Therapeutic approaches to metastasis confined to the liver

ArticleinCurrent Oncology Reports 3(2):109-115 · March 2001with4 Reads
DOI: 10.1007/s11912-001-0009-4
Abstract
Liver metastases nearly always represent disseminated cancer, and systemic therapies are usually indicated. However, in a minority of patients—some with colorectal cancer, others with selected tumors—management of the hepatic disease may be clinically important and even curative. This review identifies unique patient subgroups and novel treatment approaches that may be indicated in patients with liver metastases.
    • "Flat polyps are more likely to be missed than sessile ones as they do not, or only slightly, alter the colonic contour. However, they have a clearly different soft tissue attenuation compared to fat1718192021. the aforementioned lesion was interpreted as a large lipomatous ileocaecal valve. The second missed lesion greater than 10 mm was a 10–15-mm polyp. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Virtual colonoscopy (VC) enables three-dimensional view of walls and internal lumen of the colon as a result of reconstruction of multislice CT images. The role of VC in diagnosis of the colon abnormalities systematically increases, and in many medical centers all over the world is carried out as a screening test of patients with high risk of colorectal cancer. Material/Methods We analyzed results of virtual colonoscopy of 360 patients with clinical suspicion of colorectal cancer. Sensitivity and specificity of CT colonoscopy for detection of colon cancers and polyps were assessed. Results Results of our research have shown high diagnostic efficiency of CT colonoscopy in detection of focal lesions in large intestine of 10 mm or more diameter. Sensitivity was 85.7%, specificity 89.2%. Conclusions Virtual colonoscopy is noninvasive and well tolerated by patients imaging method, which permits for early detection of the large intestine lesions with specificity and sensitivity similar to classical colonoscopy in screening exams in patients suspected for colorectal cancer. Good preparation of the patients for the examination is very important for proper diagnosis and interpretation of this imaginge procedure.
    Full-text · Article · Sep 2014
    • "As a result, resection and transplantation remain the only curative options, but a variety of factors often eliminate these possibilities181920. These limitations have fostered the development of locoregional drug treatment strategies, such as direct hepatic artery infusion (HAI) and transcatheter hepatic artery chemotherapy (TAC)212223242526. These approaches exploit the difference in the vascular supply of tumor and normal parenchyma; hepatic tumors are fed by a neovascularized hepatic arterial route, while the normal liver parenchyma is supplied mainly from the portal vein [27, 28]. "
    [Show abstract] [Hide abstract] ABSTRACT: We have investigated a rapidly reversible hydrophobization of therapeutic agents for improving first-pass uptake in locoregional drug therapy. This approach involves the attachment of a hydrophobic moiety to the drug by highly labile chemical linkages that rapidly hydrolyze upon injection. Hydrophobization drastically enhances cell-membrane association of the prodrug and, consequently, drug uptake, while the rapid lability protects nontargeted tissues from exposure to the highly active agent. Using the membrane-impermeable DNA intercalator propidium iodide, and melphalan, we report results from in vitro cellular internalization and toxicity studies. Additionally, we report in vivo results after a single liver arterial bolus injection, demonstrating both tumor targeting and increased survival in a mouse tumor model.
    Full-text · Article · Oct 2007
  • [Show abstract] [Hide abstract] ABSTRACT: To evaluate computed tomographic (CT) colonography in patients with clinical suspicion of colorectal cancer and in whom colonoscopy was incomplete. After incomplete colonoscopy, 34 patients underwent CT colonography before and after intravenous injection of iodinated contrast agent, in supine and prone positions. Twenty patients with no evidence of colon cancer after complete colonoscopy were included as a control group. Sensitivity and specificity of CT colonography were determined for detection of cancers, polyps, and metastases to liver. In 29 patients, surgery revealed 30 colorectal cancers (three synchronous cancers) and two ischemic lesions of the descending colon. Colonoscopy missed 10 colorectal cancers and three synchronous cancers; all were detected with CT colonography. Sensitivity and specificity for detection of colorectal cancer were 56% and 92%, respectively, for incomplete colonoscopy and 100% and 96%, respectively, for CT colonography (P <.01). Sensitivity and specificity of CT colonography in detection of polyps were 86% and 70%, respectively, for diameters of 5 mm or less; 100% and 80%, respectively, for 5-10-mm diameters; and 100% for diameters greater than 10 mm. Spiral CT of the liver revealed four metastases (2-5 cm); sensitivity and specificity were 100% and 43% for nonenhanced scans and 100% for contrast-enhanced scans (P <.01). In this selected group of patients, CT colonography provided complete information to properly address surgery of colorectal cancer and treatment of liver metastases.
    Full-text · Article · Jul 2002
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