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Tumor Thrombus (tumor + thrombus)
Kinds of Tumor Thrombus Selected AbstractsTumor thrombus in a child with primitive neuroectodermal tumorPEDIATRIC BLOOD & CANCER, Issue 6 2002Ömer Görgün MD No abstract is available for this article. [source] Adjuvant lipiodol I-131 after curative resection/ablation of hepatocellular carcinomaHPB, Issue 6 2008K. M. Ng Abstract Aim. A total of 329 patients with hepatocellular carcinoma have been treated at our unit since 1990. Following the randomized controlled trial in Hong Kong by Lau et al. in 1999, patients have been offered adjuvant lipiodol I-131. The aim of this study was to determine the effectiveness of adjuvant lipiodol I-131, following potentially curative surgery with resection and/or ablation, on overall and disease-free survival rates. Material and methods. The prospectively updated hepatocellular carcinoma database was analysed retrospectively. A total of 34 patients were identified to have received adjuvant lipiodol I-131 post-curative treatment with surgical resection and/or ablation. Patient demographics, clinical, surgical, pathology, and survival data were collected and analysed. Results. Three patients received ablation alone, 24 resection, and 7 resection and ablation. Of the 34 patients treated, there were 2 possible cases of treatment-related fatality (pneumonitis and liver failure). Potential prognostic factors studied for effect on survival included age, gender, serum AFP concentration, Child-Pugh score, cirrhosis, tumor size, portal vein tumor thrombus, tumor rupture, and vascular and margin involvement. The median follow-up duration was 23.3 months. The overall median survival was 40.1 months, while the overall survival rates at 1, 2, 3, and 4 years were 87.1%, 71.7%, 60.7%, and 49.6%, respectively. Median duration to recurrence was 22.3 months. Conclusion. Administration of adjuvant lipiodol I-131 is associated with good overall survival. [source] Clinical outcome of surgical management for patients with renal cell carcinoma involving the inferior vena cavaINTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2007Tomoaki Terakawa Background: The objective of this study was to evaluate the clinical outcome after surgical management of renal cell carcinoma (RCC) extending to the inferior vena cava (IVC). Methods: This study included a total of 55 patients (41 men and 14 women; mean age, 59.3 years) with RCC (39 right- and 16 left-sided tumors) involving the IVC, who underwent radical nephrectomy and tumor thrombectomy between 1983 and 2005 at a single institution in Japan. The level of thrombus was classified as follows: level I, infrahepatic; level II, intrahepatic; level III, suprahepatic; and level IV, extending to the atrium. Clinicopathological data from these patients were retrospectively reviewed to identify factors associated with survival. Results: There were 11 and 18 patients who were diagnosed as having lymph node and distant metastases, respectively. Twenty-two patients had tumor thrombus in level I, 20 in level II, 10 in level III, and 3 in level IV. Pathological examinations demonstrated that 34 and 21 patients had clear cell carcinoma and non-clear cell carcinoma, respectively, 42, 9 and 4 were pT3b, pT3c and pT4, respectively, and 6, 35 and 14 were Grades 1, 2 and 3, respectively. Cancer-specific 1-, 3- and 5-year survival rates of these 55 patients were 74.5%, 51.4% and 30.3%, respectively. Among several factors examined, clinical stage (P = 0.047), lymph node metastasis (P = 0.016), histological subtype (P = 0.034) and tumor grade (P < 0.001) were significantly associated with cancer-specific survival by univariate analysis. Furthermore, multivariate analysis demonstrated clinical stage (P = 0.037) and tumor grade (P < 0.001) as independent predictors of cancer-specific survival irrespective of other significant factors identified by univariate analysis. Conclusions: In patients with RCC involving the IVC, biological aggressiveness characterized by tumor grade rather than tumor extension would have more potential prognostic importance; therefore, more intensive multimodal therapy should be considered in patients with high grade RCC with tumor thrombus extending into the IVC. [source] Application of cardiopulmonary bypass for resection of renal cell carcinoma and adrenocortical carcinoma extending into the right atriumINTERNATIONAL JOURNAL OF UROLOGY, Issue 3 2006TATSUMASA OCHI Aim:, The application of cardiopulmonary bypass to atrial involvement represents an important advance that has improved the safety and technical efficacy of a difficult surgical undertaking. Our experiences of the management of extended thrombi into the right atrium in patients with retroperitoneal malignancy using a cardiopulmonary bypass were discussed. Methods:, Data were reviewed for five patients (two men and three women; mean age, 60.4 years; range, 49,79 years) with retroperitoneal tumors displaying intracardiac tumor extension. Tumors originated in the right kidney in four patients, and in left adrenal gland in one patient. Cardiopulmonary bypass was used in all cases. Results:, Mean total blood loss was 6059 mL. Mean operative time was 14.7 h. No intra- or postoperative complications due to surgical technique were encountered, and no significant bleeding occurred during incision of the inferior vena cava or after removal of tumor thrombus. The follow-up period ranged from 3 to 20 months with a mean of 12.6 months. Of the five patients, three died of metastatic diseases, one died of liver dysfunction and one remains disease free as of 18 months postoperatively. Conclusions:, Our experience indicates that this procedure can be safely used for atrial involvement. Although superior long-term survival cannot be shown yet, favorable early results and a lack of perioperative complications were identified. [source] Intraoperative transesophageal echocardiography for inferior vena caval tumor thrombus in renal cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 4 2004TAKEHIRO OIKAWA Abstract Background : We investigated the advantages of intraoperative transesophageal echocardiography (TEE) during inferior vena caval tumor thrombectomy in renal cell carcinoma (RCC). Methods : Five patients with RCC that extended into the inferior vena cava (IVC) underwent radical nephrectomy. To remove the tumor thrombus in the IVC, an inflated Fogarty balloon catheter was used to pull the thrombus below the level of the hepatic veins with real-time TEE monitoring. Results : In all cases, TEE monitoring during surgery provided an accurate and excellent view of the IVC thrombus. TEE was particularly helpful for the thrombectomy to minimize hepatic mobilization by using occlusion balloon catheter in two patients whose thrombus extended to the intrahepatic IVC. Conclusions : Intraoperative real-time TEE monitoring is a safe, minimally invasive technique that can provide accurate information regarding the presence and extent of IVC involvement, guidance for placement of a vena caval clamp, confirmation of complete removal of the IVC thrombus and intervention using catheters to assist in thrombectomy. [source] Surgical results for hepatocellular carcinoma with bile duct invasion: A clinicopathologic comparison between macroscopic and microscopic tumor thrombusJOURNAL OF SURGICAL ONCOLOGY, Issue 4 2005Minoru Esaki MD Abstract Background The aim of this study was to evaluate the prognostic factors and long-term results after surgery in patients with hepatocellular carcinoma (HCC) with bile duct invasion. Methods The records of 38 HCC patients with microscopic (tumor thrombus was found in more than the second order branch of the biliary tree; n,=,19) and macroscopic (tumor thrombus was found in no more than the second order branch of the biliary tree; n,=,19) bile duct invasion were reviewed in this study. Survival rates were calculated with regard to 18 clinicopathological factors. A log-rank analysis was performed to identify which factors predict the prognosis. The relationships between the degree of bile duct invasion and 17 clinicopathologic factors were also compared. Results The overall 1-, 3-, and 5-year survival rates were 79%, 45%, and 33%, respectively. The indicators of a favorable prognosis included no intrahepatic metastases, curative surgical resection, and macroscopic bile duct invasion. Conclusion We found a favorable long-term postoperative result for HCC patients with macroscopic bile duct invasion. Even if HCC tumor thrombus is recognized in the major branches of bile duct, extensive and curative surgical treatment should be recommended when hepatic functional reserve is satisfactory without intrahepatic metastases. J. Surg. Oncol. 2005;90:226,232. © 2005 Wiley-Liss, Inc. [source] Major liver resections for hepatocellular carcinoma on cirrhosis: Early and long-term outcomesLIVER TRANSPLANTATION, Issue S2 2004Lorenzo Capussotti Since the lack of donors, liver resections continue to be the treatment of choice for cirrhotic patients with good liver function and resectable hepatocellular carcinoma (HCC). Moreover, over the past 2 decades, an increasing number of major hepatic resections have been performed. The aim of this study is to evaluate short- and long-term outcomes of 55 cirrhotic patients undergoing major hepatic resection with particular attention to the survival of the patients with gross portal vein invasion or large size tumors. Twenty-two patients (40%) required intra- or post-operative blood transfusion. Medium tumor size was 66.6±29.2 mm; 7 patients had large size (> 10 cm) HCCs. A single node was present in 38 cases (69.1%). There was a gross portal vein tumor thrombus (PVTT) in 13 patients (23.6%). Resection was non-curative in 4 cases. In-hospital mortality and morbidity rates were 5.5% and 30.9%, respectively. The overall and disease-free survival rates were 36.2% and 42.8%, respectively. Overall 5-year survival rates of patients with large size tumors was 17.1%. Ten patients with a gross PVTT had an R0 resection with a 26.6% 5-year survival rate. In conclusion, major hepatic resections for HCC can be performed with low mortality and morbidity rates. HCCs with PVTT or greater than 10 cm in size have very limited options of treatment; the favorable long-term results of our study suggest that they should undergo surgery if a radical resection can be achieved. (Liver Transpl 2004;10:S64,S68.) [source] Laparoscopic cytoreductive nephrectomy with cytokine therapy for metastatic renal cell carcinomas compared with open nephrectomyASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2010T Fujita Abstract Introduction: We retrospectively reviewed and compared the operation records and long-term results of patients with metastatic renal cell carcinoma (mRCC) who underwent laparoscopic cytoreductive nephrectomy and those who underwent open procedure. Methods: A total of 75 patients with mRCC who underwent cytoreductive nephrectomy between 1997 and 2007 were studied: 23 patients in the laparoscopy group (LCN group) and 52 in the open group (OCN group). Most patients received interferon-based cytokine therapy after surgery. Patients with tumor thrombus in the inferior vena cava were excluded from this study. Results: Operating time in the LCN group was significantly longer than in the OCN group (320.3 min vs 269.6 min, P=0.049). Blood loss was less in the LCN group (527.8 ml) than in the OCN group (1372.3 ml, P=0.072). Convalescence was shorter in the LCN group (18.1 d) than in the OCN group (32.9 d, P<0.0001). Median follow-up periods were 15 months (range 2,110 months) and 17 months (range 1,103 months) in the LCN group and OCN group, respectively. There was no statistically significant difference between the two groups with regard to disease-specific patient survival and progression-free survival. Conclusions: Laparoscopic cytoreductive nephrectomy is a feasible alternative for patients with mRCC because its benefits include less blood loss and shorter convalescence. In addition, the long-term oncological results of laparoscopic cytoreductive nephrectomy are comparable to those of the open procedure. [source] Hepatocellular carcinoma with main portal vein tumor thrombusCANCER, Issue 6 2009Treatment with 3-dimensional conformal radiotherapy after portal vein stenting, transarterial chemoembolization Abstract BACKGROUND: Hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT) is often associated with poor prognosis. We retrospectively assessed the effectiveness of percutaneous transhepatic portal vein stenting and transarterial chemoembolization (PTPVS-TACE) combined with or without 3-dimensional conformal radiotherapy (3-DCRT) for HCC with MPVTT. METHODS: Forty-five patients with HCC complicated by MPVTT were treated with PTPVS-TACE. Among them, 16 patients (group A) received 3-DCRT with 30-60Gy as daily 2Gy fractions. The remaining 29 patients (group B) received no radiotherapy. The tumor responses, complications, stent patency rates, and cumulative survival rates were evaluated, and the Kaplan-Meier method and log-rank test were used for survival analysis. RESULTS: No severe complications were associated with PTPVS-TACE and 3-DCRT. The objective response rate (CR and PR) was 35.6%. The 60-, 180-, and 360-day cumulative stent patency rates were 93.3%, 62.2%, and 34.6% in group A, and 58.6%, 21.7%, and 10.8% in group B, respectively, showing significant difference between the 2 groups (P < .01). The mean patency time was 475.20 ± 136.97 and 199.58 ± 61.40 days, respectively. The 60-, 180-, and 360-day cumulative survival rates were 93.8%, 81.3%, and 32.5%, respectively, for group A, 86.2%, 13.8%, and 6.9%, respectively, for group B. Significant statistical differences were detected between the 2 groups (P < .01). CONCLUSIONS: These findings suggest that sequential therapy by PTPVS-TACE-3-DCRT is possibly an effective treatment modality for HCC complicated by main portal vein tumor thrombus. Cancer 2009. © 2009 American Cancer Society. [source] | ||||||||||||||||||||||