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Advanced Hepatocellular Carcinoma (advanced + hepatocellular_carcinoma)
Selected AbstractsThe outcomes of elderly patients with hepatocellular carcinoma treated with transarterial chemoembolizationCANCER, Issue 23 2009Thomas Yau MD Abstract BACKGROUND: The authors evaluated and compared the treatment outcomes of transarterial chemoembolization (TACE) between young (,70 years) and elderly (>70 years) patients at their institute over an 18-year period. METHODS: Advanced hepatocellular carcinoma (HCC) patients who received TACE at the authors' center were analyzed retrospectively. The demographic data, TACE-related morbidities, and survival outcome were compared between these 2 age groups. RESULTS: Between 1989 and 2006, 843 patients who were ,70 years old and 197 patients who were >70 years old received TACE treatment for advanced HCC. There were significantly more comorbid illnesses associated with the elderly patients than the young patients (64 % vs 33%, P < .01). Moreover, elderly patients who received TACE treatment for HCC were at earlier stages of disease (P < .01). Both the overall median survival (14.0 months vs 8.1 months, P < .003) and disease-specific survival (15.2 months vs 8.7 months, P < .001) were significantly higher in elderly than young patients. The most commonly encountered TACE-related morbidity in both age groups was liver function derangement. Young patients had a significantly higher rate of developing liver derangement after TACE than elderly patients (21% vs 11%, P < .01). Conversely, the elderly patients had a significantly higher rate of developing peptic ulcer disease with TACE treatment than young patients (2.5% vs 0.5%, P = .01). Overall, there was no significant difference in TACE-related mortality between the young and elderly patients (3% vs 4%, P = .49). CONCLUSIONS: This study has confirmed the comparable efficacy and tolerability in using TACE for the treatment of advanced HCC in young and elderly patient populations. Cancer 2009. © 2009 American Cancer Society. [source] Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma: Is the addition of subcutaneous interferon-,-2b beneficial?HEPATOLOGY RESEARCH, Issue 3 2009Satoe Takaki-Hamabe Aim:, We previously reported the benefits of hepatic arterial infusion chemotherapy (HAIC) using cisplatin (CDDP), 5-fluorouracil (5-FU) [low-dose FP], and leucovorin/isovorin for advanced hepatocellular carcinoma (HCC). In this study, we investigated the efficacy of combination therapy with HAIC and subcutaneous interferon (IFN)- ,-2b in patients with advanced HCC. Methods:, Of the 48 patients, 31 received low-dose FP with leucovorin/isovorin (HAIC group) and 17 received combination therapy comprising low-dose FP with isovorin and subcutaneous IFN-,-2b (combination group). Prognostic factors were evaluated by univariate and multivariate analyses of the patient and the disease characteristics. Results:, There were no significant differences in the response rate (patients with complete or partial response/all patients; P = 0.736) and survival (P = 0.399) between both groups. Univariate analysis revealed that IFN therapy was not a significant prognostic factor. Multivariate analysis showed 3 variables, namely, Child,Pugh score (P = 0.010), ,-fetoprotein level (P = 0.0047), and additional therapy (P = 0.002), to be significant prognostic factors. Conclusions:, We considered that combination therapy with HAIC and subcutaneous interferon (IFN)-,-2b was not beneficial for advanced HCC. [source] Evaluation of newly developed combination therapy of intra-arterial 5-fluorouracil and systemic pegylated interferon ,-2b for advanced hepatocellular carcinoma with portal venous invasion: preliminary resultsHEPATOLOGY RESEARCH, Issue 2 2009Kazuhiro Kasai Aim:, Prognosis is extremely poor for advanced hepatocellular carcinoma (HCC) in patients with portal invasion. The present study evaluated the efficacy of combined intra-arterial 5-fluorouracil (5-FU) and systemic pegylated interferon (PEG-IFN),-2b in patients with advanced HCC. Methods:, The subjects comprised nine HCC patients with portal vein thrombosis treated using subcutaneous administration of PEG-IFN,-2b (50,100 µg on day 1 of every week, for 4 weeks) and intra-arterial infusion of 5-FU (250 mg/day for 5 h on days 1,5 of every week, for 4 weeks). For four patients with hepatitis C virus (HCV) infection, oral administration of ribavirin (400,800 mg/day) was added. At the end of every cycle, response to therapy was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) guidelines. Results:, Partial response (PR) was observed in seven of nine patients, with stable or progressive disease in the remaining two patients. Tumors were resectable in three patients displaying PR after treatment. Tumor markers decreased significantly after therapy. Serum HCV-RNA titers were markedly decreased and became undetectable in all patients with HCV infection. National Cancer Institute,Common Toxicity Criteria: version 3.0 (NCI-CTC) grade 3 thrombocytopenia was seen in one case at the end of treatment, but was resolved with cessation of treatment. Other adverse effects were manageable. Conclusion:, Combination therapy with intra-arterial 5-FU and systemic PEG-IFN,-2b may be useful as a palliative treatment for patients with advanced HCC. A prospective controlled trial using a larger population of patients with advanced HCC is needed to evaluate this new combination therapy. [source] Efficacy of splenectomy for hypersplenic patients with advanced hepatocellular carcinomaHEPATOLOGY RESEARCH, Issue 12 2008Masashi Hirooka Aim:, Chemotherapy for advanced hepatocellular carcinoma (HCC) patients with hypersplenism is generally unsatisfactory, as a lower-dose therapy is usually administered. Splenectomy may represent a better approach to overcoming the complication due to hypersplenism in patients with advanced HCC. This retrospective study was conducted to evaluate whether HCC patients who undergo splenectomy show improved prognosis. Methods:, We examined 34 HCC patients. Twenty-two had thrombocytopenia and/or leucopenia and underwent laparoscopic splenectomy. The completion rate of full-dose drug regimens, the response rate, the toxicity of chemotherapy and the cumulative survival rate were compared between the splenectomy and non-splenectomy groups. Results:, The response rate and the cumulative survival rate in the splenectomy group were significantly better than that in the non-splenectomy group. Conclusions:, Splenectomy is an efficient method for advanced HCC patients with hypersplenism treated by chemotherapy. [source] Chemotherapy for advanced hepatocellular carcinomaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 5 2008Kwang-Hyub Han No abstract is available for this article. [source] Expression and immunogenicity of NY-ESO-1 in hepatocellular carcinomaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8 2006Shinichiro Nakamura Abstract Background and Aim:, The present study was designed to investigate the expression of and humoral response against NY-ESO-1 in patients with hepatocellular carcinoma and to analyze the relationship between expression of NY-ESO-1 mRNA and clinicopathological features. Methods:, NY-ESO-1 mRNA and protein expression in surgically resected hepatocellular carcinoma specimens, adjacent non-cancerous liver and non-tumor bearing liver were examined by reverse transcription-polymerase chain reaction and immunohistochemical staining using a monoclonal antibody against NY-ESO-1 (ES121), respectively. The antibody response to NY-ESO-1 was examined by enzyme-linked immunosorbent assay using recombinant NY-ESO-1 protein. Results:,NY-ESO-1 mRNA was detected in 18 of 41 (43.9%) hepatocellular carcinomas. No NY-ESO-1 mRNA was expressed in 41 paired non-cancerous specimens and 18 specimens histologically diagnosed as liver cirrhosis or chronic hepatitis. Immunohistochemistry revealed heterogeneous expression of NY-ESO-1 protein in three of 18 NY-ESO-1 mRNA-positive hepatocellular carcinomas. None of 23 NY-ESO-1 mRNA-negative hepatocellular carcinomas expressed NY-ESO-1 protein. Antibody against NY-ESO-1 protein was detected in two of 92 patients with hepatocellular carcinoma. Both of these patients had tumors invading main branches of the portal vein. Conclusions:, The present study has demonstrated the expression of NY-ESO-1 mRNA in hepatocellular carcinoma and NY-ESO-1 antibody production in patients with advanced hepatocellular carcinoma. Although the enhancement of NY-ESO-1 protein expression and the activation of immune response of the patients with hepatocellular carcinoma are necessary, NY-ESO-1 has the potential to be a good target molecule for immunotherapy against advanced hepatocellular carcinoma. [source] Chemotherapy for highly advanced hepatocellular carcinomaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2001Kyuichi Tanikawa No abstract is available for this article. [source] Pilot study: rapamycin in advanced hepatocellular carcinomaALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 6 2010M. Schöniger-Hekele Summary Background, The PI3K/Akt/mTOR signal pathway is involved in hepatocarcinogenesis. Rapamycin (=sirolimus), a specific mTOR inhibitor, leads to G(1) arrest of many malignant cell lines and currently, analogues of rapamycin are being investigated as a cancer chemotherapeutic adjuvant. Aim, To study the toxicity and tolerability of rapamycin therapy in patients with advanced hepatocellular carcinoma (HCC). Methods, Between June 2005 and February 2007, patients with advanced HCC, not eligible for any established therapy, were included in the study. Results, Eighteen patients (F/M: 5/13) with compensated liver cirrhosis (Child A n = 11, Child B n = 5, Child C n = 2) and histologically proven HCC were included in this study. According to the BCLC staging system, most of the patients enrolled had an advanced HCC: BCLC stage B: n = 2, Barcelona Clinic Liver-Cancer (BCLC) stage C: n = 14, BCLC stage D: n = 2. Overall, therapy with rapamycin was well tolerated. Most common toxicities were thrombocytopaenia and anaemia. We did not observe any partial or complete tumour response. At 3 months, two patients had stable disease and at 6 months, all patients had progressed. The median overall survival was 5.27 months, median time to progression was 3 months. Conclusion, Rapamycin is well tolerated in patients with advanced HCC, but only minimally effective. [source] How to overcome multidrug resistance in chemotherapy for advanced hepatocellular carcinomaLIVER INTERNATIONAL, Issue 4 2010Soo Hyung Ryu No abstract is available for this article. [source] Hepatic arterial infusion of chemotherapy for advanced hepatocellular carcinomaASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 2 2010Yu-Yun SHAO Abstract Treatment of advanced hepatocellular carcinoma (HCC) remains a significant problem for clinicians. Sorafenib, the only approved agent, improves survival rate, but is associated with a low tumor response rate. Alternative approaches for the treatment of advanced HCC are urgently needed. Hepatic arterial infusion of chemotherapy (HAIC) is a promising modality for the treatment of advanced HCC. Since its introduction, there have been improvements in implantable pumps, in catheter implantation and in the convenience and safety of HAIC in general. Numerous clinical studies have shown that HAIC provides moderate therapeutic efficacy with substantially favorable toxicity profiles in selected patient groups with advanced HCC. However, the lack of large randomized studies means that HAIC is not yet a well-established treatment for advanced HCC. We believe there is an urgent need for the further investigation of HAIC for the treatment of advanced HCC. [source] Targeted agents for the systemic treatment of advanced hepatocellular carcinomaASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 2 2009Arun AZAD Abstract The prognosis for advanced hepatocellular carcinoma is poor and systemic therapy has historically been of limited benefit. However, novel targeted agents offer promise in improving patient outcomes. In a recent phase III study the oral multi-tyrosine kinase inhibitor sorafenib was demonstrated to have a survival advantage over a placebo in advanced hepatocellular carcinoma. Similar efficacy was demonstrated in a phase III trial limited to an Asian,Pacific group of patients. While these results are encouraging, it is vital to make further progress. In this review we examine current knowledge of targeted agents in advanced hepatocellular carcinoma. We also address some of the key issues that require exploration regarding the use of targeted agents in advanced hepatocellular carcinoma. [source] Combined intraarterial 5-fluorouracil and subcutaneous interferon-, therapy for advanced hepatocellular carcinoma with tumor thrombi in the major portal branchesCANCER, Issue 2 2002Masato Sakon M.D. Abstract BACKGROUND The prognosis of hepatocellular carcinoma (HCC) invading into the major branches of the portal vein (Vp3) is extremely poor. METHODS Eleven consecutive patients with HCC and Vp3 were treated with 2,6 cycles of a "basic" combination therapy consisting of continuous arterial infusion of 5-fluorouracil (450,500 mg/day, for the initial 2 weeks) and subcutaneous injection of interferon-, (5 million international units, 3 times/week, 4 weeks). In the first 3 patients, methotrexate (90 mg/day 1 of every week), cisplatin (10 mg/day), and leucovorin (30 mg/days 2 and 3 of every week) also were administered for the initial 2 weeks ("full" regimen). RESULTS In 8 (73%) of 11 patients, an objective response (complete response [CR] or partial response [PR]) was observed with marked regression of tumor and decrease in tumor markers. The use of the full regimen was associated with objective response in all patients; instead, they developed thrombocytopenia or leukopenia. In the subsequent 8 patients with basic regimen, 5 patients showed CR (2 cases) or PR (3 cases; objective response rate, 63%), and leukopenia was observed only in 1 patient. CONCLUSIONS Simple combination therapy with subcutaneous interferon-, and intraarterial 5-fluorouracil therefore is a promising treatment modality for intractable HCC with Vp3. Cancer 2002;94:435,42. © 2002 American Cancer Society. [source] | |||||||||||||||||||||||||