Liver cancer
Liver cancer. It is 1-1.5% of all malignant tumors. The most frequently developed hepatocellular carcinoma (90%), less often, cholangiocellular (10%). The development of liver cancer can occur against the background of previous cirrhosis or without it.
The clinical symptoms, depending on this, are different. If a sharp deterioration in the general condition is noted against the background of signs of cirrhosis of the liver, rapid loss of body weight, pain in the right upper quadrant, an increase in laboratory signs of liver dysfunction, the appearance of ascites, and the size of focal formations according to ultrasound tomography, it is reasonable to suggest liver cancer. In other cases, on the background of a favorable general condition, the liver is enlarged by palpation, and on ultrasound and computer tomograms a tumor with small formations or without them is detected (the nodular form). Sometimes a large node is not detected (diffuse form). With the progression of the disease, intra-abdominal bleeding, jaundice, ascites, and other symptoms may develop.
Diagnosis of liver cancer is established with a tumor biopsy (percutaneous, laparoscopic). It is important to determine ifphetoprotein in the blood, the level of which in hepatocellular carcinoma is high in 70-90% of patients. The degree of spread of the disease is also established with angiography. Differential diagnosis is performed with metastatic cancer. Metastases of liver cancer occur within the body, less often (30-50%) in periportal lymph nodes, lungs, bones.
Treatment. With localized liver cancer, liver resection is performed. Five-year survival rate averages 15-30%, the best results are obtained with a highly differentiated cancer. Temporary objective and subjective improvement gives a ligation or embolization of the hepatic artery. Improvement is also observed with chemotherapy carried out through the hepatic artery (5-fluoro-uracil, adriamycin, mitomycin C) or systemically intravenously using combinations of adriamycin-50 mg / m2 on day 1 and 5-fluorouracil-600 mg / m2 in 1 8th and 8th days; Carminomycin - 18 mg / m2 on day 1 and bleomycetin - 10-15 mg every other day, 5 doses.
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