September 28, 2012

Surgery


Surgery options are limited to individuals whose tumors less than 5 cm and confined to the liver, with no invasion of blood vessels.

Liver resection

The purpose of  liver resection is a complete lifting of the tumor and surrounding liver tissue without leaving any corresponding tumor behind.
This option is limited to patients with one or two small tumors (3 cm or less) and a perfect liver function, ideally without associated cirrhosis. As a result of the strict guidelines of this, in practice, only very few patients with liver cancer can undergo liver resection. The biggest concern about resection is that after surgery, patients may develop liver failure. Liver failure can occur if the remaining fragments of the liver is not sufficient to provide the support necessary to live. Even in patients selected with care, approximately 10% of them expected to die soon after surgery, usually as a result of liver failure.
When a small part of the normal liver is removed, the remaining liver can grow back (regenerate) to the original size within one to two weeks. An air-cirrhotic liver, however, can not grow back. Therefore, before resection is done for cancer of the liver, the liver is not tumor be biopsied to determine whether there is associated cirrhosis.

For patients with tumors slashed with a successful, five-year survival is approximately 30 to 40%. This means that 30 to 40% of patients who actually underwent liver resection for liver cancer are expected to live five years. Many of these patients, however, will have a recurrence of liver cancer elsewhere in the liver. More than that, it should be noted that the survival rate of patients not treated with tumor sizes are similar and similar liver function may be comparable. Several studies from Europe and Japan have shown that the survival figures with injections of alcohol or procedures with radio frequency ablation (radiofrequency ablation procedures) is comparable to the survival figures of patients who underwent resection. But again, the reader must be careful that no head comparisons with the heads of these procedures against resection.


Heart Transplant or Liver Transplantation


Liver transplantation has become an acceptable treatment for patients with end-stage liver disease of various types (eg, chronic hepatitis B and C, alcoholic cirrhosis, primary biliary cirrhosis, and sclerosing cholangitis). Survival figures for patients without liver cancer was 90% at one year, 80% in three years, and 75% in five years. Moreover, liver transplantation is an option / best option for patients with tumors less than 5 cm in size which also has signs of liver failure. In fact, as one would expect, patients with small cancers (less than 3 cm) and no involvement of blood vessels run very well. These patients have a recurrence risk of liver cancer is less than 10% after transplantation. On the other hand, there is a very high risk of recurrence in patients with tumors larger than 5 cm or with involvement of blood vessels. For these reasons, when patients are being evaluated for liver cancer treatment, every effort should be made to characterize the tumor and look for signs of spread beyond the liver.

There is a severe shortage of organ donors in the United States. Today, there are approximately 18.000 patients on the waiting list for liver transplantation. Approximately 4.000 liver from a cadaver (taken time of death) are donated are available each year for patients with the highest priority. Priority is given to patients on the transplant waiting list who have the most severe liver failure. As a result, in many patients with liver cancer, when they are on the waiting list, the tumor may be too large for the patient to benefit from a liver transplant. Perform treatments that alleviate / relieve, such as TACE, when patients are on waiting lists for liver transplantation is now being evaluated.

The use of a part of a healthy liver from a living donor and healthy may provide in some patients with liver cancer a chance to undergo liver transplantation before the tumor becomes too large. This innovation is a very exciting development in the field of liver transplantation.
As a precaution, do a biopsy or aspiration of liver cancer may be avoided in patients who are considering a liver transplant. Cause to avoid pricking the heart with a needle is there about 1-4% risk of implant cancer cells from the tumor by the needle into the liver along the needle path. You see, after a liver transplant, patients taking drugs of anti-rejection is very strong to prevent the patient's immune system from rejecting the new liver. However, the immune system is suppressed to allow foci (small areas) are new from the cancer cells to multiply / multiply rapidly. Foci-new foci of cancer cells would normally be on hold at bay by the immune cells of an intact immune system.

In summary, liver resection should be reserved for patients with small tumors and normal liver function no evidence of cirrhosis. Patients with tumors that much or greater should receive therapy to relieve / ease with intra-arterial chemotherapy or TACE, provided they do not have signs of severe liver failure. Patients with stage early signs cancer and cancer in chronic liver should receive treatment to relieve / ease and undergoing evaluation for liver transplantation.
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Surgery


Surgery options are limited to individuals whose tumors less than 5 cm and confined to the liver, with no invasion of blood vessels.

Liver resection

The purpose of  liver resection is a complete lifting of the tumor and surrounding liver tissue without leaving any corresponding tumor behind.
This option is limited to patients with one or two small tumors (3 cm or less) and a perfect liver function, ideally without associated cirrhosis. As a result of the strict guidelines of this, in practice, only very few patients with liver cancer can undergo liver resection. The biggest concern about resection is that after surgery, patients may develop liver failure. Liver failure can occur if the remaining fragments of the liver is not sufficient to provide the support necessary to live. Even in patients selected with care, approximately 10% of them expected to die soon after surgery, usually as a result of liver failure.
When a small part of the normal liver is removed, the remaining liver can grow back (regenerate) to the original size within one to two weeks. An air-cirrhotic liver, however, can not grow back. Therefore, before resection is done for cancer of the liver, the liver is not tumor be biopsied to determine whether there is associated cirrhosis.

For patients with tumors slashed with a successful, five-year survival is approximately 30 to 40%. This means that 30 to 40% of patients who actually underwent liver resection for liver cancer are expected to live five years. Many of these patients, however, will have a recurrence of liver cancer elsewhere in the liver. More than that, it should be noted that the survival rate of patients not treated with tumor sizes are similar and similar liver function may be comparable. Several studies from Europe and Japan have shown that the survival figures with injections of alcohol or procedures with radio frequency ablation (radiofrequency ablation procedures) is comparable to the survival figures of patients who underwent resection. But again, the reader must be careful that no head comparisons with the heads of these procedures against resection.


Heart Transplant or Liver Transplantation


Liver transplantation has become an acceptable treatment for patients with end-stage liver disease of various types (eg, chronic hepatitis B and C, alcoholic cirrhosis, primary biliary cirrhosis, and sclerosing cholangitis). Survival figures for patients without liver cancer was 90% at one year, 80% in three years, and 75% in five years. Moreover, liver transplantation is an option / best option for patients with tumors less than 5 cm in size which also has signs of liver failure. In fact, as one would expect, patients with small cancers (less than 3 cm) and no involvement of blood vessels run very well. These patients have a recurrence risk of liver cancer is less than 10% after transplantation. On the other hand, there is a very high risk of recurrence in patients with tumors larger than 5 cm or with involvement of blood vessels. For these reasons, when patients are being evaluated for liver cancer treatment, every effort should be made to characterize the tumor and look for signs of spread beyond the liver.

There is a severe shortage of organ donors in the United States. Today, there are approximately 18.000 patients on the waiting list for liver transplantation. Approximately 4.000 liver from a cadaver (taken time of death) are donated are available each year for patients with the highest priority. Priority is given to patients on the transplant waiting list who have the most severe liver failure. As a result, in many patients with liver cancer, when they are on the waiting list, the tumor may be too large for the patient to benefit from a liver transplant. Perform treatments that alleviate / relieve, such as TACE, when patients are on waiting lists for liver transplantation is now being evaluated.

The use of a part of a healthy liver from a living donor and healthy may provide in some patients with liver cancer a chance to undergo liver transplantation before the tumor becomes too large. This innovation is a very exciting development in the field of liver transplantation.
As a precaution, do a biopsy or aspiration of liver cancer may be avoided in patients who are considering a liver transplant. Cause to avoid pricking the heart with a needle is there about 1-4% risk of implant cancer cells from the tumor by the needle into the liver along the needle path. You see, after a liver transplant, patients taking drugs of anti-rejection is very strong to prevent the patient's immune system from rejecting the new liver. However, the immune system is suppressed to allow foci (small areas) are new from the cancer cells to multiply / multiply rapidly. Foci-new foci of cancer cells would normally be on hold at bay by the immune cells of an intact immune system.

In summary, liver resection should be reserved for patients with small tumors and normal liver function no evidence of cirrhosis. Patients with tumors that much or greater should receive therapy to relieve / ease with intra-arterial chemotherapy or TACE, provided they do not have signs of severe liver failure. Patients with stage early signs cancer and cancer in chronic liver should receive treatment to relieve / ease and undergoing evaluation for liver transplantation.