Eyelid metastasis originated from gastric-cancer.

The incidence of cutaneous metastasis from neoplasms of internal organs is uncommon, and in particular eyelid metastasis from gastric cancer is extremely rare. We report on such a case together with a review of a total of 6 cases. Of the 6 cases, 5 were males and 4 were pathologically low-grade differentiated adenocarcinoma. The presentation of eyelid mass was 3 nodular, 2 diffuse and one ulcerative without characteristics of its location. All the cases involved systemic disease and the effective treatment was not performed. We consider that the number of cases with eyelid metastasis from gastric cancer is actually much higher and that gastroenterologists should pay more attention to such cases in order to adequately grasp the pathogenesis.

Radical treatment of brain metastasis of colorectal-cancer.

Among 15 patients with brain metastases from colorectal cancer, the eight patients treated by open surgery+whole brain irradiation (35-45 Gy) or gamma-knife surgery had significant improvement in their neurologic symptoms and were able to return to their daily life. Survival from the time of diagnosis of brain metastases to death averaged 7.6 months in these radically-treated patients compared to 1.7 months in the conventional group (p<0.05). If performance status permits, aggressive treatment such as open surgery or gamma-knife surgery should be an option for treatment of brain metastasis of colorectal cancer.

[Studies on postoperative arterial infusion chemotherapy using implanted reservoir for hepatocellular carcinoma].

The effect of postoperative arterial infusion therapy using implanted reservoir was evaluated in 28 cases of resected hepatocellular carcinoma which showed at least one of those findings as Vp (+), Vv (+), IM (+) and more than 5 cm in tumor diameter. Ten of them underwent arterial infusion therapy with combination ADM and CDDP after hepatic resection (IA group) and the rest underwent no regional chemotherapy (control group). The one-, two- and three-year cumulative disease-free survival rates between control group and IA group were 55.6% against 80.0%, 25.4% against 70.0%, and 16.9% against 37.3%, respectively. The one-, two- and three-year cumulative survival rates between control group and IA group were 71.8% against 90.0%, 51.8% against 70.0% and 41.5% against 56.0%, respectively, a difference that was not statistically significant. We suggest this therapy can prevent intrahepatic recurrence, although it does not improve prognosis. To achieve a better prognosis, a new arterial infusion chemotherapy more effective than this one must be developed.

[Intra-arterial infusion chemotherapy for unresectable hepatocellular carcinoma using an implantable reservoir].

Arterial infusion therapy using implantable reservoirs was used in 44 patients with hepatocellular carcinoma which was unresectable for severe liver dysfunction or advanced tumor. The prognosis for patients with whom the double lumen reservoir developed by our department which can occlude the hepatic artery, was compared with that of patients for whom the conventional reservoir was employed. We also evaluated the reduction surgery previous to infusion therapy for tumor-advanced unresectable HCC. The six-month survival rates (Kaplan-Meier method) of the double lumen reservoir cases were significantly higher than for conventional reservoir cases. The survival rates of the cases of reduction surgery and infusion therapy (within only one year) were higher than for infusion therapy cases. Not only the use of the double lumen reservoir but the reduction surgery for unresectable HCC increases the effectiveness of infusion therapy and improves the prognosis.

[Intraportal vein infusion chemotherapy after hepatectomy for hepatocellular carcinoma--preliminary report].

Four cases of advanced hepatocellular carcinoma patients were treated by intra-portal infusion of 5-FU immediately after surgery. 5-FU at 120-250 mg daily was injected continuously via portal catheter from postoperative day 4 to 21. Two cases with short administration period of 4 days died of recurrence on the residual liver at 9 and 7 months after hepatic resection. Another 2 cases with a total amount of 5-FU at 2,165 mg and 2,250 mg, respectively, survived 4 years 3 months and 4 year 8 months each. Mild leukocytopenia and transient liver dysfunction were found as side effects. Intraportal infusion of anticancer drugs is a promising means to prevent intrahepatic micrometastasis after resection of hepatocellular carcinoma.

[Functioning disorders after surgery of rectum cancer--(1). Functioning prognosis of defecation disorder following anus preserving operation].

Thirty-three anus-preserved rectal cancer patients with anterior resection or low anterior resection were asked about their postoperative defecation conditions with questionnaires after a more than one and half year postoperative period. Beforehand the residual anorectum length was defined by subtracting the length of the specimen AW and 1.5 cm as suturing width from the length of the anal verge through the anal tumor margin during romanoscopic examination. Involuntary soiling frequently occurred in the cases with a less than 9 cm residual anorectum, in the female cases and in the cases associated with lateral lymph node dissection. But these factors have no definite relation to the time of disappearance of involuntary soiling. Half of the cases were normalized in 2 years, and 80% in 3 years. Frequent bowel movement occurred in a high percentage of cases, especially in the cases with short residual anorectum or with lateral lymph node dissection. Frequency of defecation decreased from 8-9/day up to 6 months later, to 5/day up to one year later, and 2-3/day up to 6 years later. Improvement of the above-mentioned condition was slightly delayed in the less than 6 cm residual anorectum group and in females, but not in the lateral lymph node dissection group. Anastomosis insufficiency caused a delay in recovery from involuntary soiling.