Abstract:

Introduction: treatment of gastric cancer (GC) remains an urgent problem in oncology. One of the unsolved problems in treatment of gastric cancer remains the treatment of patients with liver metastases. With the development of interventional radiology, it became possible to treat gastric cancer patients with liver metastases.

Aim: was to improve results of treatment of gastric cancer patients with liver metastases by using of trans-arterial chemoembolization (TACE).

Material and methods: we analyzed results of 60 patients for the period 2008-2020, who suffered for metastatic liver disease, previously they received combined treatment for stomach cancer at various times. The average age of patients was 58,1 ± 5,8 years. When planning TACE, all patients had a general condition above 80% according to Karnovsky, according to ECOG 1-2. All TACE patients with liver metastatic foci were treated with Lipiodol 6-8ml + Doxorubicin 25mg/m². The interval between TACE cycles was 1,5-2 months. Each patient received 5-6 TACE courses.

Results: immediate results showed the effectiveness of treatment after 2 courses of TACE in 49 (81,7%) patients: partial regression was noted in 36 (60%) patients, and significant regression of the process was noted in 13 (21,6%) patients, stabilization of the process was noted in 11(18,3%) patients. With dynamic follow-up 37 (61,7%) patients lived 6 months, 24 (40%) patients lived 12 months, 11 (18,3%) patients lived 18 months, 8 (13,3%) patients lived 24 months, only 3 (5,0%) patients lived 36 months. The median survival rate was 15,5 ± 1,2 months.

Conclusions: immediate and long-term results of the study, carrying out TACE in patients with metastases of gastric cancer to the liver was effective in 50% of patients. Currently, to improve the survival rate and quality of life of patients with metastases of gastric cancer, the technique of trans-arterial chemoembolization can be considered as an effective, low-toxic method of treatment and it can be the method of choice.

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https://doi.org/10.12659/MSM.922988

Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

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Abstract:

Procedure of pre-operative ultrasonic imaging was conducted for nine patients with verified diagnosis of cervical adenocarcinoma. All the diagnosis were morphologically confirmed. A complex ultrasonic examination consisted of transabdominal and transvaginal echography of true pelvis organs as well as transabdominal examination of abdomen cavity and retroperitoneal space. All patients underwent true pelvis ultrasonic scanning including CDM mode, ED and Doppler pulse - wave mode. Based on the analyzed data, it was defined that echography makes it possible to determine the behavior of tumor local growth and to reveal metastases. We have traced a clear relationship of a disease stage on a ultrasonically fixed tumor size. An attempt is made to reveal specific echographic signs of adenocarcinoma of the cervix.

Abstract:

Purpose. Was to evaluate possibilities of FDCTA as a method of colorectal liver metastases (CLM) detection and differentional diagnostics.

Materials and methods. FD-CT-A was performed to examine 41 patients. Patients with lobe CLM (n =15) were included into the 1-st group. Purpose was to exclude metastatic lesions of contralateral lobe before surgical treatment. Patients with bilobar metastatic spread (n = 26) were included into the 2-nd group. Purpose was to detect metastases before and during regional therapy. Scanning was performed on the hybryde angiographic system Innova-4100 «GЕ Нealthcare, USA» with 5 sec scanning time, fov 23 × 23 cm, delay from 10 to 22 sec during hepatic arteriography 15–40 ml Ultravist-370 «Bayer Schering Pharma, Germany» with rate 2–4 ml/sec.

Results. In the first group 40 CLM were detected. The number of metastases in each patient ranged from 1 to 12 (mean – 3). The size of metastases ranged from 9,1 mm to 150,0 mm (mean – 36,7 mm, median – 30,2 mm). 14 of all CLM (35%) were 20 mm and less. Right hemyhepatectomy was provided for 6 patients, left hemyhepatectomy – for one. In the second group 282 CLM were detected. The number of metastases in each patient ranged from 2 to 31 (mean – 11). The size of metastases ranged from 3,2 mm to 81,0 mm (mean – 17,4 mm, median – 12,7 mm). 209 of all CLM (74%) were equal or smaller then 20 mm in diameter.

Conclusion. FD-CT-A is the perspective method for detection and differentional diagnostics of CLM.
 

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Abstract:

Aim: a case report of a 5-year experience of regional (arterial chemoembolization) treatment of a patient with isolated liver metastases of skin melanoma.

Materials and Methods: in 1994, the patient performed excision of melanoma in the right scapular region. Patient didn't undergo another treatment. During examination in 2006 metastasis in the liver was revealed. Patient recieved five rounds of chemotherapy Aranoza, Temodal, Kanglite. Metastatic tumer, sized 16,5 х14,5 х18,5 cm, occupied right liver lobe with deformation of it. After gaining this data - patient received 2 courses of liver chemoembolization in 2008.

Results: during the 5 years follow-up - progression of tumor lesion is not noticed.

Conclusion: the optimal transarterial chemoembolization creates possibilities for an efficient delivery of drugs and tumor embolization particles in the affected organ, particularly in the liver. In addition to surgery (with resectable formations) and systemic chemotherapy, above capabilities regional transarterial therapy can provide long term as new palliative treatment of patients with metastatic melanoma.

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Abstract:

Aim: was to investigate the safety and efficacy of transarterial embolization in patients with hypervascular spinal metastases and primary tumors before surgical resection.

Materials and methods: 39 patients with spinal metastases and primary tumors underwent angiography and preoperative transarterial embolization with spherical particles, coils and the liquid cohesive composition before surgical resection. Following parameters were evaluated: types of tumor, gender, time interval between embolization and surgery, the influence of these parameters on intraoperative blood loss, surgical content, safety for the patient.

Results: Intraoperative blood loss in patients undergoing embolization was up to 500 ml - 29(74,4%), to 1000 mL - 2(5,1%), to 2000 mL - 3(7,7 %), 2000 mL - 5(12,8%). Average value of blood loss for RCC 546,2 ml, for other metastases - 373,5 mL, for primary tumors - 2488,8 mL. There have been no in-hospital mortality related with the intraoperative blood loss. All patients received standard supportive care, emergency blood transfusion was not performed. 3(7,7%) patients after endovascular interventions had complications in the form of temporary neurological deficit, 15 (38,5%) had postembolization syndrome.

Conclusion: In the embolization group, intraoperative blood loss was correlated with type of tumor and type of surgical resection. Preoperative embolization is safety and effectively to decrease intraoperative blood loss for patients with hypervascular spinal tumors. 

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Abstract:

Aim: was to estimate first own results of arterial radioembolization (RE) in patients with primary or metastatic liver malignancy.

Materials and methods: in 2009, RE of the right (n=3) or left (n=1) hepatic artery using Yttrium-90 glass microspheres (Therasphere) was performed in 4 patients: 3 with hepatocellular carcinoma on cirrhosis complicated by portal vein branch thrombosis (contraindication for chemoembolization), and 1 patient with colorectal liver metastases.

Results: all RE procedures were technically successful. The radiation dose to the tumor was 1 20-150 Gy The post embolization syndrome was minimal and uncomplicated. After RE, partial tumor response and stabilization were noted in 2 patients each. Patients survived from 14 to 32 months.

Conclusion: RE is well-tolerated and safe procedure causing significant local damage of liver tumor. According to our first experience, RE is a very promising method for treatment of hepatic malignancies. 

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4.     Seidensticker R., Seidensticker M., Damm R., Mohnike K., Schutte K., Malfwertheiner P., Van Buskirk M., Pech M., Amthauer H., Ricke J. Hepatic toxicity after radioembolization of the liver using 90Y-micro- spheres: Sequential lobar versus whole liver approach. Cardiovasc. Intervent. Radiol. 2012; 35(5): 1109-1118.

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