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A literature review was written to introduce the choice of therapy for primary liver cancer (PLC).It was concluded that hepatic resection, liver transplantation, cryotherapy, microwave coagulation treatment, radiofrequency ablation, transarterial embolization or transarterious chemoembolization, percutaneous ethanol injection, radiotherapy and biotherapy could increase the survival rate, and surgical resection combined with other therapeutic methods is the main treatment for primary liver cancer.
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Objective To explore the effect of radiofrequency ablation (RFA) combined with transcatherter arterial chemo-embolization (TACE) and percaulaneous ethanol injection (PEI) for unresectable hepatic malignancies. Methods The clinical data of 41 cases of unresectable liver cancer(URLC)treated by RFA,TACE and PEI were analysed retrospectively. Results There were 30 cases of primary hepatic cancer(PHT) and 11 cases of secondary hepatic cancer in this series.Ultrasound,CT and MRI showed the tumors shrinking or stable in 26 of the 41 patients postoperatively.AFP decreased to normal in 12 cases of 16 AFP positive PHT patients after operation. No severe complication was seen in the series. Conclusions RFA combined with TACE and PEI is a safe, well-tolerated and effective method for unresectable hepatic carcinoma, and may improve the treatment efficacy of URLC.
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Objective To study the efficacy and indications of percutaneous radiofrequency ablation (PRFA) for small primary liver cancer(SPLC). Methods The clinical data of 16 patients with SPLC treated by PRFA were analysed retrospectively. Results The diameter of tumor in all 16 patients were ≤3cm. After PEFA, AFP from postive returned to negative in 93.3% of patients; and BUS and CT showed the tumors shrinking with capsule formation. The 0.5,1,2-year survival rate were 93.8%,100%,100% respectively. Conclusions PRFA for SPLC has advantages such as minitrauma, safe and effective, especiolly suitable to the patients with contrainsications of operation, or the tumor locating to the deep position of liver, or around inferior vena cava, hepatic veins or hepatic porta etc.
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Objective To sum up the effect and experience in radiofrequency ablation(RFA) for liver cancer(LC). Methods The clinical data of 102 patients with LC treated by percutaneous and intraoperative RFA were analysed retrospectively. Results RFA was used to treat 195 tumors (median diameter 5.6 cm,ranging from 1.5 to 9.5 cm) in 102 patients.Of them, primary liver cancer was found in 80 patients( 78.4%),and metastatic liver tumor was in 22 patients(21.6%). Percutaneous RFA(PRFA) and intraoperative RFA(IRFA) was performed in 77 patients(75.5%) and 25 patients(24.5%) respectively. There was no severe complications after RFA in this series. All of the 102 cases had been followed up for 3～24months,AFP positive returned to negative in 70.3%(52/74)of the patients.The rate of concreted necrosis of liver cancer showed by CT was 88.2%(90/102). The 1 year survival rate was 93.8%.Conclusions RFA is a safe and effective treatment for patients with LC. Patients with small and readily accessible tumor are the indications of PRFA;while the patients with large,multiple,perivascular or otherwise inaccessible liver tumor are also the indications for IRFA.The adoption of the TACE and other methods to occlude the vascular inflow can improve the efficacy of RFA.
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Objective To investigate and evaluate the changes of T lymphocytes and red cell immunity of peripheral blood in patients with primary hepatocyte carcinoma (PHCC) after radiofrequency ablation(RFA) treatment. Methods The pre- and post- RFA(3d,7d,14d) peripheral blood T lymphocyte subsets(T3,T4,T8,T4/T8) and red cell immunity (RBC C3 receptor flower and RBC-immuocomplex formation rate) were investigated in 120 patients with PHCC treated by RFA. Results On 7d, 14d after RFA, T3, T4 lymphocytes and T4/T8 were higher than those on preoperative day significantly(P
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Objective To evaluate the safety and efficacy of combining radiofrequency ablation(RFA) with arsenious acid(AA) locally to treat liver VX2 tumor in rabbits,and to explore its mechanism.Methods Twenty-eight New Zealand White rabbits with implanted liver VX2 tumors were randomly divided into four groups: control group(n= 7),AA group(n=7),RFA group(n=7),and combination(RFA+AA) group(n=7).ALT was measured before treatment and on the day 0,day 3,day 7 and day 14 after treatment,meanwhile ultrasonic(US) examination was performed.All rabbits were killed 14 days after treatment.Vascular endothelial growth factor(VEGF) was examined by immunohistochemistry,and the relationship of VEGF and gross tumor volume was analyzed.Results Combination(RAF+AA) therapy caused little damage to hepatic function but had better inhibited tumor growth.The level of VEGF in AA,RFA and RAF+AA group was lower than that of the control group(P
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Objective To investigate expression and clinical significance of HIF-1?、MVD and PCNA after TAE or TACE for rabbit liver carcinoma,and to identify the mechanism of hepatic carcinoma cell proliferation after the operation.Methods Thirty rabbits were implanted with liver VX2 tumors for 1 week.Then they were randomly divided into 3 groups.Control group had hepatic arterial infusion of 0.5 to 0.8 mL saline.TAE group was embolized with 0.5 to 0.8 ml UFLP.TACE group was embolized with 0.5 to 0.8 ml UFLP mixed with 2 mg THP.Two weeks after treatment,HIF-1?、MVD and PCNA expression was detected.Results Growth of the liver tumor was found in the 3 groups,and there were 15,11 and 3 new tumors found in the control group,TAE group and TACE group respectively.The expressions of HIF-1?and PCNA in control group were higher than those in TACE group,but significantly lower than those in TAE group(P
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Objective To explore the methods and outcome of comprehensive therapeatic for primary liver cancer. Methods Various therapeutic methods and outcome of 265 patients with primary liver cancer admitted in the last five years, were analyzed retrospectively .The group consisted of 238 male, and 27 female patients. The average age 47.5 years. Operation was performed in 215 cases and non-operative treatment is 50 cases. Operative treatment included resection of hepatic cancer and/or adjuvant therapy. Non-operative therapy included transcatheter hepatic chemo-embolization(TACE),percutaneous ethanol injection (PEI)、drug delivery system(DDS)、cryosurgery、radiofrequency ablation(RFA). Results The resection rate, and mortality and morbidity rates were 57%(215/377), 74.9%(161/215), 0.5%(1/215), and 19% respectively. The overall 1-,2-,3-year survival rate were 78.9 %,59.3%,33.5%, respectively, in patients who received comprehensive treatment centered around surgical resection, and 62.3%,32.3%,22.8%, respectively, in 45 patients who received non-surgical resection treatment. Conclusions Liver resection combined with other nonoperative modalities are ideal ways to treat primary liver cancer at the present time, and for different stages of primary liver cancer different treatment modalities are used.
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Objective To investigate the effect and the prognostic factors of radiofrequency ablation(RFA) for primary liver cancer(PLC).Methods RFA was performed in 195 patients with PLC,and the efficency was evaluated with univariate analysis.Cox′s regression analysis model was used to analyze the factors affecting the prognosis.Results In the whole group of patients,the 1,2,3 and 5-year overall survival rate was 80.5%,67.4%,49.1% and 32.7% respectively,and in the patients with small PLC(the size≤3 cm),the 1,2,3 and 5-year overall survival rate was 91.7%,81.2%,60.5% and 40.4% respectively.The Cox regression models indicated that the independent factors in determining the prognosis were: Liver function of Child-Pugh stage,tumor size and occlusion of hepatic inflow during RFA.Conclusions RFA is an effective mini-invasive treatment for patients with PLC,and especially for the patients with small PLC.The efficency of RFA for small PLC has the same outcome as that of surgical resection of the tumor.Liver function of Child-Pugh stage,tumor size and occlusion of hepatic inflow during RFA are the independent prognostic factors.
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Objective To investigate the effect of radiofrequency ablation(RFA) in the treatment of small liver cancer.Methods In recent 6 years,130 patients with primary or secondary liver cancer(≤5cm in diameter)were treated by RFA,among which 86 cases were primary,and 44 cases were secondary liver cancer.Among the 130 cases,18 received RFA plus TAEC,and 20 had RFA combined with PEI.Results Overall 1-and 3-year survival rate was 91.3% and 77.7% respectively.Complications occurred in 7 cases,including biliary fistula,intestinal fistula,and slight burn of skin.There was no death in this series.Conclusions RFA is an effective and safe therapeutic approach for small liver cancer ≤5cm in diameter.Its effect may be similar to that of surgical resection.
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Objective To investigate an effective method of treating primary hepatic cancer(PHC) with portal venous tumor thrombosis (PVTT). Methods The clinical data Of 23 patients with PHC and PVTT were retrospectivly analysed. Results Of the 23 patieats after hepatoma resection and PVTT extraction, continuous micro dose infusion chemotherapy or perfusion chemotherapy by DDS was adopted. In 8 patients with main portal vein tumor thrombus, 2 died, 4 recured in 6 months. In 8 patients with the first class branch of portal vein tumor thrombus, 2 recurrd in 6 months and 6 recurred in 12 months. In 4 patients with secondary class branch of portal vein tumor thrombus, l recurred in 12 months (P
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Objective To prepare the carboplatin-Fe@C nanocage-loaded chitosan nanoparticles(C-Fe@CN-CN),and observe the inhibitive effect on the proliferation of human hepatoma cell line HepG2 in vitro.Methods The C-Fe@CN-CN were prepared by the reverse microemulsion method and the character and drug release in vitro were observed.The inhibitive effect on the proliferation of the HepG2 cell was measured by MTT colorimetry,IC_(50) was calculated and the growth curve of HepG2 cell was drawn.Results C-Fe@CN-CN were in good spherical shape.The average size was 207nm?21nm with narrow distribution.The drug content was 11.40?1.31%.After a fast release during the first day,a more gradual drug release was sustained for another 4 days.C-Fe@CN-CN could apparently inhibit the proliferation of HepG2 cell inthe dose-dependent and time-dependent manner.The inhibitive effect of C-Fe@CN-CN at 24 hours was lower than that of original carboplatin,and was equal to original carboplatin at 48 hours and 72 hours.IC_(50) of C-Fe@CN-CN at 24h,48h and 72h was 135?g/ml,18.84?g/ml and 6.09?g/ml respectively.Bland nanoparticles had no cytotoxicity on HepG2 cell.Conclusions C-Fe@CN-CN possess strong magnetic responsivity,drug controlled(releasing) performance and the potential abilities of long circulation and permeation in tumor tissue.C-Fe@CN-CN can effectively inhibit the proliferation of HepG2 cell,and the blank nanoparticles express favourable biocompatibility in vitro.
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Objective To evaluate the effect of combination of surgery and transcatheter hepatic arterial chemotherapic embolism(THACE) with or without placement of drug deliery system(DDS) of portal vein for hepatocellular carcinoma with portal vein tumor thrombus (PVTT). Methods Fifteen cases of advanced HCC with PVTT were treated by hepatectomy, thrombectomy of portal vein with THACE,and 5 of the 15 cases received postoperative chemotherapy via portal vein. Results All patients survived after operation. The survival rate of 6,12,18 months was 15,12 and 9 cases respectively. Conclusions Operation is still an effective method for advanced HCC , postoperative comprehensive treatment can improve the survival rate.
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Objective To study the treatment of sponteneous rupture of hepatocellular carcinoma(SRHCC).Methods The clinical data of 64 patients with SRHCC treated by non-operation or operation were analysed retrospectively.Results The mean survival time of 14 patients treated by conservative therapy was 7 days(12 hours～12 days), the mean surival time of 31 patients treated by packing and 6 patients treated by ligation of hepatic artery was 11 days(4 hours-3 months)and 2.5 months(8 days-6 months);and the 1-month survival rate was 3.2% and 66.7% respectively.1 patient underwent transhepatic artery embolism surviving 9 days.The 1-year survival rate of 12 patients treated by hepatectomy was 66.7%;the mean survival time was 36 months(4 days-25 years and 3 months).Of the 12 patients,11 survived for over one and a half months whose liver function was Child-Pugh grade A before operation; 1 died of liver function failure 4 days after operation,whose liver function was Child-Pugh grade B before operation.Conclusions Emergent hepatectomy should be reserved for patients with an easily resectable lesion whose liver function is in Child-Pugh grade A.Early two-stage or delayed hepatectomy would be suitable for those patients who are unsuitable for emergent operation.Conservative therapy and other therapies may be used for patients with terminal stage of SRHCC.
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0.05). RFA showed a marked short term therapeutic effect for patients with PHC.Conclusions After RFA treatment of patients with PHC,the serum levels of TNF and AFP decreased,and this suggests an augmentation of organism immune function. The serum levels of TNF and AFP can assist in the assessment of the therapeutic effect and prognosis of primary hepatic carcinoma.