CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Čes. Radiol., 57, 2003, No. 3, p. 111–129. |
Comprehensive Approach to the Treatment of Malignant Liver Tumours.
State of the Art Válek A. V.1, Boudný J.1, Kiss I.2, Kala Z.3 Radiologická klinika, FN Brno - Bohunice1 přednosta doc. MUDr. A. V. Válek, CSc. Oddělení klinické onkologie, FN Brno - Bohunice2 primář MUDr. I. Kiss Chirurgická klinika, FN Brno - Bohunice3 přednosta prof. MUDr. J. Vomela, CSc. |
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Summary: Treatment of hepatic metastases is a problem. At the time of diagnosis resection of the liver is
possible in 15–30% patients. In this group however in 30–40% patients within 16–24 months recurrence
of the disease occurs in the remainder of the liver. Despite this resection is generally
considered the only way to cure these patients. The objective of other methods is according to
common practice to prolong the rest of life of these patients. Non-surgical approaches to these
patients improved and many workers consider them an alternative of resection.
The position is similar in patients with primary malignant liver tumours, in particular hepatocellular
carcinoma. In adults however hepatocellular carcinoma (HCC) is in as many as 80% inoperable
(in particular due to the freqeunt associated cirrhosis of the liver or multicentric character of the
tumour). Although in these patients liver transplantation is a possible alternative, the majority of
patients receive systemic chemotherapy.
The endeavour of a multimodal approach to the treatment of malignant liver processes is to offer
these patients optimum care and achieve thus not only prolongation of life but to cure the greatest
possible proportion of patients where surgery is not possible.
High standard treatment of liver metastases can followonly after a very good andaccurate diagnosis
with a high sensitivity and specificity which from the aspect of contemporary medicine implies in
diagnoses of livermetastases 98% and 94% resp. These results can be achieved only by a combination
of procedures which include in addition to sonography, CT andMR(with the use of specific contrast
substances) in particular CTA and CTAP.
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