Unfavorable cancers of unknown primaries: presentation and prognostic factors. A population-based 8-year experience.

Cancer of unknown primary is a mostly disseminated malignancy where detailed investigations cannot reveal a probable origin. A few subsets may respond to specific therapy, but the large majority of cases have a median survival of 3-4 months in the few population-based reports, which, however, did not use current investigations and therapy. It is not known if survival can be prolonged by chemotherapy or if supportive care is preferable, especially in the most unfavorable cases in whom chemotherapy may impair the quality of life without prolonging it.

Gene expression profiling guiding diagnosis and therapy of rare mammary-like anogenital gland carcinomas.

Cancers derived from anogenital mammary-like glands are rare, and their identification and selection of treatment for dissemination may be difficult. We encountered two such tumors, which both presented as occult primaries with nodal and hematogenous metastases. They were studied by immunohistochemistry, HER2 receptor assay, and gene expression profiling.

Undetectable late hepatic sequelae after hypofractionated stereotactic radiotherapy for liver tumors.

Hypofractionated liver stereotactic radiotherapy has produced long-term survival, but the hepatobiliary system is radiosensitive and may be severely damaged by the treatment. We have evaluated long-term radiation effects on hepatobiliary functions in the first long-term survivors reported after radiotherapy to the hepatobiliary system for liver tumors. Eleven patients were followed for up to 13 years after treatment of tumors≤9 cm in size.

Surgical displacement of risk organs to improve stereotactic radiotherapy for liver tumors.

Background And Objectives: Precision irradiation may cure some liver malignancies, but adjacent stomach and colon may interfere with the delivery of the desired high doses due to the risk for serious side effects.

Methods And Results: Preferably laparoscopic distancing of the risk organs included their mobilization, omental interposition between them and the target, and gastropexy to the lateral abdominal wall. This enabled us to more than double the radiation doses that were permitted by native anatomy.

Curative stereotactic body radiotherapy for liver malignancy.

Nine patients with 11 primary or secondary liver non-neuroendocrine malignancies with mean and maximum diameters of 4.0 and 7.7 cm became long-term survivors after precision irradiation in a stereotactic body frame.

Liver embolizations in oncology: a review. Part I. Arterial (chemo)embolizations.

Arterial embolization of the liver often temporarily retards the growth of liver tumors which are mainly nourished arterially. The use of degradable agents avoids collateral formation which would prohibit repeat procedures and permit tumor regrowth. The effect of embolizations is largest in small hypervascular lesions, e.

Liver embolizations in oncology. A review. Part II. Arterial radioembolizations, portal venous embolizations, experimental arterial embolization procedures.

Arterial embolization of the liver may temporarily retard the growth of its primary and secondary tumors which are both mainly nourished arterially. Addition of radioisotopes, mostly (131)I or (90)Y, results in radioembolizations which predominantly act by radiation and less by ischemia. They may therefore be utilized in the absence of portal venous flow when conventional embolization is hazardous.

Molecular and virological studies on a rare case of biliary papillomatosis.

In a recurrence of a rare case of biliary papillomatosis, a disease that often becomes malignant, the presence of human papillomavirus (HPV), Cytomegalovirus (CMV) and Epstein-Barr virus (EBV), as well as DNA ploidy and markers of proliferation and invasion, were examined. No such viruses were identified by polymerase chain reactions. Moreover, markers of invasion, such as laminin, and of proliferation, MIB1 and cyclin A, were absent or at normal levels despite progressive superficial growth of the tumour.

Radiosurgery for recurring liver metastases after hepatectomy.

Background/aims: Most resected liver metastases from colorectal cancer recur. A minority of liver recurrences have been re-resected, but most re-resections fail and they decrease the postoperative performance status for a longer time than the initial resections, so that less demanding potentially curative treatments need evaluation.

Methodology: Four out of 5 liver-only recurrences after 18 consecutive liver resections were limited and suitable for radiosurgery.