[Early diagnosis and rational therapy of primary carcinoma of the liver. Principles of secondary prevention].
The programme of secondary prevention of primary carcinoma of the liver focused on patients with confirmed cirrhosis of the liver can be applied readily under our conditions. It should become a rational supplement of the oncological programme. The basic objective is the detection of a small focus of the tumour in hepatic tissue not larger than 2-3 cm in diameter, based on regular clinical and laboratory examinations of cirrhotic patients (the result of alpha-fetoprotein is emphasized) and in particular ultrasonography. This is followed by the morphological verification of the tumour either by aimed biopsy during laparoscopy or by aspiration cytology with ultrasonographic control. Supplementation by CT or aimed angiography is also useful. In case of a positive finding the method of choice is above all a restricted resection. On the other hand, treatment with absolute alcohol is increasingly used. It is instilled under ultrasonographic control during repeated sessions into the tumourous focus and its regression is followed up to complete disappearance. This treatment can be combined with subsequent resection. The authors give an account of their own experience.
Chlumský
J
J
II. interní klinika, Institutu pro dalsí vzdĕlávání lékarů a farmaceutů, Praha.
Krtek
V
V
Horejsová
M
M
Chlumská
A
A
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy
Casná diagnostika a racionální terapie primárního karcinomu jater. Zásady sekundární prevence.