Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors

<p>Abstract</p> <p>Background</p> <p>Brain metastases (BM) from hepatocellular carcinoma (HCC) are extremely rare and are associated with a poor prognosis. The aim of this study was to define clinical outcome and prognostic determinants in patients with BM from HCC.</p> <p>Methods</p> <p>Between January 1994 and December 2009, all patients with HCC and BM treated in Sun Yat-sen University Cancer Center were retrospectively reviewed. Univariate and multivariate survival analyses were performed to identify possible prognostic factors.</p> <p>Results</p> <p>Forty-one patients were diagnosed with BM from HCC, an incidence of 0.47%. The median age at diagnosis of BM was 48.5 years. Thirty-three patients (80.5%) developed extracranial metastases at diagnosis of BM, and 30 patients (73.2%) had hepatitis B. Intracranial hemorrhage occurred in 19 patients (46.3%). BM were treated primarily either with whole brain radiation therapy (WBRT; 5 patients), stereotactic radiosurgery (SRS; 7 patients), or surgical resection (6 patients). The cause of death was systemic disease in 17 patients and neurological disease in 23. Patients in a high RPA (recursive partitioning analysis) class, treated with conservatively and without lung metastases, tended to die from neurological disease. Median survival after the diagnosis of BM was 3 months (95% confidence interval: 2.2-3.8 months). In multivariate analysis, the presence of extracranial metastases, a low RPA class and aggressive treatment, were positively associated with improved survival.</p> <p>Conclusions</p> <p>BM from HCC is rare and associated with an extremely poor prognosis. However, patients with a low RPA class may benefit from aggressive treatment. The clinical implication of extracranial metastases in HCC patients with BM needs further assessment.</p

Sampling methods used for the collection of particle-phase organic and elemental carbon during ACE-Asia

The semi-volatile nature of carbonaceous aerosols complicates their collection, and for this reason special air sampling configurations must be utilized. ACE-Asia provided a unique opportunity to compare different sampling techniques for collecting carbonaceous aerosols. In this paper detailed comparisons between filter-based carbonaceous aerosol sampling methods are made. The majority of organic carbon (OC) present on a backup quartz fiber filter (QFF) in an undenuded-filter sampler resulted from the adsorption of native gaseous OC rather than OC evaporated from collected particles. The level of OC on a backup QFF placed behind a QFF was lower than the level present on a backup QFF placed behind a Teflon membrane filter (TMF) indicating that gas/filter equilibrium may not be achieved in some QFF front and backup filter pairs. Gas adsorption artifacts can result in a 20-100\% overestimation of the ambient particle-phase OC concentration. The gas collection efficiency of XAD-coated and carbon-impregnated filter-lined denuders were not always 100\%, but, nonetheless, such denuders minimize gas adsorption artifacts. The median fraction of particle-phase OC that is estimated to evaporate from particles collected by denuder-filter samplers ranged from 0 to 0.2; this value depends on the sampler configuration, chemical composition of the OC, and sampling conditions. After properly correcting for sampling artifacts, the measured OC concentration may differ by 10\% between undenuded- and denuder-filter samplers. Uncorrected, such differences can be as large as a factor two, illustrating the importance of sampling configurations in which gas adsorption or evaporation artifacts are reduced or can be corrected. (C) 2003 Elsevier Science Ltd. All rights reserved