Biomedical subjects

Y Ku

Publications and source records attributed to Y Ku.

183 records · Page 11Linked to original sources

PubMedDate not supplied

Two-staged treatment with local resection and percutaneous isolated hepatic chemoperfusion for advanced pancreatic cancer with multiple liver metastases: report of a case.

There have been disappointingly few effective treatment modalities for multiple liver metastases from pancreatic cancer. Percutaneous isolated hepatic perfusion, which was developed by us for delivering dose-intensive chemotherapy to the liver, has a high efficacy in the majority of patients with multiple primary and secondary liver tumors. We herein report the first experience of a two-stage treatment with extended local resection and subsequent two percutaneous isolated hepatic perfusions for advanced pancreatic ductal adenocarcinoma with liver metastases. The second percutaneous isolated hepatic perfusion with high-dose cisplatin and mitomycin G demonstrated a distinct regression of metastatic liver tumors. Although a long-term patient survival was not obtained due to local recurrence, liver metastases have been well controlled ever since. Given that further studies establish the efficacy of percutaneous isolated hepatic perfusion also in this field, this modality would be used as prophylaxis as well as treatment of liver metastasis in patients with advanced pancreatic ductal adenocarcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Proliferating cell nuclear antigen, p53, and c-erbB-2 expression in relation to clinicopathological variables and prognosis in cancer of the ampulla of Vater.

BACKGROUND/AIMS: Various clinicopathological factors have been thought to influence the prognosis of ampullary cancers. Recent advances in molecular biology should provide much useful information on the prognostic factors of ampullary carcinomas. METHODOLOGY: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 were immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and prognosis were studied and correlations among these factors were investigated. RESULTS: The mean PCNA-positive rate was 39.1%. The percentages of cases positive for p53 and c-erbB-2 were 53% and 23%, respectively. No correlation was seen between PCNA, p53, or c-erbB-2 expression and clinicopathological variables. The optimum cut-off of PCNA indices influencing recurrence was decided as 40% by receiver operator characteristic curves. The cumulative disease-free survival rate of patients from the > or = 40% PCNA positive rate group was significantly poorer than that of the < 40% PCNA positive rate group (P < 0.01). p53 accumulation and c-erbB-2 expression were not correlated with prognosis. Multivariate analysis revealed that the PCNA positive rate and lymph node metastasis independently contributed to survival (P < 0.05). CONCLUSIONS: PCNA expression is a useful prognostic marker; however, p53 and c-erbB-2 overexpression are not useful as biomarkers for ampullary cancers.

Adult↗

PubMedDate not supplied

Efficacy of repeated percutaneous isolated liver chemoperfusion in local control of unresectable hepatocellular carcinoma.

BACKGROUND/AIMS: Percutaneous isolated liver chemoperfusion (PILP) with hepatic venous isolation and charcoal hemoperfusion (HVI-CHP) enables high-dose intraarterial infusion of cytotoxic agents while reducing systemic toxicity. We report here the effect of repeated PILP with HVI-CHP on local control of unresectable hepatocellular carcinoma (HCC). METHODOLOGY: After placement of a hepatic arterial infusion (HAI) catheter, a 4-lumen-2-balloon catheter (24F) was introduced into the retrohepatic inferior vena cava through the femoral vein, and the balloons were inflated to accomplish HVI. During HAI of adriamycin (60-150 mg/m2), total hepatic venous outflow was captured via fenestrations of one major lumen between the balloons and pumped out into CHP filters. The filtered blood was returned to the right atrium through the end opening of another major lumen of the catheter. Of 30 patients, 8 had repeated PILP in a range of 2-4 treatments, and 22 had a single treatment. RESULTS: Eleven (52%) of 21 evaluable patients in the single PILP group and 7 out of 8 patients (88%) in the repeated PILP group had partial or complete response. Median durations of response in responding patients were 6 and 21 months in the single and the repeated PILP groups, respectively (p=0.02). The 1- and 2-year survival rates (single vs. repeated) were 57% vs 88%, and 29% vs 70%, respectively (p=0.05). CONCLUSIONS: Repeated PILP could be performed safely in patients with advanced HCC and significantly prolonged the duration of remission in patients with unresectable HCC.

Adult↗