Cancer Treatment Today

The detection rate of hepatocellular carcinoma in FDG (fluorodeoxy glucose)-PET is 50 to 70%, and it is inferior to that in ultrasonic testing and computed tomograph. Since dephosphorization enzymatic activity is high in hepatocellular carcinoma, especially of highly-differentiated type, the FDG is pumped out of the cells. Studies seem to peg sensitivity of FDG PET for detection of HCC at the unacceptable 50%, though it is higher for less differentiated

Ono T; Yamanoi A; Nazmy El Assal O; Kohno H; Nagasue N Adjuvant chemotherapy after resection of hepatocellular carcinoma causes deterioration of long-term prognosis in cirrhotic patients: metaanalysis of three randomized controlled trials. - Ono T - Cancer -15-JUN-2001; 91(12): 2378 Jonathan D Schwartz et al, Neoadjuvant and adjuvant therapy for resectable hepatocellular carcinoma: Review of the randomised clinical trials (2002) Lancet Oncology,

For patients with advanced hepatocellular carcinoma who are not candidates for surgical resection, liver transplantation, or localized tumor ablation, systemic chemotherapy remains an option. Unfortunately, hepatocellular carcinoma is a relatively chemotherapy-resistant tumor; therefore, outcomes using this mode of treatment are less than satisfactory. The only FDA approved drug for this cancer is Nexavar (sorafenib). Sorafenib, a multitargeted oral

The prognosis for patients with solid tumors metastatic to the liver is poor. Transcatheter arterial chemoembolization (TACE), most frequently performed by intra-arterially injecting an infusion of antineoplastic agents mixed with iodized oil (Lipiodol), has been extensively used in the treatment of large HCC tumors. A newer approach is to use drug coated microspheres. However, although massive tumor necrosis can be demonstrated in most cases, a

Lay Summary: Theraspheres are being investigated for liver cancer and colon cancer metastases. It is considered investigational at this time. TheraSphere -- a therapy that consists of millions of microscopic, radioactive glass microspheres (20-30 microns diameter) -- is infused into the arteries that feed inoperable liver tumors, bathing the malignancy in high levels of extremely localized radiation. In some studies of highly selected pateints the

Hepatic epithelioid hemangioendothelioma is a rare, low-grade malignant vascular tumor that was first described as a distinct entity by Weiss and Enzinger in 1982. Since then less than 200 cases ahve been reported.Most of teh attemtps at cure invovle hepatic trasnplantation. There is no single effective treatment, though spontaneous regression and response to chemotherapy and interferon are reported. Complete response to six courses of carboplatin

Chemosensitivity assays are controversial but most experts believe that they do not reliably assist in selecting chemotherapy. There is more evidence for chemoresistance assays but this also remains disputed. Chemoresistance assays are a modification that tests resistance to chemo rather than sensitivity. They work on the assumption that if celss show reesistance to very high concentrations of a drug in vitro, they will also be resistant in vivo

Nexavar is FDA approved for hepatocellular carcinoma as a single agent. Tarceva is a targeted anticancer drug that works by blocking a biological pathway referred to as the epidermal growth factor receptor (EGFR) pathway. The EGFR pathway is involved in cell growth and replication and when mutated or altered, excessive replication of cells can occur. Tarceva has been shown to improve treatment outcomes in selected patients with advanced non–small

The only proven potentially curative therapy for HCC remains surgical, either hepatic resection or liver transplantation, and patients with single small HCC ( 5 cm) or up to three lesions 3 cm should be referred for assessment for these treatment modalities. However, these treatments cannot be applied in metastatic disease.  In regard to chemotherapy, palliative systemic therapy with doxorubicin (Adriamycin) has been considered a standard of therapy

It is a fairly rare for benign liver lesions causing pain and there are no specific guidelines for thist. However, the literature contains many reports of this procedure being performed for non-cancer diagnosis(2,4). In experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Perioperative morbidity and mortality and long-term survival after laparoscopic resection  appear to be comparable to those after open