V`EpE @@@ @@@@ hp=RE`E EN DB E     & . 67 DI I ivnals CP - Switzerland PT - Journal Article LG - English EM - 199401 Revised: 20001218. Entry Week: 199401 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0894-8569a- United States PT - Journal Article LG - English EM - 199707 Revised: 20001218. Entry Week: 199707 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0016-5107i underwent laparoscopic cryoablation of hepatic tumors from April 1996 to December 1997 was conducted. We report on this experience and comment on the feasibility and safety of the procedure based on this early trial. [References: 51] echniques a" nnn{\rtf1\ansi{\fonttbl}{\colortbl\red0\green0\blue0;\red255\green0\blue0;\red0\green0\blue255;}{ Aldrete2001 Bartolozzi1996 Bicher19959Blumgart2000 Christophi20010DeMatteo2000 Donohue1997 Fong20002 Harmsen1997 Heslin2001 Ilstrup1997 Jamison1997Jarnagin2000Lencioni19969 Medina-Franco2001 Muralidharan2001Nagorney1997 Parker2001c Rosen1997Surowiec1995 Urist2001 Vickers2001 Weber2000  AuthorsJournals Keywords ^                                 Aldrete, J.Bartolozzi, C. Bicher, H. I.Blumgart, L. H.Christophi, C.DeMatteo, R. P. Donohue, J.H. Farina Farina, Dino Fong, Y. Harmsen, W.S. Heslin, M.J. Ilstrup, D.M. Jamison, R.L.Jarnagin, W. R. Lencioni, R.Medina-Franco, H.Muralidharan, V.Nagorney, D.M. Parker, M. Rosen, C.B. Surowiec, A. Urist, M.M. Vickers, S.M. Weber, S. M.  Ann Surg OncolArchives of SurgeryEuropean Radiology83Journal of Microwave Power & Electromagnetic Energy Journal of Surgical Oncology Sensors  ^($*Colorectal Neoplasms/pa [Pathology]("*Colorectal Neoplasms/su [Surgery]("*Colorectal Neoplasms/th [Therapy] *Cryosurgery(%*Ethanol/ad [Administration & Dosage] *Hepatectomy(#*Hyperthermia, Induced/mt [Methods]("*Hyperthermia,Induced/mt [Methods] *Infusion Pumps,Implantable *Lasers/tu [Therapeutic Use]("*Liver Neoplasms/dt [Drug Therapy]$*Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] *Liver Neoplasms/th [Therapy]$ *Microwaves/tu [Therapeutic Use]*Neoplasms/th [Therapy],&*Solvents/ad [Administration & Dosage] 0 (Solvents)64-17-5 (Ethanol)Acrylic Resins,'Adipose Tissue/ah [Anatomy & Histology]$Adipose Tissue/ph [Physiology] AdolescenceAdultAgedAged,80 and over analysis AngiographybloodBody TemperatureCarcinoembryonic AntigenCause of DeathChemotherapy,Adjuvant$Colorectal Neoplasms/*pathology,&Colorectal Neoplasms/dt [Drug Therapy](#Colorectal Neoplasms/mo [Mortality]Combined Modality Therapy Cryotherapy diagnosisDisease-Free SurvivalEquipment Design Ethanol FemaleFollow-Up StudiesGelsHeat HepatectomyHepatic ArteryHuman0*Hyperthermia, Induced/is [Instrumentation]Infusions,Intra-Arterial InjectionsLiverLiver Cirrhosis0-Liver Neoplasms/*mortality/secondary/*surgery$Liver Neoplasms/di [Diagnosis]$!Liver Neoplasms/dt [Drug Therapy]$Liver Neoplasms/mo [Mortality] Liver Neoplasms/su [Surgery]Liver/pa [Pathology] Liver/us [Ultrasonography] Lung/ah [Anatomy & Histology]Lung/ph [Physiology]Lymph Magnetic Resonance ImagingMale methods Middle AgeModels, Structural Morbidity mortalityMultivariate Analysis,)Muscle, Skeletal/ah [Anatomy & Histology]$ Muscle, Skeletal/ph [Physiology] Necrosis New York City/epidemiologyPredictive Value of Tests Probability Prognosis Proportional Hazards ModelsProspective Studies RegistriesRemission InductionSeverity of Illness Index surgerySurvival Analysis Survival Rate therapyThermal Conductivity Time FactorsTomography,X-Ray ComputedTreatment Outcome Ultrasonography,Doppler,Color United States  13Colorectal hepatic metastases: resection, local ablation, and hepatic artery infusion pump are associated with prolonged survivalPIHeslin,M.J. Medina-Franco,H. Parker,M. Vickers,S.M. Aldrete,J. Urist,M.M.2 2001 3/2001*Colorectal Neoplasms/su [Surgery] *Cryosurgery *Hepatectomy *Infusion Pumps,Implantable *Liver Neoplasms/sc [Secondary] Adolescence Adult Aged Aged,80 and over analysis Carcinoembryonic Antigen Chemotherapy,Adjuvant Colorectal Neoplasms/dt [Drug Therapy] Colorectal Neoplasms/mo [Mortality] Combined Modality Therapy Cryotherapy diagnosis Female Follow-Up Studies Hepatic Artery Human Infusions,Intra-Arterial Liver Liver Neoplasms/dt [Drug Therapy] Liver Neoplasms/mo [Mortality] Liver Neoplasms/su [Surgery] Male methods Middle Age mortality Proportional Hazards Models surgery Survival Rate therapy Treatment Outcome United States Registries Multivariate Analysis318-323Archives of Surgery 1363BACKGROUND: Treatment of metastatic colorectal cancer to the liver is not uniform. We describe the management of metastatic colorectal cancer of the liver at a single institution during a 10-year period. METHODS: From January 1, 1990, through December 31, 1999, 174 patients were identified from the tumor registry at the University of Alabama at Birmingham with a diagnosis of metastatic colorectal cancer to the liver. Patient, tumor, laboratory, operative, and adjuvant therapy factors were analyzed, with overall survival as the endpoint. Log-rank tests were used for univariate analysis, Cox-proportional hazards model for multivariate analysis, and Kaplan-Meier curves were used for graphical representation of survival. Significance was defined as P<.05. RESULTS: Median age was 60 years (age range, 18-92 years). Seventy-nine percent of patients had synchronous liver metastases at the time of diagnosis of the primary colorectal tumor. The primary tumor was in the colon and rectum 75% and 25% of the time, respectively. Of the 89 patients who underwent operation, 73 received definitive surgical treatment for their liver metastases. Fifty-two patients underwent lobectomy or wedge resection, 5 underwent cryotherapy, and 16 had a hepatic artery infusion pump (HAIP) inserted. Median follow-up duration of surgically treated patients was 26 months. Operative mortality was 1.3%. The 3-year actuarial survivals for patients who underwent resection, HAIP, or those with unresectable disease were 70 months, 32 months, and 3 months, respectively (P<.001). By multivariate analysis, surgical intervention, a carcinoembryonic antigen level less than 200 microg/L, or a low T stage of the primary tumor were associated with prolongation of survival. CONCLUSIONS: Surgical resection should be attempted for hepatic colorectal metastases, as this is associated with prolonged overall survival. Hepatic artery infusion pump insertion seems to prolong overall survival for those with unresectable hepatic metastases, but it is not equal to resection. Aggressive surgical management of patients with hepatic colorectal metastases is safe, may prolong overall survival, and therefore should be considered in all patients with metastases confined to the liver\VDB - MEDLINE UI - 21152645 IN - Department of Surgery, University of Alabama, Birminghan 35294, USA. marty.heslin@ccc.uab.edu JC - 8ia, 9716528 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 20010405. Entry Week: 20010405 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0004-0010 551ZTHepatic resection for metastatic colorectal cancer results in cure for some patientsRLJamison,R.L. Donohue,J.H. Nagorney,D.M. Rosen,C.B. Harmsen,W.S. Ilstrup,D.M. 1997 5/1997~x*Colorectal Neoplasms/pa [Pathology] *Hepatectomy *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/su [Surgery] blood Cause of Death Colorectal Neoplasms/mo [Mortality] Disease-Free Survival Female Follow-Up Studies Human Liver Liver Neoplasms/mo [Mortality] Lymph Male Predictive Value of Tests Probability Remission Induction surgery Survival Rate Time Factors United States505-510Archives of Surgery 1325280 patient population with five year survival 27% after resection. Disease-free survival at 5 years represents cure in nearly allvoOBJECTIVES: To determine the long-term disease-free and overall survivals for patients undergoing hepatic resection for colorectal cancer metastases and to define significant predictors of improved patients survival. DESIGN: Retrospective review. SETTING: Single tertiary care center. PATIENTS: Two hundred eighty consecutive patients underwent hepatic resection for colorectal cancer metastases at the Mayo Clinic from 1960 to 1987. Fifty patients alive at the completion of the study had a mean follow-up of 11.3 years (median, 121 months). MAIN OUTCOME MEASURES: Disease-free interval following initial hepatic resection and death. RESULTS: The overall 5-year survival of the 280 patients was 27%. Twenty-eight patients were alive at 10 years from the time of hepatic resection, and the 10-year actuarial survival was 20%. Only 2 patients alive and free of disease at 5 years had recurrent disease. For all other patients who were free of disease more than 5 years after hepatic resection and died, the cause of death was not cancer related. No patients characteristics or features of the primary tumor affected survival. Clinical presentation of metastatic disease, configuration of hepatic lesions, the presence of extrahepatic lymph node involvement, and the existence of resectable extrahepatic disease significantly affected long-term patient survival. Need for perioperative blood product transfusion was associated with a lower probability of long-term survival. CONCLUSIONS: Disease-free patient survival beyond 5 years from surgical resection of colorectal cancer metastases to the liver represents patient cure in nearly all instancesF?DB - MEDLINE UI - 97305118 IN - Department of Surgery, Mayo Clinic, Rochester, Minn, USA JC - 8ia, 9716528 Journal Subset AIM Journals CP - United States PT - Journal Article LG - English EM - 199706 Revised: 20001218. Entry Week: 199706 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0004-0010 0 333PJEthanol injection for the treatment of hepatic tumours. [Review] [99 refs] Bartolozzi,C. Lencioni,R.J 1996 1996*Ethanol/ad [Administration & Dosage] *Liver Neoplasms/dt [Drug Therapy] *Solvents/ad [Administration & Dosage] 0 (Solvents) 64-17-5 (Ethanol) Angiography Ethanol Hepatectomy Human Injections Liver Liver Cirrhosis Liver Neoplasms/di [Diagnosis] Liver Neoplasms/mo [Mortality] Magnetic Resonance Imaging Morbidity mortality Probability Survival Rate Tomography,X-Ray Computed Treatment Outcome Ultrasonography,Doppler,Color682-696sEuropean Radiology6h5lfPercutaneous ethanol injection (PEI) is a relatively new therapeutic technique for the treatment of liver tumours. PEI is now considered a reliable alternative to surgical resection for cirrhotic patients with a single, small hepatocellular carcinoma (HCC). Intratumoral injection of absolute ethanol, in fact, achieves complete ablation of HCC nodules 3 cm or less in diameter with a high probability. Moreover, PEI is not associated with significant morbidity or mortality and does not damage non-cancerous liver parenchyma. Long-term survival rates of PEI-treated patients were similar to those obtained in matched patients submitted to partial hepatectomy. In large HCC lesions, the anticancer effect of PEI can be significantly enhanced by pretreatment of the tumour with transcatheter arterial chemoembolisation. PEI may also be effectively used to destroy adenomatous hyperplastic nodules in liver cirrhosis, which represent precancerous lesions. The results of PEI in the treatment of liver metastases, in contrast, have been far less encouraging than in the case of HCC, so that PEI is not recommended when other interventional procedures such as radiofrequency electrocautery or interstitial laser photocoagulation are available. Imaging procedures plays a key role in PEI, as they provide a reliable assessment of the therapeutic effect of the procedure. [References: 99]RLDB - MEDLINE UI - 97088197 IN - Department of Radiology, University of Pisa, Italy JC - cl3 Journal Subset AIM Journals CP - Germany PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 199702 Revised: 20001218. Entry Week: 199702 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0938-7994 P29leInterstitial laser thermotherapy in the treatment of colorectal liver metastases. [Review] [143 refs]$Muralidharan,V. Christophi,C. 2001 1/2001*Colorectal Neoplasms/pa [Pathology] *Colorectal Neoplasms/th [Therapy] *Hyperthermia,Induced/mt [Methods] *Lasers/tu [Therapeutic Use] *Liver Neoplasms/sc [Secondary] *Liver Neoplasms/th [Therapy] Colorectal Neoplasms/mo [Mortality] Human Liver Liver Neoplasms/mo [Mortality] Liver/pa [Pathology] Liver/us [Ultrasonography] Morbidity Necrosis surgery Survival Rate therapy Treatment Outcome United States Cause of Death 73-81"Journal of Surgical Oncology761Metastatic liver disease is the commonest cause of death in patients with colorectal cancer. A small proportion of these patients (10%) may be treated by surgical resection with five year survival approaching 35-40%.Alternative treatment modalities for localised hepatic disease include in situ ablative techniques that have the advantages of percutaneous application and minimal morbidity. These include Interstitial Laser Thermotherapy (ILT), Radio Frequency Ablation, Percutaneous Microwave therapy, and Focussed Ultrasound Therapy. This article focuses specifically on the development and utilisation of ILT in the treatment of colorectal liver metastases. It provides a review of the pathophysiological factors involved, present status of clinical studies, and future directions. ILT is a safe technique for the treatment of colorectal liver metastases. It may be delivered by minimally invasive techniques to lesions considered unresectable by present criteria. Limitations include the extent and completeness of tumour necrosis achieved as well as imaging techniques. Clinical problems include a lack of controlled studies. Assessment of long-term survival in prospective randomised trials is needed to assess the efficacy of this procedure. [References: 143]DB - MEDLINE UI - 21126325 IN - Hepato-Biliary Section, Monash University, Department of Surgery, Alfred Hospital, Prahran, Australia. Vijayaragavan.Muralidharan@med.monash.edu.au JC - k79, K79, K79, 0222643 Journal Subset Index Medicus CP - United States PT - Journal Article PT - Review PT - Review, Tutorial LG - English EM - 20010315. Entry Week: 20010315 RefMgr field[1]: Journal RefMgr field[8]: Not in File RefMgr field[26]: 0022-4790s Surowiec, A. Bicher, H. I.ZTHeating characteristics of the TRIPAS hyperthermia system for deep seated malignancy:3Journal of Microwave Power & Electromagnetic Energy 1995303l 135-40Acrylic Resins Adipose Tissue/ah [Anatomy & Histology] Adipose Tissue/ph [Physiology] Body Temperature Equipment Design Gels Heat Human Hyperthermia, Induced/is [Instrumentation] *Hyperthermia, Induced/mt [Methods] Lung/ah [Anatomy & Histology] Lung/ph [Physiology] *Microwaves/tu [Therapeutic Use] Models, Structural Muscle, Skeletal/ah [Anatomy & Histology] Muscle, Skeletal/ph [Physiology] *Neoplasms/th [Therapy] Thermal ConductivityleA deep heating hyperthermia device TRIPAS (a triapplicator system) consisting of three independent, dielectrically loaded horn applicators operating in phase at 300 MHz was investigated. The heating characteristics produced by this hyperthermia system were analyzed by means of thermochromic liquid-crystal cards and a modified CDRH (Center for Devices and Regulatory Health) elliptical phantom. Both homogenous and inhomogeneous phantoms were used, simulating high and low permittivity tissues (muscle and lung). These equivalent tissues were made of polyacrylamide gel. The semiquantitative heating pattern analysis showed a central heating of 1/3 of maximum heating at a depth of 10 cm in both homogenous (muscle) and heterogenous (muscle/fat) phantoms. Also more uniform temperature/SAR distributions were generated in muscle equivalent material than those in lung. 110342407g9g 2000 OctmHBSurvival after resection of multiple hepatic colorectal metastases 643-50$BACKGROUND: Hepatic resection is potentially curative in selected patients with colorectal metastases. It is a widely held practice that multiple colorectal hepatic metastases are not resected, although outcome after removal of four or more metastases is not well defined. METHODS: Patients with four or more colorectal hepatic metastases who submitted to resection were identified from a prospective database. Number of metastases was determined by serial sectioning of the gross specimen at the time of resection. Demographic data, tumor characteristics, complications, and survival were analyzed. RESULTS: From August 1985 to September 1998, 155 patients with four or more metastatic tumors (range 4-20) underwent potentially curative resection by extended hepatectomy (39%), lobectomy (42%), or multiple segmental resections (19%). Operative morbidity and mortality were 26% and 1%, respectively. Actuarial 5-year survival was 23% for the entire group (median = 32 months) and there were 12 actual 5-year survivors. On multivariate analysis, only number of hepatic tumors (P = .005) and the presence of a positive margin (P = .003) were independent predictors of poor survival. CONCLUSIONS: Hepatic resection in patients with four or more colorectal metastases can achieve long-term survival although the results are less favorable as the number of tumors increases. Number of hepatic metastases alone should not be used as a sole contraindication to resection, but it is clear that the majority of patients will not be cured after resection of multiple lesions.'d]Hepatobiliary Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.LEWeber, S. M. Jarnagin, W. R. DeMatteo, R. P. Blumgart, L. H. Fong, Y. 1068-9265 Journal ArticleAnn Surg OncolAdult Aged Colorectal Neoplasms/*pathology Female Human Liver Neoplasms/*mortality/secondary/*surgery Male Middle Age New York City/epidemiology Prognosis Prospective Studies Severity of Illness Index Survival Analysislehttp://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11034240