INDEX

A Ablative therapies, 247. See also specific

types, e.g., Radiofrequency ablation (RFA)

Adenocarcinoma. See also specific types, e.g., Biliary cystadenocarcinoma

metastatic, markers for, 33, 33t Adenoma, hepatic

pediatric, 302 radiologic imaging and staging of, 53-54,

54f-55f Adhesion molecules, 193-195

carcinoembryonie antigen, 194 E-cadherin, 194 hepatocyte growth factor, 195 integrin, 193-194 in invasion substeps, 193-194 larninin, 194 in migration and motility, 195 selectins, 194 transforming growth factor, 195

Alpha-fetoprotein (AFP) in hepatocellular carcinoma, 3, 60-61, 234 in pediatric hepatoblastoma, 306

Angiogenesis, 183, 185 in hepatic metastasis, 185-188, 186f, 186t

Angiogenic factors, 185-188, 186f, 186t Angiosarcoma, hepatic

liver transplantation for, 90 pathologie features of, 30-31 pediatric, 308

Anoikis, 198 colon cancer metastasis and, 198-199

Anti-angiogenic factors and agents, 185, 186t, 188

Apoptosis, 196--199 anoikisand,198-199 apoptotic factors in, 197, 197t Bel protein family in, 197, 197t colon cancer and, 197-198 colon cancer metastases and, 198 therapeutic implication of, 199 triggers of, 196--197, 196f

Apoptotic factors, 197, 197t Arteriography, of cholangiocarcinoma, 127

B Basement membrane, in invasion and

metastasis, 191-192 Bel protein family, 197 Bile duct cancer. See Cholangiocarcinoma Bile duct carcinoma. See

Cholangiocarcinoma Biliary cystadenocarcinoma, pathologie

features of, 28 Biliary obstruction, malignant, 157-177

bilateral stenting in, 172-174, 175f, 176f biliary stents for, self-expanding metaI,

166--171 (See also Biliary stents, self-expanding metaI)

draining both liver lobes in, 172-173 endoscopic palliation for, 172 endoscopie technique for, 158-162, 16lf endoscopie technique for, biliary stents in,

161, 16lf endoscopie technique for, biliary tree in,

159 endoscopie technique for, cholangiogram

in, 159 endoscopic technique for, deep

cannulation in, 160 endoscopic technique for, duodenoscope

in, 159 endoscopic technique for, MR

cholangiopancreatography of, 160 endoscopic technique for, pancreatogram

in, 159 endoscopic technique for, patient

preparation in, 158-159 endoscopic technique for, rendezvous

procedure in, 161-162 endoscopic technique for,

sphincterectomy in, 160 endoscopic technique for, stricture

dilation in, 160-161, 16lf endoscopic technique for, tissue sampling

in, 160, 16lf endoscopic technique for, with mid- or

proximal bile duct stricture, 159, 161f with hilar and metastatic lesions,

171-176, 175f-176f

314 Index

historical perspective on, 157-158 large bore plastic endoprosthesis

palliation for, 172 sites of, 157 stent placement complications in, 163-166 stent placement complications in:

ERCP-related,163-165 stent placement complications in:

stent -related, 165-166 stent placement results in, 162-163 stenting proximal biliary tree in, 171

Biliary stents, self-expanding metal, 166-171 Diamond,166 Endocoil, 166 Nitinol, 166 vs. plastic, 169-171 spiral Z, 168-169, 168f-169f, 174, 176f types of, 166-167 Unistep delivery device, 167 Wallstent, 166-168, 167f-168f, 169, 174,

175f Za,166

Breast carcinoma immunohistochemical stains for, 33t metastases of, CT of, 43, 43f

C E-Cadherin, 194 CaIcification, in metastases, 42, 43f Carcinoembryonic antigen (CAE), 194,232 Caspases, 196 Cavemous hemangioma, pediatric, 301, 302f Cell surface adhesion molecules. See

Adhesion moleeules Chemoembolization, transcatheter arterial,

10 1-107. See also Transcatheter arterial chemoembolization

Children. See Pediatric liver tumors Cholangiocarcinoma, 88, 117-135. See also

Biliary obstruction, malignant with biliary obstruction, malignant, 160 causative factors in, 118-120, 118t classification of, 27 clinical features of, 3-5 clinical presentation of, 120-121 diagnostic studies of, 122-127,

122f-124f, 126f diagnostic studies of: CT, 122-123,

122f-124f

diagnostic studies of: endoscopic retrograde cholangiopancreatography (ERCP), 125-127, 126f

diagnostic studies of: laparoscopy, 127 diagnostic studies of: late-phase

portography, 127 diagnostic studies of: magnetic resonance

cholangiopancreatography (MRCP), 125

diagnostic studies of: MRl, 125 diagnostic studies of: percutaneous

transhepatic cholangiography (PTC), 125-127

diagnostic studies of: positron emission tomography (PET), 127

diagnostic studies of: ultrasound, 125 distribution of, 118, 118f epidemiology of, 3,27, 117 etiologic risk factors for, 4t with hepatocellular carcinoma, 29, 120 liver transplantation for, 88-89 markers for, 33, 33t pathologie features of, 27-28, 28f pathology of, 121-122 pediatric, 310 prognostic factors in, 129 radiologie imaging and staging of, 50-51 treatmento~ 130-135 treatment of: chemotherapy, 133-134 treatment of: hilar bile duct, 128 treatment of: intrahepatic, 127-128 treatment of: liver transplantation, 132 treatment of: palliation, 132-133 treatment of: radiotherapy, 134-135 treatment of: resection, 130-132 treatment of: resection, tumor recurrence

after, 130, 130t Cirrhosis, in cholangiocarcinoma, 118 Cirrhosis, in hepatocellular carcinoma, 2, 16,

17t,45,59-60,81,234 resection in, 66-68, 234-235 screening for, 62

Clinical risk score, for hepatic metastases, 7-8,8t

Coagulation necrosis. See also Radiofrequency ablation (RFA)

induction of, 248-249 Colon cancer metastases

anoikisand,198-199 apoptosis and, 198

Colorectal cancer

apoptosis and, 197-198 epidemiology of, 207, 219, 232 metastases of, 219 patterns of recurrence of, 220

Colorectal metastases, hepatic, 185 c1inical features of, 7-8 c1inieal risk score for, 7-8, 8t gross pathology of, 34f subsequent, CEA screening for, 232 survival with, 233

Colorectal metastases, hepatic, surgical resection of

patient selection in, 232-234 with recurrent disease, 219-225 with recurrent disease: patient selection

in, 220-221 with recurrent disease: results of,

222-225, 224t with recurrent disease: technical

considerations in, 221-222 survival with, 233

Combined hepatocellular-cholangio carcinoma, 29

Computed tomography (CT) of breast carcinoma metastases, 43, 43f of cholangiocarcinoma, 122-123,

122f-l24f of gallbladder cancer, 147, 148f of hepatic metastases, 41-44, 42f-43f,

79-80 of hepatocellular carcinoma, 45, 46f-47f,

234 of metastatie tumors, hepatic, 41-44,

42f-43f, 79-80 of mucinous adenocarcinoma of colon

metastases, calcified, 42, 43f ofradiofrequency ablation, 260-261,

26Of,26lf Cryoablation. See Cryosurgery Cryosurgery, 269-276

applications of, current, 273 applications of, future, 276 c1inieal results with, 274-275 c1inical results with: in colorectal

metastases, 274-275 c1inieal results wi th: in hepatocellular

carcinoma,274 c1inical results with: in other metastatic

tumors, 275 equipment for, 271-272 experimental results with, 270-271

Index 315

history and rationale of, 269 mechanism of, 269-270 operative technique in, 272-273

Cryotherapy. See Cryosurgery Cyc1ooxygenase, in invasion and metastasis,

193 Cysteine aspartate proteases, 196

E E-cadherin, 194 Embryonal sarcoma, 31-32, 3lf, 32f

pediatric, 308, 309f Endoscopic retrograde

cholangiopancreatography (ERCP) for biliary obstruction, malignant: history

of, 157-158 for biliary obstruction, malignant:

technique of, 158-162, 16lf (See also under Biliary obstruction, malignant)

for cholangiocarcinoma, 125-127, 126f for gallbladder cancer, 148

Epidermal growth factor (EGF), 189-190 Epithelioid hemangioendothelioma

liver transplantation for, 89-90 pathologie features of, 29-30, 30f

Ethanol injection, percutaneous (PEI). See Percutaneous ethanol injection (PEI)

Extracellular matrix (ECM), in invasion and metastasis, 191-192

F Fibrolamellar carcinoma, hepatocellular,

22-23, 24f, 25f, 87 liver transplantation for, 87-88 radiologic imaging and staging of, 48, 49f

Fibrosarcoma, pediatric, 310 Flukes, in cholangiocarcinoma

bile duct, 4, 27 liver, 119

Focal nodular hyperplasia pediatric, 302 radiologic imaging and staging of, 52, 54f

G Gallbladder carcinoma, 145-153

with biliary obstruction, malignant, 160 c1inical features of, 5-6

316 Index

diagnosis of, 147-148, 148f epidemiology of, 145 laparoscopic safety in, 151-152 location of, 145 pathology of, 146-147 presentation of, 145-146 risk factors for, 5-6, 5t staging of, 148-149, 149t treatment of: chemotherapy and radiation

tlierapy, 152 treatment of: laparoscopic

cholecystectomy in, 151-152 treatment of: palliation in, 152-153 treatment of: surgery in, 150-151

Germ cell tumors, pediatric, 310 Growth factor receptors, 188-189, 189f

tyrosine kinase, 188-189, 189f Growth factors, 188-191

epidermal,189-190 insulin-like, 190-191 mechanism of action of, 188

H Hamartoma, pediatric mesenchymal, 302,

303f Heat sink effect, 255-256, 256f Hemangioendothelioma, pediatric, 299-301,

300f Hemangioma

cavernous,pediatric,301,302f radiologic imaging and staging of, 51-52,

52f-53f Hemangiosarcoma, liver transplantation for,

90 Hepatic adenoma

pediatric, 302 radiologic imaging and staging of, 53-54,

54f-55f Hepatic anatomy, 229-232, 23Of, 23lf

functional, 230, 230f sectoral, 230, 230f segmental,231-232,231f

Hepatic angiosarcoma, liver transplantation for, 90

Hepatic arterial infusion (HAI), for colorectal metastases, 279-294

anatomic basis of, 280 efficacy of, 281-285 efficacy of: as adjuvant treatment after

liver resection, 284-285

efficacy of: for unresectable liver metastases, 281-284, 281t, 282t

pharmacological basis of, 280 pump placement complications in,

291-293 pump placement complications in:

gastroduodenal, 291 pump placement complications in:

hemorrhagic, 293 pump placement complications in: septic,

293 pump placement complications in:

thrombosis, 282f, 291-292 rationale for, 280 technical aspects of, 285-291 technical aspects of: hepatic arterial

anatomy in, 285, 286f technical aspects of: hepatic arterial

anatomy in, aberrant, 286f, 288-289 technical aspects of: postoperative

assessment of, 289-291, 290f technical aspects of: preoperative

evaluation of, 285, 286f technical aspects of: pump design in, 285 technical aspects of: surgical technique in,

287-288 toxicity of, 293-294 toxicity of, decreasing hepatic, 294

Hepatic artery chemoembolization (HAB), 9 Hepatic malignancies

clinical features of, 1-9 (See also specific malignancies)

incidence of, 1 Hepatic malignancies, primary, 1. See also

specific types, e.g., Hepatocellular carcinoma

classification of, 15t-16t clinical features of, 1-6 (See also specific

malignancies) Hepatic malignancies, secondary. See

Metastatic tumors, hepatic Hepatic reserve function, 64-66, 65t Hepatic transplantation. See Transplantation,

liver Hepatitis B virus (HBV), hepatocellular

carcinoma and, 2, 17t, 59-60, 81, 234 Hepatitis C virus (HBV), hepatocellular

carcinoma and, 2,16, 17t, 59-60, 81, 234

Hepatoblastoma, 25 liver transplantation for, 89

pathologie features of, 25-26, 26f Hepatoblastoma, pediatric, 303-307, 304t,

305f-307f conditions associated with, 303, 304t congenitai,307-308 epidemiology of, 303 histologieal sub types of, 303 preoperative chemotherapy for, 306--307 presentation and diagnosis of, 303-305,

305f recurrence of, 307 staging of, 305, 306f surgieal resection of, 305 transcatheter arterial embolization of, 306 tumor marker for, 306

Hepatocellular carcinoma (HCC), 59, 81-82. See also Hepatie adenoma

adjuvant therapies for, 69-70 adjuvant therapies for: chemotherapy and

chemoimmunotherapy, 70 adjuvant therapies for: hormonal, 70 adjuvant therapies for: other agents, 70 with cholangiocarcinoma, 29, 120 ciassification of, 18t ciinical features of, 1-3 ciinical presentation of, 60 combination therapies for, 68-69 combination therapies for: ablative, 69 combination therapies for: multi-modality,

69 eombination therapies for: preoperative

transcatheter arterial embolization, 68 combination therapies for: selective portal

vein embolization, 68-69 cryosurgery for, 274 CT findings in, 45, 46f-47f epidemiology of, 59, 81, 101,234,247 fibrolamellar, 22-23, 24f, 25f grading of, 21-22, 22f high grade, 20 hypervascular lesion in, 45, 46f hypodense mass in, 45, 47f incidence of, 16 lesion detection in, 48 liver transplantation for, 81-87 (See also

under Transplantation, liver) markers for, 33, 33t MR findings in, 47, 47f-48f natural history of, 59 osteociastic giant cells, 24 pathology of, 16

Index 317

pathology of, gross, 18, 19f pathology of, microscopic, 19-20, 19f, 20f pediatric, 308 with portal vein thrombosis, 45, 46f preoperative assessment of, 62-66 preoperative assessment of: ciassification

systems in, 63, 63t, 65-66 preoperative assessment of: favorable

outcome prognosis in, 62-63 preoperative assessment of: hepatic

reserve function in, 64-66, 65t preoperative assessment of: laboratory

values in, 63 preoperative assessment of: Okuda

staging in, 63, 63t preoperative assessment of: tumor

evaluation in, 66 prevention of, 3 prognostie indicators for, 83-85 prognostie indicators for: Iymph node

involvement, 84 prognostic indicators for: TNM stage,

84-85 prognostie indieators for: tumor

morphology, 85 prognostic indicators for: tumor size and

number, 83-84 prognostic indicators for: vascular

invasion, 85 prognostic predietors in, 22, 82 radiologie imagingand staging of, 45-48,

46f-48f risk factors for, 2, 16, 17t, 45, 59-60 scierosing, 24 screening strategies for, 2-3, 60-62 small cell, 23 spindie cell, 23 surgical options in, 86--87 surgical resection of, 66-68, 101,247 surgical resection of, morbidity after, 63 surgical resection of, patient selection in,

234-235 surgical resection of, rates of, 62, 81 survival with, 101,248 trabeculaein,19-20,20f variants of, 22-25 vascular invasion in, 20, 21f, 48

Hepatocellular-cholangio carcinoma, 29 Hepatocyte growth factor (HGF), 195 Hepatolithiasis, in cholangiocarcinoma, 4

318 Index

I Immunohistochemical stains, for liver

tumors, 33, 33t Indocyanine green (ICG) clearance test, 64 Insulin-like growth factor (lGF), 190-191 Integrin, 193-194 Interleukin-2 receptor (sIL-2R), in

hepatocellular carcinoma, 61 Invasion and metastasis, tumor, 191-193

basement membrane and extracellular matrix in, 191-192

cyclooxygenase in, 193 matrix metalloproteinases in, 192-193,

192t

K KAll,200 Klatskin's tumor, 27, 88. See also

Cholangiocarcinoma

L Laminin, 194 Laparoscopic cholecystectomy, of

gallbladder carcinoma, 151-152 Laparoscopy

of cholangiocarcinoma, 127 of gallbladder carcinoma, 151-152

Laparotomy, for hepatic metastases, adjuncts to exploration at, 208-209

Left lateral segmentectomy, 236f, 243-244 Leiomyosarcoma, pediatric, 310 Lipiodol, 102 Liver anatomy, 229-231, 230f, 23lf

functional, 230, 230f sectoral, 230, 230f segmental,231-232, 231f

Liver cancer. See specific types, e.g., Hepatocellular carcinoma

Liver disease, alcoholic in cholangiocarcinoma, 118 in hepatocellular carcinoma, 2, 16, 17t,

45,59-60,81,234 in hepatocellular carcinoma, resection in,

66-68,234-235 in hepatocellular carcinoma, screening

for, 62 Liver resection. See Surgical resection Liver transplantation. See Transplantation,

liver

Lobectomy, left hepatic, 236f, 240-242, 24lf incision and exposure in, 240 parenchymal transection in, 242 portal dissection in, 242 posterior dissection in, 241-242 resectability in, mobilization and

assessmentof, 240-241, 24lf Lobectomy, right hepatic, 236-240, 236f

incision and exposure in, 236-237 parenchymal transection in, 239-240 portal dissection in, 238-239 posterior dissection in, 237-238 resectability in, mobilization and final

assessment of, 237 Lymph node involvement, as prognostic

indicator, 84 Lymphoma, markers for, 33, 33t

M Macrotrabecular patterns, 19, 20f Magneticresonance

cholangiopancreatography (MRCP) of biliary obstruction, malignant, 160 of cholangiocarcinoma, 125 of gallbladder cancer, 148

Magnetic resonance imaging (MRI) of cholangiocarcinoma, 125 of hepatocellular carcinoma, 47, 47f-48f,

234 of metastatic tumors, hepatic, 44-45, 45f,

80 of radiofrequency ablation, 262

Malignant fibrous histiocytoma, pediatric, 310

Malignant mesenchymal tumors, pediatric, 308

Matrix metalloproteinases (MMPs), in invasion and metastasis, 192-193, 192t

Melanoma, immunohistochemical stains for, 33t

Mesenchymal hamartoma, pediatric, 302, 303f

Metastasis, 183. See also Invasion and metastasis

Metastatic cascade, 183-185, 184f Metastatic tumors, hepatic, 6-7, 248

adhesion molecules in, 193-195 (See also Adhesion molecules)

angiogenesis in, 185-188, 186f, 186t

apoptosis in, 196--199 (See also Apoptosis)

biology of, 183-200 from colorectal cancer, cryosurgery for,

274-275 from colorectal cancer, hepatic arterial

infusion for, 279-294 (See also Hepatic arterial infusion (HAI»

from colorectal cancer, natural history of, 219-220

from colorectal cancer, patient selection for surgical resection of, 232-234

from colorectal cancer, patterns recurrence of, 220

diagnosis of, 78-81 growth factors and receptors in, 188-191,

189f (See also Growth factors) from hepatocellular carcinoma, 81-82 from hepatocellular carcinoma, patient

selection for surgical resection of, 234-235

histology of, 78-79 immunohistochernical stains for, 33, 33t invasion and metastasis of, 191-193 invasion and metastasis of: basement

membrane and extracellular matrix in, 191-192

invasion and metastasis of: cyclooxygenase in, 193

invasion and metastasis of: matrix metalloproteinases in, 192-193, 192t

liver transplantation for, 90--92 natural history of, 207 pathogenesis of, 183-185, 184f pathologic features of, 33-34, 34f primary, 81-82 prognosis with, 248 radiology of, 79 radiology of: CT, 41-44, 42f-43f, 79-80 radiology of: MRI, 44-45, 45f, 80 radio10gy of: ultrasound, 40-41, 4lf, 79 staging of, 80--81 suppressor genes on, 199-200 surgical resection for (See Surgical

resection) Microtrabecular patterns, 19, 20f Migration, tumor cell, 195 Morphology, tumor, as prognostic indicator,

85 Motility, tumor cell, 195 MRP l/CD9, 200

Index 319

Mucinous adenocarcinoma of colon metastases, calcified, CT of, 42, 43f

N Neuroendocrine metastases, hepatic

clinical risk score for, 8-9 cryosurgery for, 275 surgical resection for, 212-213

Neuroendocrine tumors (NET), 8-9 markers for, 33, 33t

Nm23,200

o Orthotopic liver transplantation (OLT). See

Transplantation, liver Osteoclastic giant cells, in hepatocellular

carcinoma, 24

p Paget's seed and soll theory, 184-185 Papillary cystic tumor, 28-29 Pediatric liver tumors, 299-310

benign, 299-303 benign: adenoma, 302 benign: cavernous hemangioma, 301, 302f benign: focal nodular hyperplasia, 302 benign: hemangioendothelioma, 299-301,

300f benign: mesenchymal hamartoma, 302,

303f epiderniology of, 299 malignant, 303-308 malignant: hepatoblastoma, 303-307,

304t, 305f-307f (See also Hepatoblastoma, pediatric)

malignant: hepatoblastoma, congenital, 307-308

malignant: hepatocellular carcinoma, 308 primary, 299, 299t uncommon,308-310,309f

Percutaneous ethanol injection (PEI), 107-111

imaging of results with, 109f mechanism of, 107 morbidity with, 109-110 prognostic factors in, 11 0 reported series on, 108 techniques of, 107-108

320 Index

with transcatheter arterial chemoembolization, lU-I12

volume calculations for, 107 Percutaneous image-guided ablative

therapies, 247. See also specific types, e.g., Radiofrequency ablation (RFA)

Percutaneous transhepatic cholangiography (PTC), of eholangioearcinoma, 125-127

Portography, late-phase, of eholangioearcinoma, 127

Positron emission tomography (PET), of eholangiocareinoma, 127

Prograrnmed eell death. See Apoptosis Prostate earcinoma, immunohistoehemieal

stains for, 33t Pulsed radiofrequeney ablation, 258

R Radiofrequeney ablation (RFA), 247-263

cIinical experienee with, 262 eoagulation neerosis in, induetion of,

248-249 equipment in, 249, 250f heat deposition in, 250 heat sink effect in, 255-256, 256f for hepatoeellular earcinoma, 235 imaging of, 258-262 imaging of: er, 260-261, 260f, 261f imaging of: MRl, 262 imaging of: ultrasound, 258-260, 259f injection during, 253 intemally eooled electrodes in, 253-255,

254f,255f multi-eleetrode arrays for, 251-253, 252f,

253f, 257, 257f pulsed,258 reeommendations for, eurrent, 258 results of, 262-263 technique of, 249-251 thermal destruetion in, meehanism of, 249 treatment dimensions of, inereasing, 251 vaseular inflow in, limiting, 255-257,

256f,257f Radiologie imaging and staging, 39-55. See

also speeifie modalities, e.g., Computed tomography (CT)

of eholangioeareinoma, 50-51 of fibrolamellar earcinoma, 48, 49f of focal nodular hyperplasia, 52, 54f ofhemangioma, 51-52, 52f-53f

of hepatie adenoma, 53-54, 54f-55f of hepatie metastases, 40-45 ofhepatie metastases: er, 41-44,

42f-43f,79-80 of hepatie metastases: MRl, 44-45, 45f, 80 ofhepatie metastases: ultrasound, 40-41,

41f,79 of hepatocellular earcinoma, 45-48,

46f-48f of renal eell earcinoma metastases,

hypervaseular, 42, 42f tumor localization in, 39

Redox Toleranee Index (RTI), 64-65 Renal eell eareinoma metastases,

hypervaseular, er of, 42, 42f Resection. See Surgical reseetion Rhabdoid tumor of liver, pediatrie, 309, 309f Right segmentectomy, 236f, 242-243

S Sareoma, liver transplantation for, 90 Seatter faetors, 195 Selerosing hepatoeellular earcinoma, 24 Seed, 185 Seed and soi! theory, 184-185 Segmentectomy

left lateral, 236f, 243-244 right, 236f, 242-243

Seleetins, 194 Small eell hepatocellular careinoma, 23 Somatostatin receptor scintigraphy (SRS),

212 Sonography. See Ultrasound SpindIe eell hepatocellular eareinoma, 23 Stents, biliary, 161, 161f

self-expanding metal, 166-171 self-expanding metal: Diamond, 166 self-expanding metal: Endoeoil, 166 self-expanding metal: Nitinol, 166 self-expanding metal: spiral Z, 168-169,

168f-169L 174, 176f self-expanding metal, types of, 166-167 self-expanding metal: Unistep delivery

deviee, 167 self-expanding metal, vs. plastie, 169-171 self-expanding metal: Wallstent, 166-168,

167f-168L 169, 174, 175f self-expanding meta!: Za, 166

Subpopulations,heterogeneous, 184 Suppressor genes, 199-200

Surgical resection of hepatic tumors, 229-245

patient selection, 232-235 patient selection, with colorectal

metastases, 232-234 patient selection, with hepatocellular

carcinoma, 234-235 resection types, 235-245 resection types: anatomic, 235, 236f resection types: left hepatic lobectomy,

236L 240-242, 241f resection types: left lateral

segmentectomy, 236f, 243-244 resection types: nonanatomic, 235, 236f,

244-245 resection types: right hepatic lobectomy,

236-240, 236f (See also Lobectomy, right hepatic)

resection types: right segmentectomy, 236f,242-243

techniques, 229-232 techniques, anatomy in, 229-231, 230f,

231f techniques, general principles in, 229

Surgical resection of hepatocellular carcinoma. See Hepatocellular carcinoma (HCC), surgical resection of

Surgical resection of liver metastases, 207-213

adjuncts to exploration at laparotomy for, 208-209

morbidity and mortality in, 209-210, 209t,211t

neuroendocrine, 212-213 other primary tumor sites, 213 outcome after, predictors of, 211-212 preoperative staging in, 207-208 recurrence after, 212 risk factors after, 209, 209t survival after, long-term, 211-212

Surgical resection of recurrent colorectal

T

liver metastases, 219-225 patient selection in, 220-221 results of, 222-225, 224t technical considerations in, 221-222

Technetium 99m diethylenetriamine-pentaacetic

Index 321

acid-galactosyl-human serum albumin liver scintigraphy (Tc-GSA), 65

Thorotrast, cholangiocarcinoma from, 4-5, 27, 118

TNM staging system, 80-81, 84-85 Transcatheter arterial chemoembolization

(TACE), 101-107 fundamentals of, 10 1-102 imaging of results with, 104f -105f lipiodol in, 102 morbidity with, 104-106 neoadjuvant, 106-107 with percutaneous ethanol injection,

101-107 prognostic factors in, 106 reported series on, 102-104, 103t

Transforrning growth factor (TGF), 195 Transplantation, liver, 77-92

for cholangiocarcinoma, 88-89 for epithelioid hemangioendothelioma,

89-90 for fibrolamellar hepatocellular

carcinoma, 87-88 for hemangiosarcoma, 90 for hepatoblastoma, 89 for hepatocellular carcinoma, 81-87,

234-235 for hepatocellular carcinoma, adjuvant

therapy with, 82, 86 for hepatocellular carcinoma,

perioperative chemoembolization with,86

for hepatocellular carcinoma, prognosis in, 81-82

for hepatocellular carcinoma, prognostic indicators for, 83-85

for hepatocellular carcinoma, surgical options in, 86-87

history of, 77 indications for, 78 for metastatic hepatic neoplasms, 90-92 orthotopic, 77 prognostic indicators for, 83-85 for sarcoma, 90 transarterial chemoablation with, 78

Tumor ablation therapy. See specific types, e.g., Radiofrequency ablation (RFA)

Tumor number, as prognostic indicator, 83-84

Tumor size, as prognostic indicator, 83-84 Tyrosine kinase receptors, 188-189, 189f

322 Index

U Ultrasound

V

of eholangiocarcinoma, 125 in hepatocellular earcinoma screening,

61-62 of metastatie tumors, hepatie, 40-41, 41f,

79 of radiofrequeney ablation, 258-260, 259f transabdominal, of hepatie metastases,

40-41, 4lf

Vaseular endothelial growth factor (VEGF), 185-188, 186t

Vascular invasion, as prognostie indieator, 85 Vaseular tumors, malignant hepatie

markers for, 33, 33t pathologie features of, 29-32 pathologie features of: angiosarcoma,

30-31 pathologie features of: embryonal

sarcoma, 31-32, 3lf, 32f pathologie features of: epithelioid

hemangioendothelioma, 29-30, 30f Vaseularization, in metastases, 42-43, 43f