and lytic necrosis as well as coagulation necrosis of the main tumor and the intrahepatic metastases. In conclusion, our results indicate that TIE may be a safe and promising therapy for patients with HCC.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00686668
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  • 9
    Electronic Resource
    Electronic Resource
    Effective cases of transcatheter arterioportal chemoembolization with high-dose iodized oil for hepatocellular carcinoma (1994)
    Springer
    Cancer chemotherapy and pharmacology 33 (1994), S. S69 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract By administering an excessive amount of iodized oil via the hepatic artery, anticancer drugs in the iodized oil flow into the portal vein through the arterioportal communication. This phenomenon permits chemotherapy against extracapsular infiltration by a hepatocellular carcinoma (HCC) nourished by the portal blood flow. From May 1983 through July 1992, 240 cases of HCC underwent transcatheter arterioportal chemoembolization (TAPCE) with more than 5 ml of iodized oil (mean, 15 ml) in our hospital. In all, 32 patients survived for more than 3 years, and the factors favoring the efficacy of TAPCE therapy were investigated. Doxorubicin (mean, 46 mg) was given to 31 patients and 20 mg mitomycin C was given to 1 patient. The patients included one Stage 1 case, 13 Stage 2 cases, 17 Stage 3 cases, and one Stage 4 case. The mean tumor size was 5.0 cm, and portal invasion was suggested in 8 cases by angiography. The tumors were divided into 5 types: 13 cases of the single nodular type (SN), 7 cases of the single nodular type with proliferation (SN-P), 3 cases of the multinodular fused type (MN-F), 5 cases of the multinodular type (MN), and 4 cases of the massive type. A complication of liver dysfunction was detected in 14 cases, and half of them were Child's class C. In all, 7 patients underwent hepatectomy and 6 received percutaneous ethanol injection after TAPCE. The treated area of TAPCE was classified as segmental, lobar, or total. Segmental and lobar administration of TAPCE yielded statistically effective results, and their tumor response rate was 86%. All of the MN-F and massive types showed a good tumor response. The incidence of intrahepatic distant metastasis was higher in the localized TAPCE group than in the total TAPCE group. Segmental and lobar TAPCE should be applied for localized infiltrating HCCs, even in cases associated with liver cirrhosis, but these methods have a limited capacity to prevent distant intrahepatic metastasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00686671
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  • 10
    Electronic Resource
    Electronic Resource
    Prospective and randomized clinical trial for the treatment of hepatocellular carcinoma — a comparison of L-TAE with Farmorubicin and L-TAE with Adriamycin (second cooperative study) (1992)
    Springer
    Cancer chemotherapy and pharmacology 31 (1992), S. S20 
    Details
    ISSN: 1432-0843
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A randomized clinical trial comparing L-TAE with Farmorubicin (FARM) and L-TAE with Adriamycin (ADR) in the treatment of hepatocellular carcinoma was conducted from October 1989 through December 1990. In all, 192 hospitals participated in this study and 117 patients were entered. The patients were randomly allocated to group A (L-TAE+FARM) or group B (L-TAE+ADR). There was no significant intergroup difference in background factors. Additional treatment consisting of repeated TAE or surgery was given to 66 patients. Four factors were analyzed in this study: the percentage of reduction in tumor size, the change in the AFP level, lipiodol accumulation, and survival. None of these factors differed significantly between the two groups. The final evaluation of this study will be based on differences in survival after a long-term follow-up. Toxic effects manifested less frequently in group A than in group B, and the decrease in the platelet count in the peripheral blood was significantly lower in group A than in group B. These results suggest that FARM exerts a more favorable effect than does ADR in the treatment of hepatocellular carcinoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00687099
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