| 1. |
- Andersson, Roland, et al.
(författare)
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Implantation Metastases from Gastrointestinal Cancer after Percutaneous Puncture or Biliary Drainage
- 1996
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Ingår i: European Journal of Surgery. - 1102-4151. ; 162:7, s. 551-554
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Evaluation of incidence and outcome of implantation metastases after percutaneous fine-needle biopsy or biliary drainage. Design: Retrospective study. Setting: University hospital, Sweden. Subjects: Eight patients with implantation metastases from gastrointestinal cancers after percutaneous fine-needle biopsy (n = 7) or biliary drainage (n = 1). Main outcome measures: Incidence of implantation metastases, treatment and influence on outcome and survival. Results: In two out of three patients who had had otherwise radical operations, the implantation metastases meant that the operations were palliative rather than curative. Patients who had had palliative resections of the implantation metastases developed major local complications. One patient is alive with no signs of disease after 106 months, while one is alive with disease 30 months after the diagnosis of the implantation metastases. The remaining patients have died after 6 to 23 months. Conclusion: The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seems to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis.
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| 2. |
- Cwikiel, Wojciech, et al.
(författare)
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Disappearance of esophageal carcinoma after stenting combined with endoscopic laser therapy
- 1995
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Ingår i: Cardiovascular and Interventional Radiology. - 0174-1551. ; 18:4, s. 247-250
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Tidskriftsartikel (refereegranskat)abstract
- A 92-year-old man with dysphagia secondary to squamous cell carcinoma of the esophagus was palliated repeatedly with endoscopic laser therapy and insertion of esophageal stents. During the treatment period of 32 months, the patient could be fed perorally while ingrowth of tumor, development of new stenoses at the edges of the stents, and breakage of one stent were encountered. A tracheoesophageal fistula developed at the upper edge of the first stent. The patient died from aspiration pneumonia. At autopsy, no cancer cells were found in the esophagus. Combined endoscopic laser treatment and stent therapy may keep a patient free from dysphagia during a long period of time and also may result in the complete disappearance of tumor growth in the esophagus.
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| 3. |
- Lindell, Gert, et al.
(författare)
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Liver resection of noncolorectal secondaries
- 1998
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Ingår i: Journal of Surgical Oncology. - 0022-4790. ; 69:2, s. 66-70
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Tidskriftsartikel (refereegranskat)abstract
- Background and Objectives: Hepatic resection of noncolorectal metastases appears to be performed with increasing frequency. Reported experience is limited and indications are controversial. Methods: Retrospective review of curative hepatic resection in 32 patients (median age 58 years) during 1970- 1995. The primary tumor was a carcinoid in seven patients, other endocrine tumor in five patients, malignant melanoma in three patients, stomach cancer in three patients, exocrine pancreatic cancer in two patients, gynecological cancer in two patients, sarcoma in two patients, and miscellaneous in eight patients. Seven patients (22%) had bilobar disease and 12 patients (38%) had extrahepatic growth. Results: Median survival was 32 months, and 5-year actuarial survival rate was 36% (including operative mortality). Median survival in the endocrine (n = 12) and nonendocrine (n = 20) groups was 72 and 18 months, respectively (corresponding 5-year survival rates were 56 and 25%) (P = 0.16). Prognostic factors could not be established in either group. It is, however, noteworthy that no patient with nonendocrine secondaries and more than one liver tumor or extrahepatic disease survived for 5 years. Major complications were seen in eight patients (25%), including three postoperative deaths (operative mortality 9%) occurring during the first 5 years of the study period. Conclusions: Hepatic resection of metastases from endocrine primary tumors was followed by long-term survival in a substantial proportion of patients. Long-term survival for patients with nonendocrine tumors was observed only when there was a single liver tumor and no extrahepatic growth. Further experience is needed for definition of resection criteria.
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| 4. |
- Möller, Fáll Helgi, et al.
(författare)
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Angiogenesis inhibitor TNP-470 augments the effect of repeated arterial ischemia on growth but does not affect take in a rat liver tumor model
- 1997
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Ingår i: Anticancer research. - 0250-7005. ; 17:4 A, s. 2401-2406
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Tidskriftsartikel (refereegranskat)abstract
- Transient hepatic arterial occlusion causes necrosis in solid hepatic tumors in the rat, but regrowth of tumor cells and capillaries takes place from the tumor periphery. It was therefore considered of interest to combine this treatment with the angiogenesis inhibitor TNP-470 (therapeutic model). Wistar rats with a dimethylhydrazine-induced adenocarcinoma implanted into the liver received one of the following treatments: TNP-470 + transient hepatic ischemia, transient hepatic ischemia alone, TNP-470 alone or sham solution alone. Rats were sacrificed one week after the start of treatment. In addition, we investigated if TNP-470 decreases the risk of tumor take in the liver after intraportal injection of viable tumor cells (adjuvant study). Transient hepatic ischemia combined with TNP-470 gave a smaller increase in tumor volume than transient hepatic ischemia (p < 0.01), TNP-470 (p < 0.001) alone or no treatment (p < 0.001). Transient hepatic ischemia or TNP-470 caused a significant suppression of tumor growth when compared to controls (p < 0.01 in both cases). In the adjuvant study, TNP-470 caused retardation of tumor growth (p < 0.01 as compared to controls) but did not affect tumor number. It is concluded that TNP-470 suppressed tumor growth, both alone and in combination with transient hepatic ischemia, but did not affect take of tumor.
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| 5. |
- Möller, Páll H., et al.
(författare)
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Interstitial laser thermotherapy of adenocarcinoma transplanted into rat liver
- 1997
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Ingår i: European Journal of Surgery. - 1102-4151. ; 163:11, s. 861-870
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the effect of different temperatures and exposure times in interstitial laser thermotherapy. Design: Controlled laboratory study. Setting: University hospital, Sweden. Material: 48 male Wistar FU rats with dimethylhydrazine-induced adenocarcinoma transplanted into the liver. Intervention: Treatment was given with an Nd:YAG laser and a feedback system for temperature regulation. Light was delivered into the centre of the turnout and the feedback thermistor probe was placed 3 mm from the tumour margin. Rats were treated at steady-state temperatures at the feedback thermistor of 43, 46, or 50°C for 30 minutes, and at a steady-state temperature of 46°C at the feedback thermistor also for 10 and 20 minutes. Main outcome measurement: Tumour control as assessed 6 days after treatment using light microscopical examination including immunohistochemical determination of bromodeoxyuridine (BrdU) incorporation into DNA as a measure of cell viability. Results: Complete tumour necrosis was achieved in all rats treated for 30 minutes, in 6/8 rats treated for 10 minutes and in 6/8 rats treated for 20 minutes at 46°C. During steady-state thermotherapy, temperatures at the tumour margin were about 11°higher than at the feedback thermistor (range 54-61°C). The surrounding liver tissue also became necrotic so that the total necrosis volume exceeded the pretreatment tumour volume. Conclusion: Interstitial laser thermotherapy at temperatures ranging from 54-61°C at the tumour margin ensures total necrosis of a transplanted rat liver carcinoma provided that treatment is given for 30 minutes.
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| 6. |
- Ohlsson, Björn, et al.
(författare)
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Resection of colorectal liver metastases: 25-year experience
- 1998
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 22:3, s. 268-277
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this retrospective study was to analyze survival and prognostic factors in 111 consecutive patients undergoing curative resection of liver metastases from colorectal cancer. In addition, the time periods 1971-1984 and 1985-1995 were compared; criteria for first liver resection did not change with time, whereas the attitude toward re-resection was more aggressive during the latter period. Operative mortality was 6% during 1971-1984 and 0% during 1985-1995 (3.6% for all patients). The crude 5-year actuarial survivals were 19% and 35% for patients operated during 1971-1984 and 1985-1995, respectively (25% for the whole period). Relapse at any site was observed in 52 patients (81%) operated during the first period and in 29 patients (67%) operated during the second period; re-resection was performed in 12 (23%) and 15 (52%) of these patients, respectively. Five-year survival after hepatic re-resection was 29% (no operative mortality). In the univariate analysis, significant determinants for long-term survival were, in descending order, a clear resection margin, high degree of fibrosis around the tumor, absence of extrahepatic metastases (including metastases to the liver hilum), use of an ultrasound dissector, low preoperative serum carcinoembryonic antigen (CEA) level, year of resection (1985-1995), and low/moderate grade of liver tumor. There were no 5-year survivors when extrahepatic metastases were present, the liver tumor(s) had a low differentiation or satellites, or the resection margin was involved with tumor. In the multivariate analysis, the determinants were grade of liver tumor, absence of extrahepatic tumor, few intraoperative blood transfusions, low preoperative serum CEA level, and year of resection (1985-1995). It is concluded that: (1) an increased rate of hepatic re-resection was partly responsible for the improved outcome after liver resection for colorectal metastases during recent years; (2) patients with extrahepatic metastases did not benefit from liver resection; and (3) surgery should be performed with a clear resection margin and minimal blood loss.
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| 7. |
- Olsrud, Johan, et al.
(författare)
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MRI thermometry in phantoms by use of the proton resonance frequency shift method: application to interstitial laser thermotherapy
- 1998
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Ingår i: Physics in Medicine and Biology. - 1361-6560. ; 43:9, s. 2597-2613
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Tidskriftsartikel (refereegranskat)abstract
- In this work the temperature dependence of the proton resonance frequency was assessed in agarose gel with a high melting temperature (95 degrees C) and in porcine liver in vitro at temperatures relevant to thermotherapy (25-80 degrees C). Furthermore, an optically tissue-like agarose gel phantom was developed and evaluated for use in MRI. The phantom was used to visualize temperature distributions from a diffusing laser fibre by means of the proton resonance frequency shift method. An approximately linear relationship (0.0085 ppm degrees C(-1)) between proton resonance frequency shift and temperature change was found for agarose gel, whereas deviations from a linear relationship were observed for porcine liver. The optically tissue-like agarose gel allowed reliable MRI temperature monitoring, and the MR relaxation times (T1 and T2) and the optical properties were found to be independently alterable. Temperature distributions around a diffusing laser fibre, during irradiation and subsequent cooling, were assessed with high spatial resolution (voxel size = 4.3 mm3) and with random uncertainties ranging from 0.3 degrees C to 1.4 degrees C (1 SD) with a 40 s scan time.
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| 8. |
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| 9. |
- Parada, Luis Antonio, et al.
(författare)
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Clonal chromosomal abnormalities in congenital bile duct dilatation (Caroli's disease)
- 1999
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Ingår i: Gut. - : BMJ. - 1468-3288 .- 0017-5749. ; 45:5, s. 780-782
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Caroli's disease is a rare congenital disorder characterised by cystic dilatation of the intrahepatic bile ducts and an increased risk of cholangiocellular carcinoma. The cause is unknown, but occasional familial clustering suggests that some cases are inherited, in particular when occurring in association with polycystic kidney disease and germline PKD1 gene mutations. To date, no gene responsible for familial isolated Caroli's disease has been identified, and no genetic investigations of liver tissue from patients with Caroli's disease have been reported. PATIENT/METHOD: A liver biopsy specimen from a patient with isolated Caroli's disease, without any signs of cholangiocellular carcinoma, was short term cultured and cytogenetically investigated after G banding with Wright's stain. RESULT: Cytogenetic analysis disclosed the karyotype 45-47,XX,der(3)t(3;8)(p23;q13), +2mar[cp6]/46,XX[18]. CONCLUSIONS: The finding of an unbalanced translocation between chromosomes 3 and 8 suggests that loss of distal 3p and/or gain of 8q is of pathogenetic importance in Caroli's disease. Alternatively, structural rearrangements of genes located in 3p23 and 8q13 may be of the essence. These chromosomal breakpoints may also pinpoint the location of genes involved in inherited forms of Caroli's disease not associated with polycystic kidney disease.
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| 10. |
- Parada, Luis Antonio, et al.
(författare)
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Cytogenetic abnormalities and clonal evolution in an adult hepatoblastoma
- 1997
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Ingår i: American Journal of Surgical Pathology. - 1532-0979. ; 21:11, s. 6-1381
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Tidskriftsartikel (refereegranskat)abstract
- Hepatoblastomas usually occur in children < 3 years of age, and only occasional adult cases have been described. To date, 20 cytogenetically abnormal childhood hepatoblastomas have been reported. Karyotypic investigations have shown that most hepatoblastomas are diploid or hyperdiploid, often displaying trisomies for chromosomes 2 and 20. We have cytogenetically investigated an adult hepatoblastoma for which no previous karyotypic data exist. A hypertriploid stemline with multiple numerical and structural chromosomal aberrations, including +2 and +20, was found. In addition, the tumor displayed extensive clonal evolution with 11 subclones. Although the tumor thus displayed some chromosomal abnormalities commonly observed in childhood tumors, providing further support for the importance of these abnormalities in the development of hepatoblastoma, the level of genomic complexity seen in the present case has never been described in childhood hepatoblastomas and may suggest a different etiology or pathogenesis.
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