ABSTRACT
A pilot study, to assess the therapeutic potential of percutaneous injection of wild-type p53 (wt-p53) in five patients with primary hepatocellular carcinoma is reported. Three of the five patients showed objective tumor response with reduction of the tumor volume on computed tomographic (CT) scan measurements as well as a significant fall of serum alphafetoprotein. Much further work will be needed to elucidate the mechanism of action.
Subject(s)
Carcinoma, Hepatocellular/therapy , Liver Neoplasms/therapy , Plasmids/therapeutic use , Tumor Suppressor Protein p53/therapeutic use , Adult , Aged , Aged, 80 and over , Animals , Base Sequence , Carcinoma, Hepatocellular/diagnostic imaging , Fever/etiology , Follow-Up Studies , Humans , Injections, Intralesional , Liver Neoplasms/diagnostic imaging , Liver Neoplasms, Experimental/chemistry , Liver Neoplasms, Experimental/therapy , Male , Mice , Mice, Inbred BALB C , Mice, Nude , Middle Aged , Molecular Sequence Data , Pilot Projects , Plasmids/adverse effects , Plasmids/analysis , Tomography, X-Ray Computed , Tumor Suppressor Protein p53/adverse effects , Tumor Suppressor Protein p53/analysisABSTRACT
Bleeding from the suprahepatic inferior vena cava (IVC) was encountered in a patient undergoing repeat liver resection for the fourth time due to a recurrence of colorectal liver metastases. Bleeding was observed from an IVC tear above the liver and it was not possible to control it with traditional clamping procedures including total vascular exclusion (a suprahepatic clamp). Hypothermia, cardioplegia, and circulatory arrest were all required to control the bleeding. The inferior vena cava was reconstructed with a pericardial patch. The patient recovered well and was discharged on the 14th postoperative day.
Subject(s)
Heart Arrest, Induced , Hemostasis, Surgical/methods , Hypothermia, Induced , Liver Neoplasms/surgery , Vena Cava, Inferior/surgery , Colorectal Neoplasms/pathology , Female , Hepatectomy , Humans , Liver Neoplasms/secondary , Middle Aged , ReoperationABSTRACT
Molecular genetic changes are better characterized in colorectal carcinoma than in other common adult tumours. Consistent allele losses, or loss of heterozygosity (LOH), on chromosomes 5q, 17p and 18q have been well established. These changes are associated with the prognosis of the disease. Little is known of such changes in liver metastases of colorectal origin. The extent of allelic loss and its association with clinical features were investigated in 19 patients with colorectal liver metastases by using 24 probes to detect restriction fragment length polymorphism. A high frequency of LOH on chromosomes 5q, 17p and 18q was found in these secondary tumours. No consistent loss has so far been shown in any other chromosome. The frequency of allele loss correlated significantly with prognostic features such as the number and size of liver secondaries (P < 0.005), metastasis to the lymph nodes (P < 0.01) and curative or palliative operation (P < 0.02).