Practical considerations in the treatment of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) represents one of the most common neoplasms worldwide. To date, curative treatment options include liver transplantation or resection. Unfortunately, most patients are detected with nonresectable or -transplantable HCC due to disease extension or comorbid factors, and are therefore candidates only for palliative treatments.

Elective surgery for gastrointestinal tumours in the elderly.

The geriatric population is expanding and clinical decision-making is often complicated by the effects of ageing. Age should not be the only parameter considered when addressing medical problems. Elderly subjects have been denied surgery because of their presumed higher mortality and morbidity.

Elective surgery for colorectal cancer in the aged: a clinical-economical evaluation.

A series of 56 consecutive patients, referred for surgery to a specialized institute, had elective laparotomies with various surgical procedures aimed at curing locoregional colorectal cancer. Data defining patient and tumour-related preoperative, operative and postoperative variables, including costs, were collected. The study group was divided into two age groups (< 65 vs > or = 65 years), which were similar in terms of patient- and tumour-related variables.

Personalized surgery for rectal tumours: the patient's opinion counts.

In recent times there have been many important changes in the surgical management of rectal cancer. The general thrust of these changes has been towards a less invasive approach with preservation of intestinal continuity and avoidance of the psychological sequelae of a stoma. It is also becoming increasingly apparent that profound sexual and autonomic dysfunction can be associated with abdominoperineal resection.

Follow-up in colorectal cancer patients: a cost-benefit analysis.

Background: No conclusive evidence exists concerning the effectiveness of follow-up programs after curative surgery for colorectal cancer, and presently cost-benefit analyses have not indicated that follow-up strategies increase survival or quality of life.

Methods: Five hundred five patients who survived curative surgery for stage I-III colorectal adenocarcinoma were closely followed for at least 4 years.

Results: One hundred forty-one (28%) patients had recurrence.

Clinical relevance of serological markers in the detection and follow-up of pancreatic adenocarcinoma.

Pancreatic adenocarcinoma is a relatively common malignancy and its incidence is increasing. Prognosis in these patients is poor, and surgery, the only effective treatment, saves only a minority of patients. The number in this small group of patients might be increased by early detection of pancreatic tumours.

Total rectal resection and colo-anal anastomosis with colonic reservoir for low rectal cancer.

From March 1990 to December 1992, 47 patients with primary or recurrent low rectal cancer underwent total rectal resection and a coloendoanal anastomosis. Rectal resection was extended downward to the ano-rectal junction. The restorative technique included a colo-endoanal anastomosis between the dentate line and a J-shaped colic reservoir.

Prevalence of sexual dysfunction in male cancer patients treated with rectal excision and coloanal anastomosis.

Impotency due to parasympathetic nerve injury is one of the most feared consequences of rectal cancer surgery. Sexual relationships make a significant contribution to the quality of life for almost everybody. Rectal excision and coloanal anastomosis (CAA) is a new surgical procedure for low rectal tumor with little data regarding the prevalence of sexual impairment as yet.

Total rectal resection and colo-anal anastomosis for low rectal tumours: comparative results in a group of young and old patients.

Rectal cancer incidence is increasing among the elderly who are more often considered for palliation rather than for surgical cure. Moreover, sphincter-sparing surgery is often avoided when treating the elderly. We report our experience on a consecutive series of 38 subjects, suffering from a lower third rectal tumour with a median distance of 5.

A phase II study of mitoxantrone combined with beta-interferon in unresectable hepatocellular carcinoma.

Background: Chemoimmunotherapy is being evaluated in the most common gastrointestinal tumors, but little data are available on hepatocellular carcinoma (HCC). Considering the encouraging objective response rates and the absence of important side effects obtained with mitoxantrone in HCC, we tested the activity and feasibility of a schedule combining beta-interferon (beta-IFN) and mitoxantrone.

Methods: Forty patients (ECOG Performance Status 0-1) with unresectable HCC received mitoxantrone (12 mg/m2 intravenously every 3 weeks) plus beta-IFN (3 x 10(6) U on days 1, 2, and 3; 6 x 10(6) from day 4 to day 60; and then 6 x 10(6) U three times a week for 10 months).

Role of surgery in patients with primary non-Hodgkin's lymphoma of the stomach: an old problem revisited.

The literature after 1980 dealing with the treatment of primary gastric non-Hodgkin's lymphoma (stages I and II) is reviewed. Gastrectomy is recommended for patients with acute symptoms at presentation or with complications of chemotherapy or radiotherapy. In elective cases, patients with stage I disease may be candidates for gastrectomy as a single therapy, provided that tumour-free resection margins are achieved.

Phase II trial of mitomycin C (MMC) in advanced gallbladder and biliary tree carcinoma. An EORTC Gastrointestinal Tract Cancer Cooperative Group Study.

Background: Based on a recent pharmacokinetic study suggesting that high biliary levels of mitomycin C (MMC) may be achieved as a result of an entero-hepatic recycling mechanism, we conducted a Phase II EORTC trial which involved MMC administration to patients with non-resectable biliary tract carcinoma.

Patients And Methods: Of the 34 patients entered in the study, 30 were eligible (11m + 19f, median age 58 yrs). I.

The outcome of cholangitis after percutaneous biliary drainage in neoplastic jaundice.

The purpose of this paper is to evaluate factors affecting the outcome of cholangitis after PTBD in jaundiced cancer patients. Twenty nine patients with neoplastic jaundice (male/female ratio 13/16, median age 55 years) with full clinical data, were treated by PTBD and developed cholangitis at a median of 9 days later. Four patients (14%) died of biliary sepsis a median of one month after PTBD while the other 25 survived a median of 6 months, with one week median duration of cholangitis.

Importance of orthotopic implantation for human tumors as model systems: relevance to metastasis and invasion.

Transplantation of human tumors into immunodeficient athymic nude mice has become an important experimental approach to study the biology and the treatment of human cancer. Most human tumor xenograft experiments have employed subcutaneous injection procedures, but the main limit of this technique is the lack of metastasis from the subcutaneous site. The possibility of producing experimental metastasis by intravenous injection of cells in the animals has been known for a long time, and it has been recently reported that tumorigenic properties and metastatic ability of human cancer can be altered by transplantation of the tumor into its organ or tissue of origin in the recipient animals (orthotopic transplantation).

[An epidemiological study of the health conditions of Milan traffic police with respect to pollution from vehicular traffic].

An investigation on the health effects of occupational exposure to motor vehicle exhaust and environmental pollutants was carried out on traffic wardens in Milan (Italy). Randomized samples of 292 traffic wardens (exposed group) and 60 hospital staff members (control group) underwent a physical examination and laboratory tests. No significant difference was observed between the exposed and control groups as regards general morbidity, apart from musculo-skeletal disorders in females.

Primary mucoepidermoid carcinoma of the liver. A case report.

The authors report a case of primary mucoepidermoid carcinoma of the liver in a 66-year-old woman. Electron microscopy findings suggest an origin from the biliary epithelium as well as cholangiocarcinoma, which clinical and prognostic features are similar to those of mucoepidermoid carcinoma.

[Health surveillance of the exposed to anesthetics in the environment: a complete program of preventive medicine for health personnel].

Hospital workers often can be simultaneously exposed to several potentially hazardous (biological, chemical, and physical) agents. Consequently the environmental controls and the periodic health assessments must be overall and systematic, but not too frequent. The authors suggest the establishment of an interdisciplinary group, including: Hospital Management, Technical Staff, Occupational Physician, Occupational Health Nurses, Environmental Hygienists.

Mitomycin C and lipiodol do not improve the effect of intermittent hepatic artery occlusion on liver tumour growth. An experimental study in the rat.

The effect of Mitomycin C (MMC 2.0 mg/kg bw), lipiodol (0.2 ml/kg bw) and intermittent hepatic artery occlusion on liver tumour growth, as well as their possible interrelation, were studied in 29 rats.

Differential efficacy of flavone acetic against liver versus lung metastases in a human tumour xenograft.

A human ovarian carcinoma, IGROV-1, was xenografted into different sites (i.p., s.

Inflammatory pseudotumor of the liver: report of two cases.

Inflammatory pseudotumor of the liver is a very rare lesion. Herein we describe two cases of this entity which occurred in two women aged 22 and 49 years, respectively. Both cases were considered to be clinically malignant and only the histopathologic examination revealed the non-neoplastic nature of the disease.

Hepatic arterial embolization with microencapsulated mitomycin C for unresectable hepatocellular carcinoma in cirrhosis.

From 1986 to 1988, 35 patients with a hepatoma judged either inoperable or unresectable because of coexistent cirrhosis were treated with hepatic arterial embolization of mitomycin C microcapsules. Five of these 35 patients (14.5%) could not be treated because of inability to selectively cannulate the hepatic artery and were therefore excluded from the evaluation (feasibility rate, 86%).

[Preoperative hepatic vascular evaluation: comparison of angiography and Doppler-echography].

Fourteen patients candidates to surgery for liver neoplasms (7 primitive cancers and 7 liver metastases) underwent a prospective double-blind study with digital angiography and Doppler US. The latter demonstrated the presence of the hepatomesenteric artery in all the 3 patients with this anatomical variant. In 2 cases with an early origin of the common hepatic artery, Doppler US allowed the detection of unusual signals from the left hepatic artery but could not exclude its origin from the left gastric artery.

A clinicopathologic study of primary hepatic carcinoid tumors.

Six cases of primary hepatic carcinoid tumors were studied with combined immunocytochemical and electron microscopic techniques. Positive tumor immunostaining with PHE5, LK2H10, neuron-specific enolase (NSE), serotonin, gastrin, and insulin antibodies was observed. At the ultrastructural level, cytoplasmic dense granules were seen in all the cases tested.