Kanzo
Online ISSN : 1881-3593
Print ISSN : 0451-4203
ISSN-L : 0451-4203
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Volume 52, Issue 5
Displaying 1-9 of 9 articles from this issue
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Feature Article
Original Articles
  • Clinico-histopathological analysis of hepatocellular carcinoma invading the biliary tract
    Hiroshi Yagi, Alejandro Soto-Gutierrez, Rina Tsutsui, Yoshiko Aoyagi, ...
    Article type: Original Article
    2011 Volume 52 Issue 5 Pages 280-286
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.280
    JOURNAL FREE ACCESS
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    Since hepatocellular carcinoma can rarely invade directly to intrahepatic bile duct and form tumor thrombosis, disease mechanism is not fully understood. In this study, we evaluated its prognostic factors based on 5-year survival rate. The prognosis of 28 cases after surgical resection for hepatocellular carcinoma invading to biliary tract was retrospectively evaluated. Statistical analysis showed that four factors demonstrated higher risk ratios: a) non-carrier of hepatitis B or C virus, b) 5 cm or larger tumor size, c) the absence of fibrous capsule and d) poorly differentiated tumor. However, there was no statistical difference in outcome when different surgical procedures performed. These results demonstrated that these four factors are important for postoperative outcome. Interestingly, it suggested that extra hepatic bile duct resection is not necessary for the complete removal of rare this tumor.
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  • The status and problems in subsidizing interferon treatment in Gunma prefecture
    Satoru Kakizaki, Yuichi Yamazaki, Hiroaki Hashizume, Norio Horiguchi, ...
    Article type: Original Article
    2011 Volume 52 Issue 5 Pages 287-294
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.287
    JOURNAL FREE ACCESS
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    The subsidy for interferon treatment for chronic hepatitis is made by prefectures, and differs by region. In this study, we evaluated the status of and problems with this system in Gunma prefecture. The applicants were 1212 patients with hepatitis C and 10 patients with hepatitis B during the 2 years period from April 2008 until March 2010. The percentile of actual/expected patients was 52.7%. Gunma Prefecture consists of 10 regional medical areas. There are differences in the number of applicants and physicians certified by the Japan Society of Hepatology in each area. In a questionnaire for board members of the Gunma Communicating Assembly for the Treatment of Liver Diseases, 52.6% of members expected to improve this subsidy system. Since the introduction of the subsidy system, the number of new patients receiving interferon treatment has increased substantially. However, the percentile of actual/expected patients is not sufficient. The development of novel medical systems and enlightenment of patients are urgent issues. In addition, global programs with maintenance of community cooperation and work environment established by collaboration between medical staffs and administrative officials should be arranged.
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Case Reports
  • Four cases of sporadic acute hepatitis E in Mie, Japan who were infected with European type genotype 3 hepatitis E virus
    Hiroshi Okano, Tatsunori Nakano, Shimpei Matsusaki, Tomohiro Sase, Tom ...
    Article type: Case Report
    2011 Volume 52 Issue 5 Pages 295-302
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.295
    JOURNAL FREE ACCESS
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    From 2004 to 2010, we have seen four cases of sporadic acute hepatitis E in nothern or central district of Mie Prefecture, Japan, who contracted infection of rare genotype 3 hepatitis E virus (HEV) strains. The HEV strains recovered from the four patients were 99.3-99.5% identical to each other in the 412-nucleotide sequence within ORF2 and homologous to those circulating in European countries such as Spain, United Kingdom, and the Netherlands, suggesting the long-term maintenance of the European type genotype 3 HEV strains in a restricted area in Japan. None of these four patients had histories of consuming uncooked or undercooked meat and/or viscera from infected animals and of travel to European countries, and the source of infectious origin remains unknown. These results warrant careful observation of clinical and subclinical HEV infection in this area and implementation of infection prevention measures in the future.
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  • Two cases of advanced hepatocellular carcinoma successfully treated with Peg-INFα2a once every 2 weeks as a single agent
    Hiroko Oka, Osamu Yamazaki, Takao Manabe, Osamu Kurai, Seiko Yamaguchi ...
    Article type: Case Report
    2011 Volume 52 Issue 5 Pages 303-313
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.303
    JOURNAL FREE ACCESS
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    Here we report two cases of advanced hepatocellular carcinoma successfully treated with Peg-INFα2a as a single agent. In the first case, a 71-year-old female who had undergone partial hepatectomy when she was 65 years old. The HCC recurred in the following year. Though TACE, TAI were done repeatedly, many uncontrollable tumors appeared in succession. After administration of 180 μg of Peg-INFα2a once every 2 weeks, the titer of AFP had decreased from 75738 ng/ml to 25.8 ng/ml. In the second case, a 78-year-old male who had undergone partial hepatectomy in June 2007, was treated repeatedly by TAI for multiple recurrent tumors with no effectiveness. Eight months after administration of 90 μg of Peg-INFα2a once every 2 weeks, the multiple tumors were completely disappeared.
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  • Hepatocellular carcinoma with direct invasion to the stomach and the colon of the tumor thrombus in the epiploic vein
    Tatsunari Fukuoka, Tadashi Tsukamoto, Akishige Kanazawa, Sadatoshi Shi ...
    Article type: Case Report
    2011 Volume 52 Issue 5 Pages 314-321
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.314
    JOURNAL FREE ACCESS
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    A 69 year-old man had undergone transcatheter arterial chemoembolization eight times for six years to treat hepatitis C virus-related hepatocellular carcinoma (HCC). He was admitted to our hospital for further examination of the recurrence of HCC. Abdominal computed tomography, angiography, and gastroscopy showed HCC which metastased to the stomach. We performed partial hepatectomy, distal gastrectomy, and transeverse colectomy to control the bleeding. According to the operating findings and histrogical findings, we diagnosed HCC with direct invasion to the stomach and the colon of the tumor thrombus in the epiploic vein.
    HCC with gastrointestinal involvement is rare. The prognosis of this disease is extremely poor.
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Short Communication
  • Comparison of Sorafenib response evaluation with RECIST, mRECIST and RECICL for hepatocellular carcinoma
    Eisuke Murakami, Hiroshi Aikata, Daisuke Miyaki, Yuko Nagaoki, Yoshima ...
    Article type: Short Communication
    2011 Volume 52 Issue 5 Pages 322-324
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.322
    JOURNAL FREE ACCESS
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    RECIST, mRECIST and RECICL are criteria for evaluating the therapeutic response of hepatocellular carcinoma and there are several differences among these criteria. We investigated and compared differences in the response evaluation of sorafenib treatment. As a result, mRECIST and RECIST showed a 59% disease control rate, while RECICL and mRECIST showed an 11% response rate. In RECIST and mRECIST, CR/PR/SD groups demonstrated a significantly better prognosis (P=0.02) than PD. The SD group prognosis was significantly better (P=0.045) than that of the PD group in mRECIST. Multivariate analysis of factors contributing to survival yielded the following values: disease control of mRECIST or RECIST (P=0.005), Vp (P=0.008) and pre-treatment DCP (P=0.047). Concerning Sorafenib therapy, mRECIST tend to stratify the prognosis and was considered the most useful criteria at this time.
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Rapid Communication
  • Sorafenib therapy for advanced hepatocellular carcinoma with Vp3 or 4 portal vein tumor thrombosis
    Teiji Kuzuya, Kaoru Tsuchiya, Keisuke Tanaka, Yuichiro Suzuki, Takahid ...
    Article type: Rapid Communication
    2011 Volume 52 Issue 5 Pages 325-326
    Published: 2011
    Released on J-STAGE: June 13, 2011
    DOIhttps://doi.org/10.2957/kanzo.52.325
    JOURNAL FREE ACCESS
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    We investigated efficacy of sorafenib therapy for advanced hepatocellular carcinoma (HCC) with Vp3/4 portal vein tumor thrombosis. According to modified RECIST, the therapeutic responses in Vp0/2 group (n=30) were 8 PR, 14 SD and 8 PD cases, and while those in Vp3/4 group (n=11) were 5 PR, 2 SD and 4 PD cases. The response rates and cumulative progression rates were not significantly different between two groups. The cumulative survival rates in Vp3/4 group were significantly lower than those in Vp0/2 group. The deteriorations of Child-Pugh scores in Vp3/4 group were significantly higher than those in Vp0/2 group. The possibility of the deterioration of liver function should be kept in mind during sorafenib therapy for advanced HCC with Vp3/4.
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Meeting Report
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