A novel chemotherapy for advanced hepatocellular carcinoma with tumor thrombosis of the main trunk of the portal vein

Ando, Eiji; Yamashita, F; Tanaka, Masatoshi; Tanikawa, Kyuichi

doi:10.1002/(sici)1097-0142(19970515)79:10<1890::aid-cncr8>3.0.co;2-k

Cited by 123 publications

(119 citation statements)

References 32 publications

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“…23 Moreover, HCC has been shown to have some sensitivity to 5-FU. 24 Within our study, the vast majority of patients did not receive adjuvant therapy because of the exclusion criteria. Consequently, only 4 of 24 patients received therapy with 5-FU and LEV.…”

Section: Discussionmentioning

confidence: 99%

Preoperative hepatic artery chemoembolization followed by orthotopic liver transplantation for hepatocellular carcinoma

et al. 1999

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In our experience, the primary obstacle precluding the widespread use of orthotopic liver transplantation (OLT) for definitive therapy of hepatocellular carcinoma (HCC), even for early-stage disease, is preventing tumor recurrence. Chemoembolization is an attractive strategy to minimize tumor progression before OLT because of its shown antitumor effect, ability to be repeated, and minimal systemic toxicity. Thus, this pilot study was undertaken to determine the tolerability and treatment outcomes of pretransplantation chemoembolization of HCC followed by OLT. Between 1992 and 1997, 27 patients with HCC who had cirrhosis, no extrahepatic metastasis, less than three tumor nodules of less than 5 cm each, and no evidence of vascular invasion on preoperative imaging studies were enrolled onto the protocol. Chemoembolization was performed using Ivalon particles with mitomycin, doxorubicin, and cisplatin. Twenty-four patients completed the protocol with chemoembolization and a liver transplant. The mean United Network of Organ Sharing waiting time was 167 days. Chemoembolization was well tolerated. On examination of the explanted liver, the majority of patients had a single lesion, mean tumor size was 3.66 cm (range, 1.5 to 6 cm), and the majority of patients had stage II disease. None of the transplant recipients has developed recurrent HCC (mean follow-up, 29.2 months; range, 9 to 55 months). The 1-and 2-year disease-free survival rates are 91% and 84%, respectively. In conclusion, chemoembolization followed by OLT is well tolerated and associated with excellent outcomes in selected patients with HCC. Copyright 1999 by the American Association for the Study of Liver DiseasesH epatocellular carcinoma (HCC) is one of the most common malignant tumors occurring in men worldwide, with an estimated annual incidence of 1 million cases. In the United States, HCC ranks as the 22nd most common form of cancer, with an annual incidence of approximately 2:100,000. 1 HCC is associated with chronic hepatitis B carrier state, chronic hepatitis C, cirrhosis from a wide variety of causes, iron-overload states, and exposure to aflatoxins. In one study, the natural history of 102 patients with cirrhosis with HCC who were not treated within prospective randomized trials was investigated. 2 After a median follow-up of 17 months, the 1-, 2-, and 3-year survival rates were 54%, 40%, and 28%, respectively. The adverse natural history attests to the need for establishing effective therapies for this aggressive malignancy.A variety of therapeutic modalities have been tried in the treatment of advanced HCC, including systemic chemotherapy, hepatic artery infusion of chemotherapeutic agents, hepatic artery embolization, hormonal therapy, and radiation therapy, all without long-term success. [3][4][5][6][7][8] Although surgical resection of HCC is considered the treatment of choice whenever technically feasible, long-term results after resection of even small tumors in patients with cirrhosis are disappointing; the 5-year recurrence rate is 52% a...

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Section: Discussionmentioning

confidence: 99%

Preoperative hepatic artery chemoembolization followed by orthotopic liver transplantation for hepatocellular carcinoma

et al. 1999

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“…Excess alcohol intake was defined as >75 g of ethanol per day, using data obtained by questionnaire. Body mass index (BMI) was calculated by dividing body weight (kg) by the square of the height (m (21). Regimen B consisted of cisplatin (50 mg/ body), mitomycin C (MMC, 10 mg/body) and epirubicin (EPI, 30 mg/body) as a bolus injection on day 1, and daily cisplatin (5 mg/m 2 ) followed by 5-FU (250 mg/body) on days 8-12 and 15-19.…”

Section: Patientsmentioning

confidence: 99%

Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

Hiramine

Uto

Imamura

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. Sorafenib is a kinase-targeted drug that has high efficacy for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sorafenib is more effective than hepatic arterial infusion chemotherapy (HAIC) for HCC. Twenty patients treated with sorafenib (sorafenib group) initiated at 800 mg/day and 45 patients treated with HAIC (HAIC group) for unresectable Child-Pugh A advanced HCC were investigated retrospectively. The treatment effect was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST). As a result, the overall response rate was significantly lower in the sorafenib group than in the HAIC group (P=0.03), while the disease control and survival rates did not differ between the two groups. In the sorafenib group, treatment was discontinued in 19 patients, including 12 due to side effects. In subgroups of patients treated with sorafenib, the survival rate was significantly lower in patients (n=11) administered sorafenib for <60 days compared to those (n=9) treated for ≥60 days. A shorter treatment period (<60 days) was an independent risk factor for unfavorable survival [hazard ratio (HR), 3.34; 95% confidence interval (CI), 1.45-7.66 vs. HAIC], while survival in patients treated with sorafenib for ≥60 days did not differ from those treated with HAIC (HR, 0.79; 95% CI, 0.27-2.34). In conclusion, the disease control and survival rates of patients treated with sorafenib for advanced HCC were comparable to such rates in patients treated with HAIC.However, the prognosis was poor when long-term sorafenib treatment was not possible due to side effects, demonstrating the importance of patient selection for sorafenib treatment.

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“…However, such treatment results in a low response rate (13% and 22%). Several groups have used low-dose cisplatin and 5-FU for advanced HCC with PVTT, and have reported favorable results [11][12][13] . Several recent studies have reported the survival benefits of combination therapy of intra-arterial 5-FU and subcutaneous interferon alpha (IFN-α) therapy for advanced HCC with PVTT [14][15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Systemic gemcitabine combined with intra-arterial low-dose cisplatin and 5-fluorouracil for advanced hepatocellular carcinoma: Seven cases

Uka

Aikata²,

Takaki³

et al. 2008

WJG

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The combination of intra-arterial low-dose cisplatin and 5-fluorouracil (5-FU) is effective against advanced hepatocellular carcinoma (HCC). Systemic gemcitabine chemotherapy seems effective in many cancers. We report the results of combination therapy with systemic gemcitabine, intra-arterial low-dose cisplatin and 5-FU (GEMFP). Seven patients with non-resectable advanced HCC were treated with GEMFP.

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A novel chemotherapy for advanced hepatocellular carcinoma with tumor thrombosis of the main trunk of the portal vein

Cited by 123 publications

References 32 publications

Preoperative hepatic artery chemoembolization followed by orthotopic liver transplantation for hepatocellular carcinoma

Preoperative hepatic artery chemoembolization followed by orthotopic liver transplantation for hepatocellular carcinoma

Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

Systemic gemcitabine combined with intra-arterial low-dose cisplatin and 5-fluorouracil for advanced hepatocellular carcinoma: Seven cases

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