Management options in primary and secondary liver cancer:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Surgical oncology clinics of North America
5,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XIX S., S. 215 - 486 Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
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| adam_text | MANAGEMENT OPTIONS IN PRIMARY
AND SECONDARY LIVER CANCER
CONTENTS
Foreword xv
Blake Cady
Preface xvii
T.S. Ravikumar
Molecular Determinants in the Biology of Liver Metastasis 215
Robert Radinsky and Lee M. Ellis
Metastasis is a highly selective process whereby only cells that ex¬
press the necessary phenotype are capable of completing all steps
in the metastatic process. In addition, host organ interactions with
the metastatic tumor cell play a crucial role in the formation of
viable metastases. The liver is a frequent site of metastasis owing
to both anatomic and biologic determinants. In this article, the au¬
thors have provided readers with a better understanding of the
biology of liver metastases and the molecular events leading to the
metastatic phenotype. This information is essential if new and ther¬
apeutic approaches are to be developed to treat this disease.
Imaging of Primary and Metastatic Liver Tumors 231
Jonathan B. Kruskal and Robert A. Kane
Recent technical advances in the different cross sectional modali¬
ties used for imaging liver tumors are described, and the tech¬
niques are compared and contrasted. Imaging characteristics of the
variety of primary and metastatic liver tumors are described, and
strategies for the imaging, diagnosing, and staging of liver tumors
are suggested. Certain pitfalls exist when interpreting liver studies
and the more common sources of these errors are depicted.
SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA
VOLUME 5 • NUMBER 2 • APRIL 1996 vii
Intraoperative Ultrasonography and Other Techniques for
Segmental Resections 261
Tadatoshi Takayama and Masatoshi Makuuchi
Intraoperative ultrasonography is an indispensable tool for liver
surgery, and ultrasonically guided techniques have opened the
way to new hepatectomy procedures, namely, segmental and sub
segmental resections, thereby allowing minor but systematic re¬
section in patients with poor hepatic function.
Laparoscopic Staging and Intraoperative Ultrasonography for
Liver Tumor Management 271
T. S. Ravikumar
Intraoperative ultrasonography has become an invaluable tool for
programs that perform large volume, complex liver operations. To¬
gether with laparoscopy, intraoperative ultrasonography helps in
appropriate staging, aids in decision making, and tailors opera¬
tions so as to minimize short term morbidity and optimize long
term benefit.
Primary Epithelial Hepatic Malignancies: Etiology, Epidemiology,
and Outcome After Subtotal and Total Hepatic Resection 283
David M. Nagorney and Jean Franfois Gigot
Primary hepatic malignancies are among the leading causes of can¬
cer deaths. The epidemiology, natural history, and staging of pri¬
mary hepatic tumors are reviewed. Both subtotal hepatectomy and
total hepatectomy with liver transplantation are appropriate ther¬
apeutic options based on careful patient selection. Prognostic fac¬
tors related to these tumors also are reviewed.
Cholangiocarcinoma 301
Amadeo Marcos Alvarez and Roger L. Jenkins
The aggressive application of skeletonization resection of the bili¬
ary tree often in conjunction with major lobar resection has evolved
as the most successful treatment option for patients without evi¬
dence of regional spread. Nonsurgical techniques for palliation of
patients with unresectable disease have benefited from the intro¬
duction of self expandable metal stents. To date, adjuvant proto¬
cols suffer from the absence of effective chemotherapeutic agents.
Proximal Bile Duct Tumors 317
Boris W. Kuvshinoff, Yuman Fong, and Leslie H. Blumgart
Modern radiologic diagnostic approaches that identify patients
with high bile duct cancer can predict resectability and provide
viii CONTENTS
information for biliary enteric bypass in the case of irresectability.
Twenty percent to 40% of patients are resectable by local excision
with or without hepatic resection, and this represents the only op¬
portunity for cure. Operative mortality is now acceptable and re¬
section is associated with a median survival of approximately 35
months. Numerous palliative operative and nonoperative ap¬
proaches are available, including biliary enteric bypass, transtu
moral stenting, and percutaneous endoprostheses. The role of both
intraluminal and external beam radiotherapy also is discussed.
Surgical Resection of Metastatic Liver Tumors 337
Jeffrey Kavolius, Yuman Fong, and Leslie H. Blumgart
The liver is a common site of metastatic cancers. Abundant data
now support surgical resection as the treatment of choice for meta¬
static colorectal cancer to the liver. For symptomatic neuroendo
crine tumors, resection also is a useful palliative therapy. Roles for
resection of metastatic cancer from other primary sites have yet to
be defined.
Re Resection for Colorectal Liver Metastasis 353
H. Bismuth, R. Adam, F. Navarro, D. Castaing, L. Engerran,
and A. Abascal
With the decreasing mortality and morbidity of liver resection in
the last 10 years, a more aggressive approach has emerged against
liver metastases of colorectal cancer. Repeat liver resection is being
performed for patients with isolated liver recurrence following a
first hepatectomy. Based on a 2 year experience of 55 repeat hepatic
resections performed in 44 patients, the authors observed no op¬
erative mortality and a postoperative morbidity of 15% similar to
that of first hepatectomies. Five year survival rate is 44% following
second hepatectomy. These results combined with the review of
the literature demonstrate that rehapectomy may be performed
safely and may provide the only chance of long term remission in
patients presenting with technically resectable liver recurrence in
the absence of widespread extrahepatic disease.
Interstitial Therapies for Liver Tumors 365
T. S. Ravikumar
A variety of tumor directed interstitial treatments based on
physical, chemical, and radiobiologic antineoplastic principles
have been investigated for the management of patients with un
resectable tumors confined to the liver. Cryosurgery, ethanol injec¬
tion, and laser photocoagulation are reviewed.
CONTENTS IX
Ablative Approach for Primary Liver Cancer:
Shanghai Experience 379
Xin Da Zhou, Zhao You Tang, and Ye Qin Yu
This article summarizes the results of 2018 patients receiving sur¬
gical treatment for pathologically proven primary liver cancer
(PLC). Special references are made to the role of cryosurgery and
cytoreduction for unresectable PLC.
Australian Experience of Cryoblation of Liver Tumors:
Metastases 391
David L. Morris and William B. Ross
The authors clinical experience of treating almost exclusively in¬
operable liver malignancy in 149 patients by cryotherapy is re¬
viewed. There was only one 30 day death; morbidity was modest.
Postoperative carcinoembryonic antigen (CEA) changes were ex¬
tremely predictive of outcome in patients with liver metastases
from colorectal cancer. For the group in which CEA levels returned
to the normal range, median survival exceeded 1000 days. In ad¬
dition, the authors reported encouraging results with cryotherapy
as an adjunct to resection.
Theoretic and Experimental Aspects of Regional Liver Infusion 399
David Allen August
Pharmacokinetic theory of hepatic arterial infusion chemotherapy
predicts that parameters, such as hepatic blood flow, hepatic drug
extraction, and extrahepatic drug clearance, may potentially be ma¬
nipulated to enhance the selectivity of hepatic artery drug admin¬
istration. In practice, diminution of hepatic blood flow through the
use of degradable starch microspheres or gelatin sponge emboli
zation has been accomplished and has improved drug selectivity.
Likewise, augmentation of hepatic drug extraction improves the
pharmacokinetic advantages of regional chemotherapy for liver tu¬
mors. Development of optimal hepatic infusion chemotherapy ap¬
proaches can be undertaken rationally and in an expeditious fash¬
ion by applying pharmacokinetic principles to create innovative
treatment regimens and by testing them in preclinical and phase I
investigations.
Regional Chemotherapy Approaches for Primary and
Metastatic Liver Tumors 411
Alan P. Venook and Robert S. Warren
There are pharmacologic principles that make regional chemother¬
apy to the liver a logical treatment strategy. Patients with colorectal
liver metastases and hepatocellular carcinoma would appear to be
the best candidates for such an approach. Although there are many
x CONTENTS
objective responses to such treatment, survival benefit has not been
demonstrated, but new regimens and refined techniques appear to
be improving results. Ultimately, regional delivery may be best
suited for innovative treatments such as biologicals and gene ther¬
apies.
Clinical and Preclinical Trials of Isolated Liver Perfusion
for Advanced Liver Tumors: Primary Liver Tumors 429
Andrew M. Lowy and Steven A. Curley
The authors evaluated a novel system to treat primary liver tumors
that combines hepatic arterial infusion of chemotherapy drugs with
complete hepatic venous isolation and extracorporeal chemofiltra
tion. All catheters used in this system can be placed percutane
ously, thus avoiding laparotomy to surgically isolate the liver. The
authors were involved in the early evaluation of the hepatic venous
isolation system to determine if higher doses of hepatic arterial
chemotherapy could be delivered safely while limiting systemic
drug exposure. Pharmacologic evaluation of this novel treatment
system from preclinical studies through a human phase I trial dem¬
onstrated the potential treatment advantages and problems asso¬
ciated with complete hepatic venous isolation and extracorporeal
chemofiltration.
Isolated Liver Perfusion for Liver Metastases:
Pharmacokinetic Advantage? 443
T. S. Ravikumar and Kim Dixon
The pharmacokinetic advantage of a novel system to noninvasively
isolate the hepatic venous outflow and infuse high doses of che¬
motherapy (doxorubicin or 5 FU) is discussed and compared with
intravenous infusion and intra arterial infusion without hepatic ve¬
nous detoxification. This dose intensification schema may provide
new pharmacokinetic and pharmacodynamic principles for the
treatment of a variety of tumors metastasizing the liver, including
melanoma, sarcoma, and adenocarcinoma.
Management of Pediatric Liver Tumors 451
Laura C. Bowman and Caroline A. Riely
Historically, children with liver tumors were uniformly considered
to have a poor prognosis and were approached warily by pediatric
surgeons and oncologists. Over the last decade, however, advances
in diagnostic imaging technology, discovery of effective chemo¬
therapy, and improved surgical techniques have greatly facilitated
the management of children with hepatic tumors. Although ortho
topic liver transplantation has emerged as a viable treatment
option in the management of hepatic malignancies, including he
patoblastoma and hepatocellular carcinoma, its use is still contro¬
versial.
CONTENTS X1
Gene Therapy for Liver Tumors 461
Yves Panis, Ali Reza Kienmanesh Rad, Olivier Boyer, Didier Houssin,
Jean Loup Salzmann, and David Klatzmann
Therapeutic gene transfer has progressed quite rapidly in recent
years. Noticeably, it has now reached the clinical stage in both
fields of inherited and acquired diseases. Numerous studies of
liver targeted gene therapy and cancer gene therapy have sup¬
ported the hope that such innovative approaches may be of help
in the treatment of primary or secondary liver tumors. In this ar¬
ticle, the main strategies of experimental, hepatic cancer gene ther¬
apy in the prospect of a clinical use are reviewed.
Overview and Future Prospects 475
James H. Foster
At present, resection affords highly selected patients with limited
liver cancer their only choice for cure. Palliation with currently
available agents and techniques often is not successful, but recent
advances promise a brighter future.
Index 483
Subscription Information Inside back cover
XU CONTENTS
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| spelling | Management options in primary and secondary liver cancer T. S. Ravikumar, guest ed. Philadelphia [u.a.] Saunders 1996 XIX S., S. 215 - 486 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Surgical oncology clinics of North America 5,2 Tumeurs du foie - Thérapeutique Liver Neoplasms therapy Leberkrebs (DE-588)4034943-3 gnd rswk-swf Chirurgie (DE-588)4009987-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Leberkrebs (DE-588)4034943-3 s Chirurgie (DE-588)4009987-8 s DE-604 Ravikumar, T. S. Sonstige oth Surgical oncology clinics of North America 5,2 (DE-604)BV007071205 5,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007211602&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Management options in primary and secondary liver cancer Surgical oncology clinics of North America Tumeurs du foie - Thérapeutique Liver Neoplasms therapy Leberkrebs (DE-588)4034943-3 gnd Chirurgie (DE-588)4009987-8 gnd |
| subject_GND | (DE-588)4034943-3 (DE-588)4009987-8 (DE-588)4143413-4 |
| title | Management options in primary and secondary liver cancer |
| title_auth | Management options in primary and secondary liver cancer |
| title_exact_search | Management options in primary and secondary liver cancer |
| title_full | Management options in primary and secondary liver cancer T. S. Ravikumar, guest ed. |
| title_fullStr | Management options in primary and secondary liver cancer T. S. Ravikumar, guest ed. |
| title_full_unstemmed | Management options in primary and secondary liver cancer T. S. Ravikumar, guest ed. |
| title_short | Management options in primary and secondary liver cancer |
| title_sort | management options in primary and secondary liver cancer |
| topic | Tumeurs du foie - Thérapeutique Liver Neoplasms therapy Leberkrebs (DE-588)4034943-3 gnd Chirurgie (DE-588)4009987-8 gnd |
| topic_facet | Tumeurs du foie - Thérapeutique Liver Neoplasms therapy Leberkrebs Chirurgie Aufsatzsammlung |
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