Debulking surgery and arterial embolization for unresectable liver cancer.

Hepatocellular carcinomas measuring less than 5 cm in diameter became completely necrotic after arterial chemoembolization with Lipiodol, doxorubicin, and gelfoam more often than larger lesions. In 60 patients, we surgically debulked large unresectable tumors, with the aim of subsequently embolizing residual small tumors transarterially. Forty-seven patients were actually embolized.

Juxtacaval liver resections with the use of an internal IVC shunt tube.

Almost one tenth of more than 370 hepatectomies, mostly for tumors, involved resection of major parts of the caudate lobe, subsegment 1. Five of them were for tumors or hemangiomas here, compressing or invading the vena cava; two were for metastases of colorectal cancer located very close to the junctions of the right and middle hepatic veins with the vena cava. We would previously have deemed these tumors unresectable.

[A randomized controlled study of PSK combined immuno-chemotherapy for adenocarcinoma of the lung. The Advanced Lung Cancer Immuno-chemotherapy Study Group].

In a randomized controlled study of chemotherapy (CDDP 100 mg/m2 day 1, VDS 3 mg/m2 day 1, 8, 15) vs. immuno-chemotherapy combined with PSK 3 g/day for adenocarcinoma of the lung (stage III, IV, p. s.

Endoscopic laser coagulation through an optical laser balloon.

An endoscope was equipped with a saline-filled latex rubber balloon at its tip to displace contaminating blood, bile, or gastric contents during operative portoscopy, biliary endoscopy, or upper gastrointestinal endoscopy. A fiber with its tip inside the balloon transmitted energy from an Nd:YAG laser for coagulation of tumors in one bile duct cancer, in six portal vein growths from primary liver cancers, and in a superficially growing stomach cancer. The balloon increased the precision of irradiation by making lesions easier to identify through displacement of bile or blood and by keeping the fiber tip at a fixed position relative to the lesion.

Repair of the diaphragm with an external oblique muscle flap.

The technique for repair of large defects in the diaphragm by the use of an ipsilateral or contralateral flap from the external oblique abdominal muscle was successfully used during five hepatic resections and has been described herein.

[Effect of morphine in cancer pain].

The usefulness of oral morphine to alleviate pain has been tested in 70 patients with cancer. The efficacy was found to be 87% (61/70). The starting dose was 10 mg/d-12 mg/d (mean 36 mg/d), and the maximum dose was 10 mg/d-3,600 mg/d.

Multimodal treatment of hepatocellular carcinoma.

Our multimodal treatment of hepatocellular carcinoma (HCC) has brought about a significant improvement of the survival rate. It consists of a combination of hepatectomy and transcatheter arterial embolization using lipiodol (L-TAE). In order to facilitate L-TAE, we have developed a special catheter with notches.

[Advantages and disadvantages of L-TAE in diagnosis and treatment of hepatocellular carcinoma].

Transcatheter arterial embolization using lipiodol ultra-fluid (L-TAE) is frequently used for hepatocellular carcinoma (HCC). Its advantages are: (1) Excellent therapeutic and diagnostic ability in our pathological study of 153 resected tumors. (2) Preoperatively, we can localize HCC and prevent spreading of cancer cells by manipulation at hepatectomy.

Combined peripheral and central chemoembolization of liver tumors. Experience with lipiodol-doxorubicin and gelatin sponge (L-TAE).

Patients with primary and a few with secondary liver tumors were embolized through the hepatic artery. Lipiodol and doxorubicin occluded peripherally, which was immediately followed by central embolization with gelatin sponge cubes. Preoperative embolizations were made for diagnostic and possible surgical adjuvant purposes.