[Clinical significance of hepatic and splenic volumes measured by computed tomography in patients with alcoholic liver cirrhosis].

Hepatic and splenic volumes were measured by computed tomography in 43 patients with alcoholic liver cirrhosis (AL-LC), 10 patients with HBs antigen-positive liver cirrhosis (B-LC), 6 patients with HCV associated liver cirrhosis (C-LC) and 6 healthy subjects. Hepatic volume was significantly larger in the patients with AL-LC than in those with B-LC, those with C-LC or healthy subjects. Hepatic volume in patients with AL-LC was also significantly larger in the anti-HBc antibody (anti-HBc)-negative patients than in the anti-HBc-positive patients. This data suggests HBV occult infection may decrease hepatic volume. Hepatic volume showed significantly positive correlations with serum levels of total bilirubin (T. bil), gamma-GTP, type IV collagen levels, continuing alcohol intake and Child-Pugh score, and also showed significant negative correlation with cumulative alcohol intake and prothrombin time (PT). Splenic volume showed significantly positive correlations with serum levels of T. bil and Child-Pugh score, and also showed significantly negative correlations with serum albumin, PT, platelet count and BCAA (branched chain amino acids)/tyrosine ratio. Stepwise logistic regression analysis showed that enlarged hepatic volume, presence of hepatocellular carcinoma and elevated serum gamma-GTP were independently significant risk factors for the development of hepatic failure. Serial determination of hepatic and splenic volume may be useful for the estimation of liver function and prognosis in the patients with AL-LC.

Complete regression of esophageal cancer with concomitant liver metastasis achieved by concurrent chemoradiation therapy.

We report a patient with esophageal cancer with concomitant liver metastasis in whom complete response was achieved by chemoradiation therapy. A 66-year-old man was diagnosed as having stage IVB esophageal cancer with synchronous metastasis in the liver and cardiac lymph node, and concurrent chemoradiation therapy was started. The chemotherapy, consisting of 5-fluorouracil (300 mg/body per day, continuous infusion) and low-dose cisplatin (5 mg/body per day on 1-5 days every week), was performed for 7 weeks. In addition, radiation therapy (2 Gy/day on 1-5 days every week) was employed for both the local and the metastatic lesions, along with the chemotherapy. Throughout the course of this therapy, the patient did not experience severe toxicity, and this chemoradiation therapy resulted in complete regression of both the local and the metastatic diseases. Subsequently, he was followed-up as an outpatient without any maintenance therapy, and he has been free of disease for 38 months after completion of the therapy. This concurrent chemoradiation therapy may be effective for esophageal cancer even with visceral metastasis.