Kuninori Uemura

Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer

In six adult patients with nonresectable liver cancer, as well as in mature New Zealand white rabbits with implanted VX2 carcinoma in the liver, the artery feeding the hepatic lobe with the malignant lesion was ligated, and an oily contrast medium (Lipiodol Ultra‐Fluid) was injected into the hepatoproximal lumen of the ligated artery of the liver with carcinoma. The oily contrast medium was detected in all the branches of the artery injected, and thereafter was found only in tumor tissue for 7 days experimentally and for 16 months clinically. Taking advantage of this phenomenon, the therapeutic effect of the injection of an oily anticancer drug (bleomycin oil suspension) into the hepatoproximal lumen of the ligated hepatic artery was investigated in rabbits with VX2 carcinoma of the liver. The mean concentration level of bleomycin in the tumor tissue was 2.4 ± 0.4 μg/g 1 week after the injection of bleomycin oil suspension (1.5 mg potency/kg) in three rabbits. However, its concentration level in nontumorous tissue of the liver was undetectably low in two rabbits, but 0.6 μg/g in the third rabbit. The group of rabbits receiving an injection of bleomycin oil suspension into the ligated artery had a significantly longer mean survival time than those of the experimental group receiving an injection of saline solution of bleomycin into the ligated artery as well as the three other groups treated (P < 0.02, N = 5 for each group). It may be concluded that an oily anticancer drug injected into the hepatoproximal lumen of the ligated hepatic artery can intensify the anticancer effects of a ligation of the hepatic artery for liver cancer. Cancer 52:2193‐2200, 1983.

A CASE OF LUNG AND SKIN METASTASES FROM THYROID PAPILLARY CARCINOMA-A PATIENT WHO SURVIVED FOR A LONG TIME WITH MULTIMODAL THERAPIES AFTER TUMOR RELAPSE-

A 54-year-old man was admitted to our hospital because of thyroid papillary carcinoma invading the upper mediastine. We performed an operation against local recurrence 3 times after the first operation for the primary lesion. Lung metastasis appeared about 6 years after the first operation, and we tried various kind of therapies, such as 131I therapy, external radiotherapy, chemotherapy, and immunotherapy, but none of them could control the metastatic lesions. Finally, hemoptysis from lung metastases occurred and it was controlled by BAE (bronchial artery embolization). The patient also had painful skin metastases, which were resected. We consider that the establishment of a new therapy for patients with thyroid papillary carcinoma which is effective and which supports QOL is very important.

A CASE OF EARLY PRIMARY CANCER OF THE DUODENAL BULB

A surgically treated case of primary early cancer of the duodenal bulb was reported. The case was a 68-year-old man without any symptoms who was admitted to our hospital for further investigation, because an abnormarity of the stomach was suspected by mass screening examination. X-ray examination of the upper gastrointestinal tract revealed a round, well defined and elevated lesion, 4.5 cm in diameter, on the posterior wall of the duodenal bulb, and no abnormal findings in the stomach. Endoscopic examination showed a polypoid lesion with cauliflower-like appearance and the endoscopic biopsy specimen revealed an adenocarcinoma. Under a preoperative diagnosis of cancer of the duodenal bulb, pancreatoduodenectomy and lymphnode dissection were performed, because the tumor size was as large as 4.5 cm in diameter and possible metastases to the regional lymphnodes were not excluded. The resected tumor was 4.5×3.7 cm in size and 1.5 cm in height.Histological diagnosis was a well differentiated adenocarcinoma limited within the mucosa with no lymphnode metastasis. Postoperative course was uneventful and the patient is enjoying a symptom-free life as of 10 months after the operation.