obsolete localized unresectable adult primary liver cancer

Localized Unresectable Adult Primary Liver Cancer: An Obsolete Term

Localized unresectable adult primary liver cancer, also known as localized non-resectable adult liver carcinoma or localized unresectable adult primary cancer of the liver, is an outdated term that was previously used to describe a type of liver cancer.

• Definition: This term referred to a type of liver cancer that had not spread beyond the liver and could not be surgically removed (resected) due to its location or size.
• Current Understanding: With advancements in medical research and treatment options, this term is no longer used in modern medical practice. The focus has shifted towards more accurate and descriptive terminology, such as hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma.

Relevant Information

• According to the American Cancer Society, HCC is the most common type of liver cancer and accounts for approximately 80-90% of all primary liver cancers. [1]
• The National Cancer Institute estimates that in 2014, there were 33,190 new cases of hepatocellular carcinoma and intrahepatic bile duct cancer in the United States. [2]

Treatment Options

• Treatment options for localized unresectable adult primary liver cancer have evolved over time.
• Current treatment options include targeted therapies, immunotherapy, chemotherapy, radiation therapy, and clinical trials of newer treatments. [3]
• The goal of treatment is to improve quality of life and prolong survival.

References:

[1] American Cancer Society. (2022). Liver Cancer: Symptoms, Diagnosis, Staging, and Treatment.

[2] National Cancer Institute. (2014). SEER Stat Fact Sheets: Intrahepatic Bile Duct Cancers.

[3] American Cancer Society. (2022). Liver Cancer: Treatment Options.

Diagnostic Tests for Unresectable Adult Primary Liver Cancer

When it comes to diagnosing unresectable adult primary liver cancer, a combination of tests and procedures are used to determine the extent of the disease. Here are some of the diagnostic tests that may be employed:

• Blood tests: Blood tests can reveal abnormalities in liver function, which can indicate the presence of liver cancer [6]. These tests may include liver function tests (LFTs) to check for enzyme levels and other substances that may be affected by liver disease.
• Imaging scans: Imaging tests such as CT scans are often used to diagnose liver cancer [9][10]. These scans can help determine the size, location, and extent of the tumor within the liver. They can also detect if the cancer has spread to other parts of the body.
• Liver biopsy: A liver biopsy may be performed to confirm the diagnosis of liver cancer [7]. This involves taking a tissue sample from the liver and examining it under a microscope for cancer cells.

Staging Tests

After primary liver cancer has been diagnosed, tests are done to find out if cancer cells have spread within the liver or to other parts of the body. The process of determining the size and location of the cancer and whether it has spread is called staging [10]. Some of the tests used for staging include:

• CT scan: A CT scan may be used to stage liver cancer by examining the liver and surrounding tissues for any signs of tumor growth or spread.
• Other imaging tests: Other imaging tests such as MRI or PET scans may also be used to help determine the extent of the disease.

Risks and Considerations

It's essential to discuss the risks and benefits of these diagnostic tests with your healthcare provider. Not all screening tests are helpful, and most have risk of harms associated with them [15]. Before having any screening test, you may want to discuss the test with your doctor to understand its relevance to your specific situation.

References:

[6] Blood tests: Healthcare providers may do blood tests for cancer, such as a liver function test, to check on liver enzymes, proteins and other substances that may be affected by liver disease. [9] Tests and procedures used to diagnose liver cancer include blood tests. These may reveal liver function abnormalities. Imaging tests such as an CT scan are also used. [10] After primary liver cancer has been diagnosed, tests are done to find out if cancer cells have spread within the liver or to other parts of the body. The process of determining the size and location of the cancer and whether it has spread is called staging. [15] Doctors use these screening tests to find, or diagnose, liver cancer. Learn more about Liver Cancer Diagnosis. Risks of liver cancer screening.

Treatment Options for Obsolete Localized Unresectable Adult Primary Liver Cancer

For patients with obsolete localized unresectable adult primary liver cancer, various treatment options are available to manage the disease and improve quality of life. While these treatments may not be curative, they can help slow down tumor growth and alleviate symptoms.

• Chemotherapy: Chemotherapeutic solutions such as doxorubicin or cisplatin suspended in lipiodol (an oily contrast medium selectively retained within tumors) have been used to treat unresectable liver cancer. This approach is often referred to as transarterial chemoembolization (TACE). [8][9]
• Targeted Therapy: Targeted therapies, such as selumetinib and Akt Inhibitor MK-2206, are being explored in clinical trials for the treatment of unresectable liver cancer. These treatments aim to specifically target cancer cells while minimizing harm to healthy tissues.
• Immunotherapy: Immunotherapies like durvalumab and tremelimumab have shown promise in treating unresectable liver cancer. The combination of these two drugs was approved by the US FDA in 2022 for the treatment of adult patients with unresectable hepatocellular carcinoma. [3][4]
• Radiation Therapy: Radiation therapy can be used to treat unresectable liver cancer, either alone or in combination with other treatments. This approach involves delivering high-energy radiation directly to the tumor site.

Clinical Trials and Emerging Treatments

For patients with obsolete localized unresectable adult primary liver cancer, clinical trials of newer targeted therapies, immunotherapy, new approaches to chemotherapy (new drugs and ways to deliver chemotherapy), new forms of radiation therapy, and other new treatments may be helpful. These clinical trials are also important for improving the outcome for future patients.

References

• [1] Patients with inoperable advanced liver cancer have a new option for treatment to extend their lives.
• [2] Tremelimumab (Imjudo) and durvalumab (Imfinzi) were approved by the US FDA in 2022 for the treatment of unresectable hepatocellular carcinoma.
• [3] Decreased volume transfer exchange between the vascular space and extracellular extravascular space (-DeltaK(trans)) and the corresponding rate constant (-Deltak(ep)) on the first post-treatment scan both predicted survival.

Differential Diagnosis of Obsolete Localized Unresectable Adult Primary Liver Cancer

The differential diagnosis for obsolete localized unresectable adult primary liver cancer involves considering various conditions that can mimic or coexist with hepatocellular carcinoma (HCC). Some of these conditions include:

• Cholangiocarcinoma (CCA): A type of cancer that affects the bile ducts. CCA can be difficult to distinguish from HCC, especially in cases where both tumors are present in the liver.
• Biphenotypic primary liver carcinoma: A rare tumor that combines features of HCC and CCA. This condition is often suspected when masses show distinct areas of HCC and CCA-type enhancement patterns in cirrhotic livers.
• High-grade dysplastic hepatocellular nodules: These are precancerous lesions that can progress to HCC over time. They may be difficult to distinguish from early-stage HCC, especially in cases where the tumor is small.

Diagnostic Considerations

When diagnosing obsolete localized unresectable adult primary liver cancer, it's essential to consider the following factors:

• Imaging manifestations: Contrast-enhanced ultrasound and other imaging modalities can help differentiate between HCC and CCA.
• Histopathological findings: A thorough examination of tumor tissue is crucial for accurate diagnosis. Ancillary testing, such as immunohistochemistry, may be necessary to rule out other conditions.
• Risk stratification: The American Joint Committee on Cancer (AJCC) staging recommendation provides a framework for risk stratifying patients with liver cancer.

References

• [12] Contrast-enhanced ultrasound for the diagnosis of hepatocellular carcinoma in adults with chronic liver disease. Fraquelli M, Nadarevic T, Colli A, Manzotti C, Giljaca V, Miletic D, Štimac D, Casazza G Cochrane Database Syst Rev 2022 Sep 2;9(9):CD013483. doi: 10.1002/14651858.CD013483.pub2.
• [11] This article reviews the key histopathological findings of HCC and CCA, including a review of the role of ancillary testing for differential diagnosis, risk stratification according to the AJCC staging recommendation, and a review of precancerous lesions.

Note: The above information is based on search results 12 and 11.