Results of Hepatectomy for Hepatocellular Carcinoma at the National Cancer Center Hospital

The number of hepatectomies has increased greatly in recent years. Surgery for hepatocellular carcinoma (HCC) in the normal liver has not increased. However, the increase in numbers of hepatectomies for HCC associated with liver cirrhosis is remarkable. More than 80% of our hepatectomy cases were cirrhotic and about 80% of these cirrhotic cases had HCCs 5cm or less in diameter. The operative mortality rate has improved in the latter half of this series, from 10.1% (9/89) to 1.5% (5/338), in spite of an increase in cases with poor liver function. This corresponds to a decrease in the mean value of the annual operative blood loss. The survival rates after hepatectomy for all cases (n = 378) were 40.6% ± 6.6 (% ± SE) for 5 year and 22.7% ± 5.3 for 10 year at the end of 1988. A difference of the 5-year survival rate between the patients operated on before 1981 (n = 78, 25.6% ± 4.9) and after 1982 (n = 300, 46.1% ± 4.8) was observed (p<0.05). Because the cancer-free survival rates of the patients operated on in the two periods, before 1981 and after 1982, were almost the same, the recent improvement of the survival rates seems to be due to a prolongation of survival time after recurrence

The Neural Basis of Recursion and Complex Syntactic Hierarchy

Language is a faculty specific to humans. It is characterized by hierarchical, recursive structures. The processing of hierarchically complex sentences is known to recruit Broca’s area. Comparisons across brain imaging studies investigating similar hierarchical structures in different domains revealed that complex hierarchical structures that mimic those of natural languages mainly activate Broca’s area, that is, left Brodmann area (BA) 44/45, whereas hierarchically structured mathematical formulae, moreover, strongly recruit more anteriorly located region BA 47. The present results call for a model of the prefrontal cortex assuming two systems of processing complex hierarchy: one system determined by cognitive control for which the posterior-to-anterior gradient applies active in the case of processing hierarchically structured mathematical formulae, and one system which is confined to the posterior parts of the prefrontal cortex processing complex syntactic hierarchies in language efficiently

Technical progress in living donor liver transplantation for adults

These manoeuvres should improve graft function and survival

A Phase II Trial of Combined Treatment of Endoscopic Mucosal Resection and Chemoradiotherapy for Clinical Stage I Esophageal Carcinoma: Japan Clinical Oncology Group Study JCOG0508

Standard treatment for clinical stage I esophageal cancer with submucosal invasion (T1b) has been surgical resection. We conducted a Phase II trial to evaluate the efficacy and the safety of combined treatment of endoscopic mucosal resection (EMR) and chemoradiotherapy for clinical stage I (T1b) esophageal cancer. Patients diagnosed as having clinical stage I (T1b) esophageal cancer which is considered to be resectable by EMR are eligible. When pathological examination of the EMR specimen confirms T1b tumor with negative or positive resection margin, the patient undergoes chemoradiotherapy. The study continues until 82 patients with T1b tumor with negative resection margin are enrolled from 20 institutions. The primary endpoint is 3-year overall survival (OS) in pT1b cases with negative resection margin. The secondary endpoints are 3-year OS and progression-free survival in all eligible cases, OS in pT1a-MM cases with margin-negative, complications of EMR and adverse events of chemoradiotherapy. The data from this trial will be expected to provide a non-surgical treatment option to the patients with clinical stage I (T1b) esophageal cancer

Reduced p21WAF1/CIP1protein expression is predominantly related to altered p53 in hepatocellular carcinomas

To investigate the relationship between the expression of p21WAF1/ClP1protein and p53 status and the possible role of the two proteins in hepatocellular carcinomas (HCCs), we examined the expression of p21WAF1/CIP1and p53 immunohistochemically in 81 tumours from 65 patients with hepatocellular carcinoma. p21WAF1/CIP1protein was absent from 59 of 81 tumours (72.8%), and altered p53 expression was found in 43 (53.1%). p21WAF1/CIP1expression was significantly associated with p53 status (P= 0.0008); 38 of 59 tumours lacking p21WAF1/CIP1protein were accompanied by altered p53 expression. Further analyses showed that p21WAF1/CIP1expression was inversely correlated with p53 expression in hepatitis C virus (HCV)-related HCCs, but not in HBV-related hepatocellular carcinomas and hepatocellular carcinomas without viral infection. All 11 tumours with intrahepatic metastasis showed altered p21WAF1/CIP1or p53 expression. In contrast, no intrahepatic metastasis was found in any of the 17 tumours without abnormal expression of either of the two proteins. These results suggest that: (1) different modes of p21WAF1/CIP1regulation are involved in HCCs differing in their hepatitis viral infection status, and p21WAF1/CIP1expression appears to be predominantly related to altered p53 in HCV-related HCCs; (2) disruption of the p53–p21WAF1/CIP1cell- cycle-regulating pathway may contribute to malignant progression of HCC. © 2000 Cancer Research Campaig