ABSTRACT
A 66-year-old male who underwent radical resection for esophageal cancer (stage IV) was diagnosed with multiple hepatic metastasis 1 year and 3 months after the surgery. He underwent hepatic resection and received systemic chemotherapy (FAP: 5-FU, ADR, CDDP), as the post-operative adjuvant therapy. One year and 3 months later, there was a huge recurrence in the residual liver and hepatic arterial infusion chemotherapy (FAP) was performed. The recurrent lesion disappeared completely after 3 sessions of arterial infusion chemotherapy. The arterial infusion chemotherapy was continued in the outpatient clinic and the recurrent lesion is well controlled. At present, this patient has returned to social life, 2 years and 3 months after the hepatic resection. The utility of hepatic arterial infusion chemotherapy and hepatectomy for postoperative multiple hepatic metastasis from esophageal cancer was shown in the present case.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/secondary , Carcinoma, Squamous Cell/therapy , Esophageal Neoplasms/pathology , Hepatectomy , Liver Neoplasms/secondary , Liver Neoplasms/therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Cisplatin/administration & dosage , Combined Modality Therapy , Doxorubicin/administration & dosage , Drug Administration Schedule , Esophageal Neoplasms/surgery , Fluorouracil/administration & dosage , Hepatic Artery , Humans , Infusions, Intra-Arterial , Lymphatic Metastasis , MaleABSTRACT
Surgical resection, transcatheter arterial embolization (TAE) and percutaneous ethanol injection therapy (PEIT) are effective for hepatocellular carcinoma (HCC), but the recurrence rate is high. We have devised a new therapy of transarterial immuno-embolization (TIE) with OK-432, fibrinogen and thrombin, and 2 cases are reported. Case 1: A 78-year-old Japanese male with HCC (diameter, 4 cm in subsegment 5) received TIE. The tumor size was markedly decreased, and the patient survived for more than 3 years without recurrence. Case 2: A 61-year-old Japanese male with HCC (diameter, 4.5 cm in segment 5) received hepatic subsegmentectomy following TIE. Histological examination of resected specimens following TIE showed massive infiltration of mononuclear cells in the main tumor. Tumor recurrence had developed three times thereafter, but was effectively treated by TIE. TIE may be an effective therapy for HCC.
Subject(s)
Carcinoma, Hepatocellular/therapy , Embolization, Therapeutic , Immunotherapy , Liver Neoplasms/therapy , Picibanil/administration & dosage , Aged , Fibrinogen/administration & dosage , Hepatic Artery , Humans , Iodized Oil/administration & dosage , Male , Middle Aged , Thrombin/administration & dosageABSTRACT
The efficacy of transarterial immuno-embolization therapy (TIE) was examined in six operable patients with hepatocellular carcinoma (HCC). We administered OK-432, fibrinogen (30 mg/ml) and thrombin (1 U/ml) through a catheter which was inserted into the tumor-feeding artery. In all patients with a high level of tumor markers (AFP and PIVKA-II), the level decreased promptly to less than the pretreatment level after TIE therapy. The therapy has not caused any serious side effects. No disturbance of the coagulation-fibrinolysis system due to TIE was observed in any patient. Histological examination of resected specimens following TIE showed massive infiltration of mononuclear cells around tumor cell nests, and lytic necrosis as well as coagulation necrosis of the main tumor and the intrahepatic metastases. Our results indicate that TIE may be an effective and promising modality for HCC patients.
Subject(s)
Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic , Fibrinogen/administration & dosage , Liver Neoplasms/therapy , Picibanil/administration & dosage , Aged , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/surgery , Combined Modality Therapy , Female , Humans , Iodized Oil/administration & dosage , Liver Neoplasms/pathology , Liver Neoplasms/surgery , Male , Middle Aged , Thrombin/administration & dosageABSTRACT
The efficacy of transarterial immuno-embolization therapy (TIE) was investigated in 7 patients with multiple hepatocellular carcinoma (HCC). We administered OK-432 (10 KE), fibrinogen (30 mg/ml) and thrombin (1 U/ml) as a new treatment for HCC with intrahepatic metastasis. In all patients with a high level of AFP, the AFP level decreased promptly less than the pretreatment level after TIE therapy. High fever in all cases, epigastralgia in 6 cases and appetite loss in 3 cases were observed after TIE therapy. Our results indicate that this therapy may be a safe and effective method in HCC patients with intrahepatic metastasis.
Subject(s)
Carcinoma, Hepatocellular/therapy , Embolization, Therapeutic , Fibrinogen/administration & dosage , Immunotherapy , Liver Neoplasms/therapy , Picibanil/administration & dosage , Administration, Oral , Aged , Carcinoma, Hepatocellular/secondary , Fluorouracil/administration & dosage , Hepatic Artery , Humans , Iodized Oil/administration & dosage , Liver Neoplasms/secondary , Male , Middle Aged , Thrombin/administration & dosageABSTRACT
A multidisciplinary treatment for hepatocellular carcinoma including preoperative chemo-embolization with resection treatment was introduced. Recent attempts at combining lipiodol with chemo-embolization have been quite promising. An ideal multidisciplinary treatment should include an effective device using the transportal approach.