Treatment Of Hepatic Tumors Research Articles

Tri‐n‐octyl[32P]phosphine oxide. synthesis and biodistribution via the hepatic artery of rats

The purpose of this study was to analyse the biodistribution of tri-n-octyl[32P]phosphine oxide ([32P]TOPO) in rats following intrahepatic arterial injection so as to assess its potential as a radiopharmaceutical for the treatment of hepatic tumours in humans. The retention of [32P]TOPO remained high in liver and decreased rapidly in kidney, bone marrow and blood. The synthesis of [32P]TOPO was performed in a one step procedure from [32P]OCl3 and n-octyl magnesium chloride in diethyl ether at 0°C. Copyright © 1999 John Wiley & Sons, Ltd.

Tri-n-octyl[32P]phosphine oxide. synthesis and biodistributionvia the hepatic artery of rats

The purpose of this study was to analyse the biodistribution of tri-n-octyl[32P]phosphine oxide ([32P]TOPO) in rats following intrahepatic arterial injection so as to assess its potential as a radiopharmaceutical for the treatment of hepatic tumours in humans. The retention of [32P]TOPO remained high in liver and decreased rapidly in kidney, bone marrow and blood. The synthesis of [32P]TOPO was performed in a one step procedure from [32P]OCl3 and n-octyl magnesium chloride in diethyl ether at 0°C. Copyright © 1999 John Wiley & Sons, Ltd.

New oily agents for targeting chemoembolization for hepatocellular carcinoma.

The evaluation of new oily agents for targeting chemoembolization for hepatocellular carcinoma. Five types of oily preparation were injected into the hepatic artery of 54 rabbits inoculated with VX2 carcinoma cells in order to evaluate (1) the safety of these preparations, (2) their histologic distribution and the amount of agents remaining at tumor sites, and (3) computed tomographic (CT) images obtained. Of these preparations, three were made by mixing non-iodinated poppy seed oil and a thickener and then adjusted to have a viscosity lower than, equal to, or higher than that of lipiodol. A fourth preparation was a mixture of lipiodol and a thickener with a higher viscosity than lipiodol alone, and the fifth preparation was lipiodol alone. (1) No injury to the hepatic parenchyma was observed hematologically or histologically. (2) With increase in the viscosity, a significantly larger amount of agent remained at the tumor site. No agent was present at normal sites 14 days after intraarterial injection, regardless of which preparation was given. (3) On CT scans following intraarterial injection, tumor cells were visibly deeply stained in the non-iodinated preparation groups, while the lipiodol groups were not evaluable because of excessively high attenuation. The non-iodinated oily preparations and highly viscous oily preparations developed in the present study were more useful than lipiodol for treatment of hepatic tumors.

Complications associated with transcatheter arterial embolization for hepatic tumors.

Transcatheter arterial embolization (TAE) is widely used in the treatment of hepatic tumors. A total of 2,300 TAE procedures were performed with a 2-15-mL injection of a mixture or suspension of anticancer drugs and iodized oil, followed by administration of gelatin sponge particles. One or two chemotherapeutic drugs, including doxorubicin hydrochloride (10-30 mg), epirubicin hydrochloride (10-30 mg), mitomycin C (10-20 mg), and cisplatin (25-100 mg), were used for each procedure. Complications were encountered in 4.4% of cases (n = 102) and were related to the use of chemoembolic agents or the manipulation of a catheter or guide wire. These complications included acute hepatic failure (n = 6), liver infarction (n = 4) or abscess (n = 5), intrahepatic biloma (n = 20), multiple intrahepatic aneurysms (n = 6), cholecystitis (n = 7), splenic infarction (n = 2), gastrointestinal mucosal lesions (n = 5), pulmonary embolism or infarction (n = 4), tumor rupture (n = 1), variceal bleeding (n = 3), and iatrogenic dissection (n = 35) or perforation (n = 4) of the celiac artery and its branches. Knowledge of these complications is important for correct diagnosis and appropriate management.

Orientated thermotherapy of ferromagnetic thermoseed in hepatic tumors.

AIM:To study the thermotherapeutic effects of implanted ferromagnetic thermoseeds in high frequency electromagnetic field in hepatic tumors.METHODS:The ferromagnetic thermoseeds made of nickel-copper alloy, which has a lower Curie temperature, were implanted into hepatic tumors of mice. The high frequency electromagnetic field was then applied in vitro to make the ferromagnetic thermoseeds produce the hyperthermia. Before and after thermotherapy, the tumor size, pathologic alteration and animal survival period were assessed.RESULTS:The temperature at the central area of the tumor could be heated up to 50°. Most of tumors in mice disappeared with a large amount of tumor necrosis. The survival period of mice was prolonged.CONCLUSION:This thermotherapy is beneficial to directional selection and temperature control for treatment of hepatic tumors.

Intraoperative and laparoscopic sonography of the liver.

Intraoperative sonography is an important aid in the decision making process during open surgery because it can detect additional small liver tumours that may not be depicted preoperatively, even with the use of modern non invasive imaging modalities. A continued important role of intraoperative sonography is to determine hepatic anatomy, allowing for safer and easier hepatic surgery with increased parenchymal preservation. Intraoperative sonography is also used for monitoring cryogenic ablation of hepatic tumour. To overcome the inherent limitations of laparoscopic surgery, laparoscopic sonography can now be used to provide information not available during laparoscopy or laparoscopic surgery alone. In this article, the authors present the most recent techniques for intraoperative sonography. Also they emphasize the important role of intraoperative sonography and laparoscopic sonography in the surgical decision-making process in patients with hepatic or biliary disease and report the most recent advances in intraoperative sonography with respect to the treatment of hepatic tumours. Finally, they try to look forward at the possible use for intraoperative technologies that are now in their early stages.

Hepatic Inflow Occlusion Increases the Efficacy of Interstitial Laser-Induced Thermotherapy in Rat

Interstitial laser-induced thermotherapy (ILT) destroys tumors thermally. ILT was performed for treatment of liver tumors in rats to investigate the effect of hepatic inflow occlusion on temperature distribution and lesion size. Tumors were irradiated for 20 min with near-infrared light from a neodymium:yttrium–aluminum–garnet (Nd:YAG) laser. The laser light at a power of 1.5 W was delivered through a plane-cut optical fiber, the tip of which was placed in the tumor. Rats in group I received ILT without interruption of hepatic blood flow. Those in group II received ILT during hepatic inflow occlusion. Liver temperatures were measured during treatment. After 3 days the animals were sacrificed and the size of the lesions was measured. Occlusion of the hepatic inflow during ILT increased the maximum lesion diameter, as measured at the liver surface, by 47%. Linear interpolation between the temperatures measured at 6 and 12 mm distance from the fiber tip revealed that the temperature at the necrotic border just before the end of treatment was approximately 45°C in both the occluded and nonoccluded groups, indicating that the hepatic inflow occlusion caused no increase in tissue thermal sensitivity. This study shows that occlusion of the hepatic inflow during interstitial laser-induced thermotherapy causes a significant increase in lesion size, which could have implications for the treatment of hepatic tumors.

Locoregional techniques in the treatment of hepatic tumors

Locoregional techniques in the treatment of hepatic tumors

Locoregional techniques in the treatment of hepatic tumors

Journal of Surgical OncologyVolume 64, Issue 4 p. 257-261 Guest Editorial Locoregional techniques in the treatment of hepatic tumors Benjamin F. Rush Jr. MD, Corresponding Author Benjamin F. Rush Jr. MD Department of Surgery, Sections of Surgical Oncology and Liver Transplantation, UMDNJ/New Jersey Medical School, Newark, New JerseyDoctors Office Center, 90 Bergen Street, Suite 7200, Newark, NJ 07103-2499Search for more papers by this authorBaburao Koneru MD, Baburao Koneru MD Department of Surgery, Sections of Surgical Oncology and Liver Transplantation, UMDNJ/New Jersey Medical School, Newark, New JerseySearch for more papers by this author Benjamin F. Rush Jr. MD, Corresponding Author Benjamin F. Rush Jr. MD Department of Surgery, Sections of Surgical Oncology and Liver Transplantation, UMDNJ/New Jersey Medical School, Newark, New JerseyDoctors Office Center, 90 Bergen Street, Suite 7200, Newark, NJ 07103-2499Search for more papers by this authorBaburao Koneru MD, Baburao Koneru MD Department of Surgery, Sections of Surgical Oncology and Liver Transplantation, UMDNJ/New Jersey Medical School, Newark, New JerseySearch for more papers by this author First published: 07 December 1998 https://doi.org/10.1002/(SICI)1096-9098(199704)64:4<257::AID-JSO1>3.0.CO;2-8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume64, Issue4April 1997Pages 257-261 RelatedInformation

Magnetic resonance imaging control of laser destruction of hepatic metastases: Correlation with post-operative dynamic helical CT

SummaryInterstitial laser photocoagulation (ILP) is currently limited by deficient per-procedural monitoring. The purpose of this study was to evaluate MR control of ILP of hepatic metastases. Twenty-two laser activations were used to treat eight metastases in seven patients under local anaesthesia and sedation. Laser energy was delivered via optical fibres positioned in the tumour under ultrasound guidance. T1-weighted FLASH and spin-echo sequences were used to monitor the procedure. Enhanced CT was performed at 24 h to assess thermal necrosis. FLASH imaging showed an enlarging area of signal change during ILP. The final extent of this correlated closely with the extent of tissue necrosis on CT. Spin-echo imaging was disappointing because of poor contrast between the treated tissue and normal liver/untreated tumour. Per-procedural MR imaging accurately and reliably depicts ILP-induced necrosis. MR control may permit more widespread application of ILP to the treatment of hepatic tumours.

Ethanol injection for the treatment of hepatic tumours.

Percutaneous ethanol injection (PEI) is a relatively new therapeutic technique for the treatment of liver tumours. PEI is now considered a reliable alternative to surgical resection for cirrhotic patients with a single, small hepatocellular carcinoma (HCC). Intratumoral injection of absolute ethanol, in fact, achieves complete ablation of HCC nodules 3 cm or less in diameter with a high probability. Moreover, PEI is not associated with significant morbidity or mortality and does not damage non-cancerous liver parenchyma. Long-term survival rates of PEI-treated patients were similar to those obtained in matched patients submitted to partial hepatectomy. In large HCC lesions, the anticancer effect of PEI can be significantly enhanced by pretreatment of the tumour with transcatheter arterial chemoembolisation. PEI may also be effectively used to destroy adenomatous hyperplastic nodules in liver cirrhosis, which represent precancerous lesions. The results of PEI in the treatment of liver metastases, in contrast, have been far less encouraging than in the case of HCC, so that PEI is not recommended when other interventional procedures such as radiofrequency electrocautery or interstitial laser photocoagulation are available. Imaging procedures plays a key role in PEI, as they provide a reliable assessment of the therapeutic effect of the procedure.

Cryosurgery on the Treatment of Hepatic Tumors.

BACKGROUND: Primary and metastatic tumors in the liver are difficult to treat. When surgical resection is not feasible, cryotherapy is one of the several alternative approaches. METHODS: The data on outcomes from hepatic resections are reviewed, and the rationale and techniques of performing cryosurgery for unresectable hepatic cancers are described. The literature is reviewed and combined with the experiences of the authors on cryosurgery for management of hepatic tumors. RESULTS: The indications and techniques for performing cryosurgery are now well established. The procedure is relatively safe, and long-term survival rates of over 20% may be achieved. CONCLUSIONS: While cryotherapy is effective for localized tumors in the liver, additional adjuvant approaches are required to control disease in the untreated liver. Endoscopic techniques may minimize patient morbidity.

Anatomical hepatectomy for resection or transplantation

Anatomical resection has become the basis for the treatment of hepatic tumors recognizing the portal-based intrahepatic architecture of the liver. In transplantation, these principles have been applied to the creation of partial liver grafts used to treat pediatric recipients with grafts from adult donors. In this study we reviewed the results of application of these techniques in 60 patients undergoing major hepatectomy and in 47 liver transplants in children. Records of patients undergoing resection and children undergoing transplantation were reviewed. A descriptive study was performed characterizing the methods and results achieved using anatomic hepatectomy. Outcomes analyzed included surgical morbidity and survival. Sixty consecutive patients underwent major hepatectomy without operative mortality (60 days). Complications occurred in 26% of patients, requiring reoperation in 2 cases (3%); median hospital stay was 8.5 days. Of 47 liver transplants in children, 57% utilized partial grafts, and living donors were used in 15 cases. Actual patient survival is 91% 1-36 months after surgery. No patient deaths were due to technical graft failure. Major hepatic surgery can be accomplished with low mortality applying portal-based anatomy. Surgical precision is made possible by vascular isolation for hepatectomy and operative ultrasonography. These principles are essential for successful use of partial liver grafts in children.

Complications following high-dose percutaneous ethanol injection into hepatic tumors.

Percutaneous ethanol injection therapy (PEIT) with a 2-10 ml ethanol dose per session is widely used in the treatment of small hepatocellular carcinoma. Larger doses have been restricted for fear of complications. The aim of the present study was to make a retrospective evaluation of the complications following treatment of hepatic tumors with high doses of ethanol (up to 200 ml). The medical records of 15 patients treated repeatedly with PEIT were reviewed retrospectively to detect side effects or complications. Eleven of these patients had undergone transarterial chemoembolization (TAE) prior to PEIT. Of 173 ethanol injections in doses of 2-200 ml (mean 49 ml), more than 10 ml had been injected on 138 occasions. The chi-square test was used to evaluate the differences in pain frequency among the various dosage groups. Serious complications did not occur. Pain was a common side effect, occurring in 48% of the procedures. Immediate pain during the treatment was related to the ethanol dose and increased significantly with increasing doses (p < 0.01). Other side effects were rare. PEIT with doses higher than previously reported seems to be safe. This should encourage further clinical studies that aim at fully working out the clinical value of such treatment.

Biodistribution of rhenium-188 Lipiodol infused via the hepatic artery of rats with hepatic tumours

The purpose of this study was to analyse the biodistribution of rhenium-188 Lipiodol in rats with hepatic tumours following intrahepatic arterial injection to assess the potential of 188Re-Lipiodol as a radiopharmaceutical for the treatment of hepatic tumours in humans. Twelve male rats with hepatic tumours were killed at 1h, 24h and 48h after injection of approximately 7.4MBq of 188Re-Lipiodol via the hepatic artery. Samples of various organs were obtained and counted to calculate the tissue concentration. Radioactivity in the hepatic tumours was very high throughout this study, with a biological half-life of 122.9h. Radioactivity in the normal liver tissue was also high, but was significantly lower than in the tumour. The biological half-life in the normal liver tissue was 31.7h. The ratio of tumour concentration to the normal liver tissue concentration was 5.15 at 1h and rose to 7.7 at 24h and 10.84 at 48h. The level of radioactivity in the lung was high at 1h, and declined rapidly over time. The level of radioactivity in the kidney was moderate throughout the study. The radiation concentrations in muscle, spleen, testis, bone and whole blood were insignificant. We conclude that 188Re-Lipiodol should be considered as a potential radiopharmaceutical for the intra-arterial treatment of hepatic tumours.

Percutaneous Ethanol Injection for the Treatment of Hepatic Tumors: Indications, Mechanism of Action, Technique, and Efficacy

Percutaneous Ethanol Injection for the Treatment of Hepatic Tumors: Indications, Mechanism of Action, Technique, and Efficacy

Surgical treatment of hepatic tumors in childhood. Thirty-five years' experience: A. Okada, S. Kamata, M. Fukuzawa, et al. J Jpn Soc Pediatr Surg 30:35–42, 1994

Surgical treatment of hepatic tumors in childhood. Thirty-five years' experience: A. Okada, S. Kamata, M. Fukuzawa, et al. J Jpn Soc Pediatr Surg 30:35–42, 1994

Study on hepatic artery chemoembolization using temperature-sensitive liposome or lipiodol emulsion.

As a novel method for the medical application of liposomes, we have tried hepatic artery chemoembolization using temperature-sensitive liposomes with hyperthermia for the treatment of hepatic tumors. In this study, the effect of temperature-sensitive liposomes was compared with that of Lipiodol emulsion, which has been used clinically. The temperature-sensitive liposomes, consisting of dipalmitoylphosphatidylcholine or Lipiodol emulsions entrapping doxorubicin, were administered into the hepatic artery of hepatic tumor-bearing rats via a cannula. Doxorubicin administered in a liposomal form showed a high accumulative property toward tumors, with heating, while that in the emulsion form showed a slow release property toward tumors. Not only was tumor growth inhibited, but also, an actual diminishing of the tumor was observed in each form. Side effects were also examined: an abnormal rise in GPT, or necrosis of the normal tissues in liver, which was often observed in hepatic artery chemoembolization using Lipiodol emulsion, was remarkably reduced in the liposomal chemoembolization.

Percutaneous ethanol injection for the treatment of hepatic tumors: indications, mechanism of action, technique, and efficacy.

Percutaneous injection of ethanol for treatment of hepatic tumors was first described by Sugiura et al. [1] in 1983. To date, reported experience with the procedure has focused mainly on therapy of hepatocellular carcinoma (HCC) [2-15], with little information available regarding its use in treating metastatic liver lesions [16]. Interest in this technique has grown recently as a possible means of treating patients with metastatic liver disease. The purpose of this perspective is to review the indications, mechanism of action, technique, complications, and efficacy of percutaneous ethanol injection for liver tumor treatment.

Surgical Treatment of Hepatic Tumors in Childhood : Thirty Five Years&apos; Experience

Surgical Treatment of Hepatic Tumors in Childhood : Thirty Five Years&apos; Experience