Ten Best Readings
Ten Best Readings on Liver Tumors
Richard C. Karl, MD
Program Leader, Gastrointestinal Tumor Program
H. Lee Moffitt Cancer Center & Research Institute
Wanebo HJ, Chu QD, Vezeridis MP, et al. Patient selection for hepatic resection of
colorectal metastases. Arch Surg. 1996;131:322-329.
The investigators report that survival is longest in patients with three or fewer
metastases in one hepatic lobe. Generally, extended resection should be avoided,
especially in medically compromised patients.
Marcos-Alvarez A, Jenkins RL, Washburn WK, et al. Multimodality treatment of
hepatocellular carcinoma in a hepatobiliary specialty center. Arch Surg.
1996;131:292-298.
This report includes outcomes from various approaches to managing hepatocellular
cancer. Margins of less than 1 cm have a negative impact on the prognosis after resection.
Chemoembolization gave better survival than systemic therapy, and liver transplantation
should be reserved for patients with cirrhosis and a tumor diameter of less than 5 cm.
Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal
carcinoma metastases to the liver: a prognostic scoring system to improve case selection,
based on 1,568 patients. Cancer. 1996;77:1254-1262.
A simple evaluation system based on age, size of largest metastasis or CEA level, stage
of the primary tumor, disease-free interval, number of liver nodules, and resection margin
can help to determine if surgery is worthwhile.
Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of
small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med.
1996;334:693-699.
A review is presented of the authors' experience with 48 patients either with single
hepatocellular carcinomas 5 cm or less or with no more than three nodules, each of 3 cm or
less in diameter. Liver transplantation is an effective treatment for small, unresectable
hepatocellular carcinoma in patients with cirrhosis.
Baker ME, Pelley R. Hepatic metastases: basic principles and implications for
radiologists. Radiology. 1995;197:329-337.
This "state-of-the-art" feature reviews the prevalence, outcomes, biology,
vascularity, detection, and treatment of hepatic metastases with an emphasis on
implications for radiology and radiologists.
Blumgart LH, Fong Y. Surgical options in the treatment of hepatic metastases from
colorectal cancer. Curr Probl Surg. 1995;32:333-421.
The authors make a plea for a randomized trial of regional chemotherapy with no
crossover and using mortality as an endpoint to clarify many issues regarding management
of hepatic metastases.
Chung JW, Park JH, Han JK, et al. Hepatocellular carcinoma and portal vein invasion:
results of treatment with transcatheter oily chemoembolization. AJR Am J Roentgenol.
1995;165:315-321.
This Korean study of 110 patients concludes that when a tumor is limited in extent and
hepatic function is preserved, transcatheter oily chemoembolization is effective and safe
for the palliation of hepatocellular carcinoma and major portal vein invasion.
Sugihara K. Continuous hepatic arterial infusion of 5-fluorouracil for unresectable
colorectal liver metastases: phase II study. Surgery. 1995;117:624-628.
This Japanese study suggests that use of 5-fluorouracil instead of FUdR by hepatic
arterial infusion to treat hepatic metastases may produce fewer hepatobiliary
complications.
Lai EC, Fan ST, Lo CM, et al. Hepatic resection for hepatocellular carcinoma: an
audit of 343 patients. Ann Surg. 1995;221:291-298.
Advances in patient selection, operative techniques, and postoperative care have
improved the results of surgical treatment for patients with hepatocellular carcinoma.
Ravikumar TS. The role of cryotherapy in the management of liver tumors. Adv Surg.
1996;30:139-149.
A pioneer in the technique of cryotherapy of liver tumors describes the approaches and
results that can be obtained from this approach.
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Journal Volume 3 Number 5