Navegando por Palavras-chave "Hepatocarcinoma"

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    Apresentações incomuns do hepatocarcinoma: ensaio iconográfico
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2006-04-01) D'Ippolito, Giuseppe [UNIFESP]; Abreu Junior, Luiz de; Borri, Maria Lucia [UNIFESP]; Galvão Filho, Mário de Melo; Hartmann, Luiz Guilherme C.; Wolosker, Angela Maria Borri; Ribeiro, Marcelo [UNIFESP]; Salem, Marcelo Zindel; Misiara, Adriano; Universidade Federal de São Paulo (UNIFESP); Hospital São Luiz - Itaim Serviço de US/TC/RM; Hospital São Luiz Setor de Diagnóstico por Imagem; Universidade de São Paulo (USP)
    In order to evaluate atypical aspects of hepatocellular carcinoma at computed tomography and magnetic resonance imaging, we have retrospectively evaluated 100 patients with diagnosed hepatocellular carcinoma, based on combined imaging studies, laboratory results, biopsy and surgery. We have selected those cases with atypical findings at computed tomography or magnetic resonance imaging, including cystic lesions, bleeding tumors, with calcifications, with spontaneous regression, pedunculated tumors, hypovascular lesions, giant hepatocellular carcinomas, and those with unusual local invasiveness. The hepatocellular carcinoma is the most usual primary malignant lesion of the liver and usually it has a typical aspect and is associated with hepatic cirrhosis. However, in a significant number of cases, some uncommon findings can be responsible for a delayed diagnosis.
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    Contribuição da quimioembolização de hepatocarcinomas em pacientes cirróticos na espera pelo transplante hepático
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2005-02-01) Langer, Luís Francisco [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]; Amorim, Jorge Eduardo de [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To evaluate the results of hepatocellular carcinoma arterial chemoembolization in cirrhotic patients awaiting liver transplantation. MATERIALS AND METHODS: Twenty-three cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation were submitted to multiple sessions of chemoembolization using mitomycin C and lipiodol. A prospective evaluation of the following factors was performed: a) serum levels of alpha-fetoprotein; b) tumor size; c) maintenance of the viability criteria for hepatic transplantation; d) degree of liver dysfunction. RESULTS: The mean serum levels of alpha-fetoprotein were reduced by 43% during the first 13 months. The mean tumor size, as measured by the long axis, after a mean follow-up period of 13.5 months was 3.2 cm, which is considered stable for the period according to the World Health Organization criteria. The mean survival rate was 14 months. CONCLUSION: In this trial, pre-transplantation use of chemoembolization in combination with an adequately chosen therapy showed few complications and contra-indications as well as a considerable anti-tumor efficacy. Despite the fact that the adopted therapy increased survival rates in comparison to historical evolution data in hepatocellular carcinoma, this increase had not the same dimension if the median waiting time for transplantation is taken into consideration. Therefore, other strategies need to be associated to either make survival rate longer or to reduce transplantation waiting time.
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    Liver Transplantation For Carcinoma Hepatocellular In Sao Paulo: 414 Cases By The Milan/Brazil Criteria
    (Colegio Brasileiro Cirurgia Digestiva-Cbcd, 2016) Sá, Gustavo Pilotto Domingues [UNIFESP]; Vicentine, Fernando Pompeu Piza [UNIFESP]; Salzedas-Netto, Alcides Augusto [UNIFESP]; Matos, Carla Adriana Loureiro de [UNIFESP]; Romero, Luis Ramiro Núñez [UNIFESP]; Tejada, Dario Fernandes Perdomo [UNIFESP]; Bosco Massarollo, Paulo Celso; Lopes Filho, Gaspar de Jesus [UNIFESP]; Gonzalez, Adriano Miziara [UNIFESP]
    Background: The criterion of Milan (CM) has been used as standard for indication of liver transplantation (LTx) for hepatocellular carcinoma (HCC) worldwide for nearly 20 years. Several centers have adopted criteria expanded in order to increase the number of patients eligible to liver transplantation, while maintaining good survival rates. In Brazil, since 2006, the criterion of Milan/Brazil (CMB), which disregards nodules <2 cm, is adopted, including patients with a higher number of small nodules. Aim: To evaluate the outcome of liver transplantation within the CMB. Methods: The medical records of patients with HCC undergoing liver transplantation in relation to recurrence and survival by comparing CM and CMB, were analyzed. Results: 414 LTx for HCC, the survival at 1 and 5 years was 84.1 and 72.7%. Of these, 7% reached the CMB through downstaging, with survival at 1 and 5 years of 93.1 and 71.9%. The CMB patient group that exceeded the CM (8.6%) had a survival rate of 58.1% at five years. There was no statistical difference in survival between the groups CM, CMB and downstaging. Vascular invasion (p<0.001), higher nodule size (p=0.001) and number of nodules >2 cm (p=0.028) were associated with relapse. The age (p=0.001), female (p<0.001), real MELD (p<0.001), vascular invasion (p=0.045) and number of nodes >2 cm (p<0.014) were associated with worse survival. Conclusions: CMB increased by 8.6% indications of liver transplantation, and showed survival rates similar to CM.