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Biomedical subjects

Mark S Roh

Publications and source records attributed to Mark S Roh.

9 recordsLinked to original sources
PubMed2005

Staging classifications for hepatocellular carcinoma.

Evaluation and treatment of patients with hepatocellular carcinoma is dependent on accurate staging. Tumor-specific factors and the degree of underlying liver disease must be considered when evaluating patients with hepatocellular carcinoma. Clinical staging classification systems based on preinterventional data are predictive of survival and influence patient selection for various therapeutic modalities. Pathologic staging systems accurately assess prognosis and influence additional treatment post resection. The various staging systems for hepatocellular carcinoma are reviewed in detail. The benefits and limitations of these classification systems are discussed in this review. Considerable controversy remains over which classification system provides the optimum staging of hepatocellular carcinoma. The revised American Joint Committee on Cancer/International Union Against Cancer emphasizes the importance of major vascular and microvascular invasion as independent predictors of death and the negative impact of severe fibrosis/cirrhosis on survival following resection of hepatocellular carcinoma. As such, it is currently the most accurate staging system in this group of patients. Its applicability in those patients who are not candidates for resection is uncertain.

Carcinoma, Hepatocellular↗
PubMed2004

Utility of intraoperative liver ultrasound.

Intraoperative ultrasound has become an essential tool for the surgeon in the field of hepatobiliary surgery. No preoperative study has been able to duplicate the sensitivity and specificity of IOUS in the identification of occult lesions. With recent improvements in technology, IOUS has now become an indispensable means of defining the extent of disease and respectability, and providing a guide to anatomic and nonanatomic hepatic resections and minimally invasive and percutaneous ablative techniques.

Catheter Ablation↗
PubMed2004

Long-term survival after an aggressive surgical approach in patients with breast cancer hepatic metastases.

BACKGROUND: Metastatic breast cancer is generally believed to be associated with a poor prognosis. Therapeutic advances over the past two decades, however, have resulted in improved outcomes for selected patients with limited metastatic disease. METHODS: Between March 1991 and October 2002, 31 patients had hepatic resection for breast cancer metastases limited to the liver. Clinical and pathologic data were collected prospectively from breast and hepatobiliary databases. RESULTS: Median age of patients was 46 years (range, 31 to 70). Liver metastases were solitary in 20 patients and multiple in 11 patients. Median size of the largest liver metastasis was 2.9 cm (range, 1 to 8). Major liver resections (three or more segments resected) were performed in 14 patients, whereas minor resections (fewer than three segments resected) with or without radiofrequency ablation (RFA) were performed in 17 patients. No postoperative mortality occurred. Of the 31 patients, 27 (87%) received either preoperative or postoperative systemic therapy as treatment for metastatic disease. The median survival was 63 months; a single patient died within 12 months of hepatic resection. The overall 2- and 5-year survival rates were 86% and 61%, respectively, whereas the 2- and 5-year disease-free survival rates were 39% and 31%, respectively. No treatment- or patient-specific variables were found to correlate with survival rates. CONCLUSIONS: In selected patients with liver metastases from breast cancer, an aggressive surgical approach is associated with favorable long-term survival. Hepatic resection should be considered a component of multimodality treatment of breast cancer in these patients.

Adult↗