Treatment of hepatocellular carcinoma with adriamycin.Preliminary communication

Talati

J. Gastrointest. Oncol.

2017

264

168

Hepatocellular carcinoma (HCC) is the most common primary liver cancer with poor prognosis.The incidence of HCC and HCC-related deaths have increased over the last several decades. However, the treatment options for advanced HCC are very limited. Sorafenib remains the only drug approved for systemic treatment for advanced HCC. However, prior to sorafenib era conventional cytotoxic chemotherapies have been studied in advanced HCC. In this review, clinical studies of systemic chemotherapy for advanced HCC will be summarized and discussed.

Section: Introductionmentioning

confidence: 99%

Hepatocellular carcinoma (HCC): beyond sorafenib—chemotherapy

Talati

J. Gastrointest. Oncol.

2017

264

168

“…In Uganda earlier studies on PHC before the HIV epidemic showed high prevalence rates of HBV (60-80%) among patients with PHC [4][5][6][7] . Indeed analysis from Kampala cancer registry indicated an increase of PHC among women over the periods 1960-1980 and 1991 to 2005.…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B virus and HIV infection among patients with primary hepatocellular carcinoma in Kampala, Uganda

Ocama¹,

Opio²,

Kagimu³

et al. 2011

Af Hlth Sci

Background: Hepatitis B virus (HBV) is the commonest cause of primary hepatocellular (PHC) carcinoma worldwide. Coinfection with the HIV leads to more rapid progression of liver disease. Objectives: We described prevalence of HBV and HIV among patients with PHC admitted to Mulago Hospital, Kampala, Uganda. Methods:We assessed all patients admitted to the gastrointestinal service of Mulago hospital with a diagnosis of PHC for HBV and HIV infection. Results: From March to June 2008, we recruited 15 patients. Nine (60%) were male; the overall median age was 32 years (IQR 15 -67), with median ages for male and female 33 and 36 years respectively. Alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and AFP were all elevated with median values of 57.5 IU/L, 222 IU/L, 392 IU/L and 362 ng/ml respectively (IQR 14-145, 49-393, 165-1294 and 7-480). Eight (53%) patients were from North and Northeastern Uganda. The HBsAg was reactive in 13(87%) patients and HIV in 3(20%), all of whom were also co-infected with HBV. Conclusion: There is high prevalence of HBV and HBV/HIV co-infection among patients with PHC in Uganda with high mortality. Reduction in incidence and mortality due to PHC in Uganda will require urgent large scale HBV vaccination.

“…42 might be explained by the following: 1) superselective intra-hepatic arterial injection of a relatively large dose of an anticancer drug was made, 2) cirrhosis of the liver was absent and impairment of liver function was very slight, 3) the tumor was localized and encapsulated-a relatively benign nature of the encapsulated HCC has recently been e m p h a s i~e d ,~~.~* 4) the tumor was hypervascular making the intraarterially administered chemotherapeutic agent more effective, 5) the tumor cells were already necrotic in places and not very viable from the beginning, and 6) there was no metastasis intrahepatically and extrahepatically. T o our knowledge, there has as yet been not a single record of complete necrotization of HCC with chemotherapy alone, although occasional cases of remarkable response to chemotherapy have appeared in the literatu re .26, 28 The cause of fatal renal failure was most probably disseminated intravascular coagulation as suggested by the marked reduction in platelet count, mild unconjugated hyperbilirubinemia, and poikilocytosis which were not seen while he was in the hospital. The histological findings of the kidney were compatible with the diagnosis of intravascular hemolysis.…”

Section: Discussionmentioning

confidence: 99%

Complete necrotization of hepatocellular carcinoma by chemotherapy and subsequent intravascular coagulation.A case report

Harada

Makisaka

Nishimura

et al. 1978

Cancer

A 45-year-old man with hepatocellular carcinoma who developed intravascular coagulation following complete tumor regression by chemotherapy is described. After 2 doses of 10 mg of Mitomycin C given into the hepatic artery at the time of selective angiography, and 16 intravenous doses of 5-fluorouracil and Mitomycin C, 2 doses per week, subjective symptoms and hepatomegaly disappeared. Alpha-fetoprotein became negative and a remarkable change in tumor size and vasculature was noted in the arteriogram. Three months after chemotherapy, the patient developed thrombocytopenia, intravascular hemolysis, and acute renal failure. Autopsy disclosed a 8 X 7 X 5 cm solitary, encapsulated hepatocellular carcinoma in the right lobe. The tumor was surrounded by a thick capsule and completely necrotized. Neither intrahepatic invasion nor extrahepatic metastasis was observed. In the kidney, generalized fibrin thrombi were seen in the afferent arterioles of glomeruli as accounted for by intravascular coagulation.Cancer 42:67-73, 1978.E PROGNOSIS OF HEPATOCELLULAR car-T cinoma (HCC) is extremely poor and most patients die within several months from the time of d i a g n~s i s .~~'~~'~~~~~~~ Despite the various therapeutic measures employed such as hepatic lobectomy,20 ligation of the hepatic artery,'*12 anticancer chemotherapy24,31,35 and r a d i a t i~n ,~,~~ at the present time only resection of localized tumor found by early diagnosis affords complete cure or long survival.'O In the following patient, complete necrosis of a large HCC was obtained by anticancer chemotherapy, but it was followed by intravascular coagulation and renal failure. This