Saturday, January 14, 2006

cancer, liver

The liver is commonly involved with malignancy, either from metastatic spread or as the primary site. Primary tumors are classified as hepatomas and are rare. They are most often found in males between 50 and 70 years of age. The most common malignant tumor of the liver is a metastatic lesion from the breast, lung, or gastrointestinal tract. At autopsy, 30 percent to 50 percent of all cancer patients have secondary spread to the liver.
Symptoms of a hepatoma may be vague and can be confused with cirrhosis. Once the tumor is large enough, the patient may complain of pain in the right upper quadrant of the abdomen and a sudden onset of abdominal distention. Metastatic lesions lead to changes in liver function with the liver being markedly enlarged, hard and tender.
Metastatic tumors are inoperable because they are scattered throughout the liver. Chemotherapy and radiation therapy may be attempted but are rarely successful. If a hepatoma is confined to a single lobe of the liver surgery may be attempted. The prognosis is very grim with the five years survival rate at almost zero. Radiation therapy and chemotherapy are also ineffective.
Following surgery, the patient's postoperative care is similar to that for abdominal or chest surgery. Complications may include hemorrhage, hepatic failure, metabolic abnormalities, hypoglycemia, and respiratory problems.
Rossman, I. Clinical Geriatrics, 3rd ed. Philadelphia: J. B. Lippincott, Co., 1986.
Scherer, J. C. Introductory Medical-Surgical Nursing, 3rd ed. Philadelphia: J. B. Lippincott Co., 1982.

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