Primary carcinoma of the liver: Improvement in sight?

A retrospective analysis of 99 histologically verified primary liver carcinomas seen at the Department of Surgery, University of Lund, from 1965 to 1978 has been performed. The material is comparable to other studies with regard to age and sex distribution and occurrence of cirrhosis. The common presenting symptoms were abdominal discomfort and weight loss. During 1965–1970, most diagnoses were made at laparotomy or at autopsy. There was a low incidence of resectability and a short mean survival rate. In the latter half of the study, 1971–1978, wider use of thin needle biopsy, angiography and liver scan has contributed to more accurate preoperative diagnoses in this group. Diagnoses seemed also to be made at an earlier stage of the disease in this group, which led to a higher resectability. This, in combination with postoperative adjuvant chemotherapy, may have contributed to the favorable results, with more than half of the patients alive 24 months after resection.

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Résumé Une étude rétrospective de 99 cas de cancer primitif du foie vérifiés histologiquement et opérés dans le département de chirurgie de Lund de 1965 à 1978 a été entreprise. Cette série est comparable en ce qui concerne l'âge et le sexe à des stastistiques portant sur la cirrhose. Les éléments les plus constants de diagnostic furent représentés par l'inconfort abdominal et l'amaigrissement. De 1965 à 1970 le diagnostic fut surtout porté lors de la laparotomie ou a l'autopsie. Le taux de l'exérèse fut très bas ainsi que celui de la survie. De 1971 à 1978 le recours à la biopsie à l'aiguille, à l'angiographie et à la scintigraphie hépatique permis un diagnostic plus précoce ce qui a permis d'entreprendre un plus grand nombre d'exérèse. L'amélioration du traitement chirurgical combiné à la chimiothérapie post opératoire a entraÎné de meilleurs résultats, plus de la moitié des malades ayant survécu plus de 24 mois.

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Supported by grants from the Swedish Cancer Society No. 98-B80-15XA and 1081-B80-03X.     

Metastatic disease in the liver from colorectal cancer: An appraisal of liver surgery

This study supports the opinion that liver resection or metastasis enucleation with a margin of normal tissue around the tumor for liver metastases from colorectal cancer can be recommended. The 3-year survival rate of 20–25% is far better than the 3-year survival rates reported after resection of the primary organ for cancers such as, for example, the pancreas and esophagus and is almost as good as that of surgery of primary rectal cancer Dukes' C. Liver resection has an acceptably low postoperative mortality (less than 10%), morbidity, and complication rate.

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Résumé Cette étude permet d'affirmer que les méthodes de résection hépatique ou d'énucléation résection appliquées aux metastases hépatiques des cancers coliques et rectaux méritent d'Être tentées. Le taux de survie à 3 ans est de 20 à 25 pour cent. Il est supérieur à celui des exérèses pour cancer de l'oesophage ou par cancer du pancréas par exemple. Il est presqu'aussi satisfaisant que le taux de survie après exérèse du cancer rectal ayant atteint le type C de la classification de Dukes.La résection hépatique a un taux de complication, de morbidité et de mortalité post opératoire bas acceptable (moins de 10%).

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Supported by grants from the Swedish Cancer Society, grant no. 98-B80-15XA and grant no. 1081-B80-03X.     

Influence of hepatic artery ligation on survival: An experimental study in rats

Interruption of the arterial blood supply to the liver has been used clinically for more than 15 years in patients with nonresectable liver tumors. The induced effect of hepatic artery occlusion on blood flow and metabolism has been studied extensively, whereas survival time has hardly been examined. Evidence of prolongation of survival after hepatic artery ligation, although not properly statistically analyzed, has been found in previous series of experimental animals, but the effect has not been established clinically. In this experimental study of rats with adenocarcinoma in the liver, a statistically significant prolongation of survival time was observed for the animals subjected to hepatic artery ligation when compared with untreated control animals. A statistically significant increase in body weight developed in all ligated animals during the experimental period, whereas the untreated control animals showed a statistically significant decrease in body weight.     

Comparison of laser fluorescence and longitudinal microradiography for quantitative assessment of in vitro enamel caries.

A new quantitative, non-destructive method using laser-induced fluorescence (LAF) was compared with longitudinal microradiography (LMR) for assessment of mineral changes in enamel slices using an in vitro caries model. Ten enamel slices, cut longitudinally from sound natural smooth surfaces of human teeth, were exposed to de- and remineralization in a pH-cycling model. The enamel slices were subjected to LAF and LMR measurements before and at 2, 4, 7, and 9 days of demineralization. For LAF, the average fluorescence radiance decreased during the demineralization period with 11% by day 2 and 49% by day 9. For LMR, the corresponding average loss of mineral content changed with 0.01 and 0.10 kg.m-2 over the same time period. The mineral losses in each individual enamel slice measured with the two techniques were strongly correlated, r = 0.97. The Spearman rank correlation coefficient for all LAF and LMR demineralization results was 0.86. The precision (coefficient of variation) for LAF was 3.1%, corresponding to 0.005 kg.m-2, and the repeatability error for LMR was 0.02 kg.m-2, indicating a lower discrimination threshold for LAF compared to LMR. It was concluded that the new, sensitive, non-destructive LAF method provides possibilities for further improvement in the quantification of initial caries lesions in natural smooth enamel surfaces for use in in vitro studies. Furthermore, it offers potential in in situ caries studies as well as a tool in the diagnosis of early enamel caries in vivo.