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  • 1
    Online Resource
    Online Resource
    Combination of Resection and Ablative Treatment for Hepatocellular Carcinoma: Usefulness of Complementary Radiofrequency Ablation
    S. Karger AG ; 2019
    In:  Oncology Vol. 96, No. 5 ( 2019), p. 242-251
    Details
    In: Oncology, S. Karger AG, Vol. 96, No. 5 ( 2019), p. 242-251
    Abstract: 〈 b 〉 〈 i 〉 Aim/Background: 〈 /i 〉 〈 /b 〉 In HCC patients with multiple tumors in separate segments, monotherapy with surgical resection is often difficult when the estimated residual liver volume after surgery is thought to be inadequate. We evaluated the usefulness of resection combined with low invasive radiofrequency ablation (RFA) for treatment of such cases. 〈 b 〉 〈 i 〉 Materials/Methods: 〈 /i 〉 〈 /b 〉 We analyzed 115 HCC patients with countable multiple tumors (≤5) without vascular invasion and/or extrahepatic metastasis, and treated solely with resection (SR group: 〈 i 〉 n 〈 /i 〉 = 82), or with both resection and RFA (Comb group: 〈 i 〉 n 〈 /i 〉 = 33) from January 2000 to December 2017. Clinical characteristics, overall survival rate (OSR), and disease-free survival rate (DFSR) were analyzed in a retrospective manner. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were 88 males (76.5%) and the average age of all patients was 67.8 ± 8.9 years. The average number of tumors and average maximum tumor size were 2.4 ± 0.7 and 4.1 ± 2.1 cm, respectively. Forty-two (36.5%) patients were classified as beyond up-to-7 criteria. The 3- and 5-year OSRs in the SR group were 82.0 and 67.0%, respectively, and in the Comb group were 75.2 and 65.6%, respectively ( 〈 i 〉 p 〈 /i 〉 = 0.244), while the 3- and 5-year DFSRs in the SR group were 45.2 and 28.0%, respectively, and those in the Comb group were 37.3 and 23.3%, respectively ( 〈 i 〉 p 〈 /i 〉 = 0.257). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The combination of surgical resection and complementary RFA may be an effective strategy for treating HCC patients with countable multiple tumors, who are otherwise difficult to treat with surgical resection or RFA alone.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000496225
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2019
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 2
    Online Resource
    Online Resource
    Tumor Markers AFP, AFP-L3, and DCP in Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization
    S. Karger AG ; 2015
    In:  Oncology Vol. 89, No. 3 ( 2015), p. 167-174
    Details
    In: Oncology, S. Karger AG, Vol. 89, No. 3 ( 2015), p. 167-174
    Abstract: 〈 b 〉 〈 i 〉 Background/Aim: 〈 /i 〉 〈 /b 〉 We examined tumor marker levels to assess in more detail transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 We enrolled patients treated from 2000 to 2011 for HCC beyond the Milan criteria who had good hepatic reserve function (Child-Pugh A) and no portal vein thrombosis or metastases (n = 154). The modified criteria for being TACE-refractory according to the Liver Cancer Study Group of Japan (m-LCSGJ), from which the tumor marker item was excluded, and the Assessment for Retreatment with TACE (ART) score were used for determining whether the HCC was TACE refractory. α-Fetoprotein ≥100 ng/ml, fucosylated α-fetoprotein ≥10%, and des-gamma-carboxy prothrombin ≥100 mAU/ml were used to define whether tumor markers were positive. We added up the number of positive tumor markers as a prognostic score to assess in more detail the evaluation of TACE-refractory HCC. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In order to divide the patients into a refractory and nonrefractory group, the m-LCSGJ criteria [mean survival time (MST) 27.1 vs. 49.9 months; p 〈 0.001] were superior to the ART score (MST 22.0 vs. 35.1 months; p = 0.051). In the refractory group according to the m-LCSGJ criteria, the patients with a low score of positive tumor markers ( 〈 2) after 2 sessions of TACE (n = 36) showed a better prognosis than the others (n = 72) (MST 37.7 vs. 23.2 months; p = 0.014). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Patients being nonrefractory according to the m-LCSGJ criteria had a better response, and using the number of tumor markers (≥2) is an easy method for predicting the response to TACE and for a more detailed evaluation of TACE-refractory HCC.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000381808
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 3
    Online Resource
    Online Resource
    Abdominal Ultrasound Findings of Tumor-Forming Hepatic Malignant Lymphoma
    S. Karger AG ; 2017
    In:  Digestive Diseases Vol. 35, No. 6 ( 2017), p. 498-505
    Details
    In: Digestive Diseases, S. Karger AG, Vol. 35, No. 6 ( 2017), p. 498-505
    Abstract: 〈 b 〉 〈 i 〉 Aim/Background: 〈 /i 〉 〈 /b 〉 Evaluations of abdominal ultrasonography (US) findings of primary and secondary tumor-forming hepatic malignant lymphoma (HML) have not been adequately reported. In this study, we elucidated US and contrast-enhanced US (CEUS) findings in patients with HML. 〈 b 〉 〈 i 〉 Materials/Methods: 〈 /i 〉 〈 /b 〉 From January 2006 to March 2017, 25 patients with HML were enrolled (primary 7, secondary 18), each of whom was diagnosed pathologically. They were divided into 2 groups based on tumor diameter (cutoff, 30 mm). US imaging findings were retrospectively analyzed. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 All tumors in patients with a small HML ( 〈 30 mm in diameter, small group, 〈 i 〉 n 〈 /i 〉 = 14) were revealed as homogeneous hypo-echoic type (100%), with penetrating sign observed in only 1 patient. Tumors in 11 patients in the small group, examined with CEUS, showed homogeneous enhancement in the early vascular phase (91%) and a washout pattern in the portal phase (100%), and they were revealed as defective in the post-vascular phase (100%). In the large group (≥30 mm; 〈 i 〉 n 〈 /i 〉 = 11), tumors were revealed as a heterogeneous hypo-echoic lesion in 10 (91%) and penetrating sign was observed in 8 (73%). Dilatation of the distal intrahepatic bile duct by the tumor was observed in 4 patients in the large group. In 7 large group patients examined with CEUS, imaging findings in the early vascular phase varied, with 5 (71%) showing a washout pattern in the portal phase and 5 (71%) revealed as defective in the post-vascular phase. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 We found that US imaging features of HML differ depending on the tumor diameter.
    Type of Medium: Online Resource
    ISSN: 0257-2753 , 1421-9875
    URL: Article
    DOI: 10.1159/000480138
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1482221-0
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  • 4
    Online Resource
    Online Resource
    Validation of Newly Proposed Time to Transarterial Chemoembolization Progression in Intermediate-Stage Hepatocellular Carcinoma Cases
    S. Karger AG ; 2017
    In:  Oncology Vol. 93, No. Suppl. 1 ( 2017), p. 120-126
    Details
    In: Oncology, S. Karger AG, Vol. 93, No. Suppl. 1 ( 2017), p. 120-126
    Abstract: 〈 b 〉 〈 i 〉 Background/Aim: 〈 /i 〉 〈 /b 〉 Determination of failure of transarterial chemoembolization (TACE) for treatment of Barcelona Clinic Liver Cancer stage B (BCLC-B) hepatocellular carcinoma (HCC) has become important because of the development of tyrosine kinase inhibitor (TKI) treatment. We evaluated the usefulness and efficacy of the newly proposed time to TACE progression (TTTP). 〈 b 〉 〈 i 〉 Patients and Methods: 〈 /i 〉 〈 /b 〉 From 2006 to 2016, 192 BCLC-B HCC patients [median age 72 years, male/female ratio = 149/43, Child-Pugh score 5/6/7 = 106/56/30, albumin-bilirubin (ALBI) grade 1/2 = 64/128, Kinki criteria B1/B2 = 64/128] were enrolled. TTTP was defined based on a previous report and first imaging performed 3 months after initial TACE had been used to obtain baseline images. The patients were divided into three groups according to TTTP ( 〈 5, 5-10, and ≥10 months; group I, II, and III, respectively). We evaluated the relationship between TTTP and overall survival (OS) as well as the prognostic factors for death. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The median number of TACE procedures was 4 (interquartile range 3-7). There was a moderate correlation between TTTP and OS ( 〈 i 〉 r 〈 /i 〉 = 0.527, 95% CI 0.416-0.622, 〈 i 〉 p 〈 /i 〉 〈 0.001). The median survival for group I ( 〈 i 〉 n 〈 /i 〉 = 78), II ( 〈 i 〉 n 〈 /i 〉 = 49), and III ( 〈 i 〉 n 〈 /i 〉 = 65) was 24.6, 34.7, and 49.5 months, respectively (group I vs. group II, 〈 i 〉 p 〈 /i 〉 = 0.023; group I vs. group III, 〈 i 〉 p 〈 /i 〉 〈 0.001; group II vs. group III, 〈 i 〉 p 〈 /i 〉 = 0.037; Holm's method). ALBI grade 2 (HR 1.548, 95% CI 1.004-2.388, 〈 i 〉 p 〈 /i 〉 = 0.048), alpha-fetoprotein ( 〉 100 ng/mL) (HR 1.540, 95% CI 1.035-2.291, p = 0.033), and TTTP ( 〈 5 months) (HR 2.157, 95% CI 1.447-3.215, 〈 i 〉 p 〈 /i 〉 〈 0.001) were significant prognostic factors for death in multivariate Cox hazard analysis. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients with reduced TTTP, especially 〈 5 months, it might be difficult to improve prognosis with a repeated TACE procedures. In such cases, reconsideration of the therapeutic strategy might be needed when possible.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000481242
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
    Location Call Number Limitation Availability
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