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T1 Age 2 13 60-year-old T2 Sex 14 17 man T3 Clinical_event 18 27 presented E1 Clinical_event:T3 T4 Sign_symptom 51 61 metastatic E2 Sign_symptom:T4 T5 Biological_structure 62 72 lymph node T6 Biological_structure 35 50 retroperitoneal R1 MODIFY Arg1:T6 Arg2:E2 R2 MODIFY Arg1:T5 Arg2:E2 T7 Diagnostic_procedure 76 94 magnetic resonance E3 Diagnostic_procedure:T7 T8 Diagnostic_procedure 96 98 MR E4 Diagnostic_procedure:T8 R3 IDENTICAL Arg1:E4 Arg2:E3 T9 Therapeutic_procedure 138 147 resection E5 Therapeutic_procedure:T9 T10 Date 151 155 2010 E6 Date:T10 T11 Biological_structure 126 137 right liver R4 MODIFY Arg1:T11 Arg2:E5 T12 Therapeutic_procedure 173 182 resection E7 Therapeutic_procedure:T12 T13 Biological_structure 157 172 pulmonary wedge R5 MODIFY Arg1:T13 Arg2:E7 T14 Date 186 190 2012 E8 Date:T14 R6 BEFORE Arg1:E8 Arg2:E7 T15 Therapeutic_procedure 196 227 transarterial chemoembolization E9 Therapeutic_procedure:T15 T16 Detailed_description 228 233 twice T17 Date 237 241 2014 E10 Date:T17 R7 MODIFY Arg1:T16 Arg2:E9 T18 History 126 155 right liver resection in 2010 T19 History 157 190 pulmonary wedge resection in 2012 T20 History 196 241 transarterial chemoembolization twice in 2014 T21 Diagnostic_procedure 270 279 pathology E11 Diagnostic_procedure:T21 T22 Disease_disorder 300 312 liver cancer E12 Disease_disorder:T22 A1 POLARITY E12 UNCERTAIN T23 Detailed_description 294 299 mixed R8 MODIFY Arg1:T23 Arg2:E12 T24 Disease_disorder 340 351 lung cancer E13 Disease_disorder:T24 T25 Detailed_description 318 339 poorly differentiated R9 MODIFY Arg1:T25 Arg2:E13 T26 Sign_symptom 363 373 metastasis E14 Sign_symptom:T26 T27 Biological_structure 357 362 liver R10 MODIFY Arg1:T27 Arg2:E14 T28 Diagnostic_procedure 378 389 examination E15 Diagnostic_procedure:T28 T29 Coreference 395 400 tumor E16 Coreference:T29 R11 IDENTICAL Arg1:E16 Arg2:E2 T30 Biological_structure 423 431 duodenum T31 Biological_structure 433 441 pancreas T32 Biological_structure 443 450 stomach T33 Biological_structure 456 475 hepatic portal vein R12 MODIFY Arg1:T30 Arg2:E16 R13 MODIFY Arg1:T31 Arg2:E16 R14 MODIFY Arg1:T32 Arg2:E16 R15 MODIFY Arg1:T33 Arg2:E16 T34 Sign_symptom 507 513 masses E17 Sign_symptom:T34 T35 Detailed_description 494 506 unresectable R16 MODIFY Arg1:T35 Arg2:E17 T36 History 518 544 hypertension over 10 years T37 History 549 591 chronic HBV-related cirrhosis for 30 years T38 Sign_symptom 518 530 hypertension E18 Sign_symptom:T38 T39 Duration 536 544 10 years E19 Duration:T39 R17 MODIFY Arg1:E19 Arg2:E18 T40 Disease_disorder 557 578 HBV-related cirrhosis E20 Disease_disorder:T40 T41 Detailed_description 549 556 chronic R18 MODIFY Arg1:T41 Arg2:E20 T42 Duration 583 591 30 years E21 Duration:T42 R19 MODIFY Arg1:E21 Arg2:E20 T43 Medication 617 627 lamivudine E22 Medication:T43 T44 Dosage 628 637 100 mg qd R20 MODIFY Arg1:T44 Arg2:E22 T45 Medication 643 661 adefovir dipivoxil E23 Medication:T45 T46 Dosage 662 670 10 mg qd R21 MODIFY Arg1:T46 Arg2:E23 T47 Duration 675 682 6 years E24 Duration:T47 R22 MODIFY Arg1:E24 Arg2:E23 R23 MODIFY Arg1:E24 Arg2:E22 T48 Diagnostic_procedure 703 719 body temperature E25 Diagnostic_procedure:T48 T49 Lab_value 694 702 constant R24 MODIFY Arg1:T49 Arg2:E25 T50 Lab_value 723 728 37 °C R25 MODIFY Arg1:T50 Arg2:E25 T51 Diagnostic_procedure 734 748 blood pressure E26 Diagnostic_procedure:T51 T52 Lab_value 752 764 148/96 mm Hg R26 MODIFY Arg1:T52 Arg2:E26 T53 Diagnostic_procedure 774 779 pulse E27 Diagnostic_procedure:T53 T54 Lab_value 783 804 77 beats every minute R27 MODIFY Arg1:T54 Arg2:E27 T55 Sign_symptom 852 856 pain E28 Sign_symptom:T55 A2 POLARITY E28 NEG T56 Biological_structure 842 851 abdominal T57 Biological_structure 858 867 abdominal T58 Sign_symptom 868 878 distention E29 Sign_symptom:T58 T59 Sign_symptom 880 886 nausea E30 Sign_symptom:T59 T60 Sign_symptom 892 900 vomiting E31 Sign_symptom:T60 R28 MODIFY Arg1:T57 Arg2:E29 R29 MODIFY Arg1:T56 Arg2:E28 T61 Diagnostic_procedure 915 928 tumor markers E32 Diagnostic_procedure:T61 T62 Lab_value 954 960 normal R30 MODIFY Arg1:T62 Arg2:E32 T63 Diagnostic_procedure 975 999 carcinoembryonic antigen E33 Diagnostic_procedure:T63 T64 Diagnostic_procedure 1011 1028 alpha fetoprotein E34 Diagnostic_procedure:T64 T65 Diagnostic_procedure 1045 1070 carbohydrate antigen 19–9 E35 Diagnostic_procedure:T65 T66 Lab_value 1000 1009 3.7 ng/mL T67 Lab_value 1029 1039 17.3 ng/mL T68 Lab_value 1078 1086 6.1 U/mL R31 MODIFY Arg1:T68 Arg2:E35 R32 SUB_PROCEDURE Arg1:E33 Arg2:E32 R33 SUB_PROCEDURE Arg1:E34 Arg2:E32 R34 SUB_PROCEDURE Arg1:E35 Arg2:E32 T69 Therapeutic_procedure 1233 1241 ablation E36 Therapeutic_procedure:T69 T70 Detailed_description 1227 1232 local R35 MODIFY Arg1:T70 Arg2:E36 T71 Diagnostic_procedure 1261 1274 Choi criteria E37 Diagnostic_procedure:T71 T72 Diagnostic_procedure 1348 1367 computed tomography E38 Diagnostic_procedure:T72 T73 Diagnostic_procedure 1369 1371 CT E39 Diagnostic_procedure:T73 R36 IDENTICAL Arg1:E39 Arg2:E38 T74 Other_entity 1382 1756 complete response, disappearance of all lesions and no new lesions; partial response (PR), a decrease in size of 10% or a decrease in tumor density over 15% on CT and no new lesions; stable disease, not fit for complete response, PR, or progressive disease; and progressive disease, an increase in tumor size over 10% and not fit for PR by tumor density on CT or new lesions #1 AnnotatorNotes T74 This is just a description of the criteria T75 Diagnostic_procedure 1775 1777 MR E40 Diagnostic_procedure:T75 T76 Sign_symptom 1800 1804 mass E41 Sign_symptom:T76 T77 Area 1808 1820 2.8 × 3.5 cm R37 MODIFY Arg1:T77 Arg2:E41 T78 Biological_structure 1842 1850 duodenum T79 Biological_structure 1852 1860 pancreas T80 Biological_structure 1866 1879 blood vessels R38 MODIFY Arg1:T78 Arg2:E41 R39 MODIFY Arg1:T79 Arg2:E41 R40 MODIFY Arg1:T80 Arg2:E41 T81 Sign_symptom 1946 1962 signal intensity E42 Sign_symptom:T81 T82 Diagnostic_procedure 1914 1916 MR E43 Diagnostic_procedure:T82 T83 Detailed_description 1897 1912 substance phase R41 MODIFY Arg1:T83 Arg2:E43 T84 Severity 1934 1945 mildly high R42 MODIFY Arg1:T84 Arg2:E42 T85 Coreference 1974 1979 tumor E44 Coreference:T85 R43 IDENTICAL Arg1:E44 Arg2:E41 T86 Sign_symptom 2001 2017 signal intensity E45 Sign_symptom:T86 T87 Severity 1984 2000 intermediate low R44 MODIFY Arg1:T87 Arg2:E45 T88 Biological_structure 2025 2040 solid component T89 Biological_structure 2052 2057 walls R45 MODIFY Arg1:E44 Arg2:E42 R46 MODIFY Arg1:T88 Arg2:E45 R47 MODIFY Arg1:T89 Arg2:E45 T90 Therapeutic_procedure 2087 2095 ablation E46 Therapeutic_procedure:T90 T91 Sign_symptom 2130 2146 hyperechoic area E47 Sign_symptom:T91 T92 Diagnostic_procedure 2156 2158 US E48 Diagnostic_procedure:T92 #2 AnnotatorNotes E48 ultrasound T93 Detailed_description 2150 2155 axial R48 MODIFY Arg1:T93 Arg2:E48 T94 Severity 2125 2129 mild T95 Biological_structure 2109 2124 retroperitoneal R49 MODIFY Arg1:T95 Arg2:E47 R50 MODIFY Arg1:T94 Arg2:E47 T96 Diagnostic_procedure 2240 2248 biopsies E49 Diagnostic_procedure:T96 T97 Biological_structure 2227 2239 transhepatic T98 Detailed_description 2214 2226 percutaneous R51 MODIFY Arg1:T97 Arg2:E49 R52 MODIFY Arg1:T98 Arg2:E49 T99 Therapeutic_procedure 2253 2262 ablations E50 Therapeutic_procedure:T99 T100 Duration 2335 2351 about 40 minutes E51 Duration:T100 T101 Medication 2358 2374 local anesthesia E52 Medication:T101 T102 Medication 2384 2392 sedation E53 Medication:T102 T103 Diagnostic_procedure 2402 2417 ultrasonography E54 Diagnostic_procedure:T103 T104 Detailed_description 2421 2432 real-timely #3 AnnotatorNotes T104 [sp] R53 MODIFY Arg1:T104 Arg2:E54 T105 Sign_symptom 4615 4627 side effects E55 Sign_symptom:T105 A3 POLARITY E55 NEG T106 Diagnostic_procedure 4439 4452 tumor markers E56 Diagnostic_procedure:T106 T107 Diagnostic_procedure 4468 4492 carcinoembryonic antigen E57 Diagnostic_procedure:T107 T108 Diagnostic_procedure 4494 4511 alpha fetoprotein E58 Diagnostic_procedure:T108 T109 Diagnostic_procedure 4517 4542 carbohydrate antigen 19–9 E59 Diagnostic_procedure:T109 T110 Lab_value 4553 4562 3.6 ng/mL R54 MODIFY Arg1:T110 Arg2:E57 T111 Lab_value 4564 4574 26.7 ng/mL R55 MODIFY Arg1:T111 Arg2:E58 T112 Lab_value 4580 4588 8.1 U/mL R56 MODIFY Arg1:T112 Arg2:E59 R57 SUB_PROCEDURE Arg1:E57 Arg2:E56 R58 SUB_PROCEDURE Arg1:E58 Arg2:E56 R59 SUB_PROCEDURE Arg1:E59 Arg2:E56 T113 Therapeutic_procedure 2465 2477 laser fibers E60 Therapeutic_procedure:T113 R60 SUB_PROCEDURE Arg1:E60 Arg2:E50 T114 Detailed_description 2456 2464 2 Nd:YAG R61 MODIFY Arg1:T114 Arg2:E60 T115 Detailed_description 2479 2506 Echolaser X4, ESAOTE, Italy R62 MODIFY Arg1:T115 Arg2:E60 T116 Detailed_description 2511 2526 0.3 mm diameter T117 Detailed_description 2527 2557 through a 21-gauge Chiba needl T118 Sign_symptom 2568 2575 lesions E61 Sign_symptom:T118 R63 MODIFY Arg1:T116 Arg2:E60 R64 MODIFY Arg1:T117 Arg2:E60 T119 Therapeutic_procedure 2639 2647 ablation E62 Therapeutic_procedure:T119 T120 Detailed_description 2665 2686 area from 12 to 15 mm T121 Detailed_description 2696 2708 power of 5 W T122 Detailed_description 2712 2726 5 to 6 minutes R65 MODIFY Arg1:T120 Arg2:E62 R66 MODIFY Arg1:T121 Arg2:E62 #4 AnnotatorNotes T122 not a duration, but a function of the procedure R67 MODIFY Arg1:T122 Arg2:E62 T123 Diagnostic_procedure 2752 2767 ultrasonography E63 Diagnostic_procedure:T123 T124 Sign_symptom 2790 2796 lesion E64 Sign_symptom:T124 T125 Sign_symptom 2814 2830 hyperechoic zone E65 Sign_symptom:T125 T126 Diagnostic_procedure 2875 2903 contrast-enhanced ultrasound E66 Diagnostic_procedure:T126 T127 Diagnostic_procedure 2905 2909 CEUS E67 Diagnostic_procedure:T127 R68 IDENTICAL Arg1:E67 Arg2:E66 T128 Sign_symptom 2923 2940 abnormal residual E68 Sign_symptom:T128 T129 Biological_structure 2944 2980 proximal part of the pancreatic head R69 MODIFY Arg1:T129 Arg2:E68 T130 Clinical_event 3000 3009 follow-up E69 Clinical_event:T130 T131 Date 2994 2999 5-day E70 Date:T131 T132 Diagnostic_procedure 3028 3037 CT images E71 Diagnostic_procedure:T132 T133 Detailed_description 3010 3027 contrast-enhanced R70 MODIFY Arg1:T133 Arg2:E71 T134 Sign_symptom 3049 3053 mass E72 Sign_symptom:T134 T135 Detailed_description 3043 3048 lower R71 MODIFY Arg1:T135 Arg2:E72 T136 Sign_symptom 3062 3078 signal intensity E73 Sign_symptom:T136 T137 Severity 3058 3061 low R72 MODIFY Arg1:T137 Arg2:E73 T138 Sign_symptom 3089 3094 tumor E74 Sign_symptom:T138 T139 Detailed_description 3083 3088 upper R73 MODIFY Arg1:T139 Arg2:E74 T140 Sign_symptom 3122 3138 signal intensity E75 Sign_symptom:T140 T141 Severity 3104 3121 intermediate high R74 MODIFY Arg1:T141 Arg2:E75 T142 Detailed_description 3142 3169 residual in substance phase R75 MODIFY Arg1:T142 Arg2:E75 T143 Clinical_event 3207 3216 follow-up E76 Clinical_event:T143 T144 Date 3200 3206 1-week E77 Date:T144 T145 Diagnostic_procedure 3217 3221 CEUS E78 Diagnostic_procedure:T145 T146 Sign_symptom 3238 3246 enlarged E79 Sign_symptom:T146 T147 Biological_structure 3247 3262 retroperitoneal T148 Biological_structure 3263 3273 lymph node R76 MODIFY Arg1:T147 Arg2:T148 R77 MODIFY Arg1:T148 Arg2:E79 T149 Biological_structure 3282 3306 near the pancreatic head R78 MODIFY Arg1:T149 Arg2:T148 T150 Therapeutic_procedure 3409 3417 ablation E80 Therapeutic_procedure:T150 T151 Therapeutic_procedure 3425 3437 laser fibers E81 Therapeutic_procedure:T151 T152 Detailed_description 3423 3424 2 R79 MODIFY Arg1:T152 Arg2:E81 R80 SUB_PROCEDURE Arg1:E81 Arg2:E80 T153 Sign_symptom 3449 3456 lesions E82 Sign_symptom:T153 T154 Sign_symptom 3470 3486 hyperechoic zone E83 Sign_symptom:T154 T155 Diagnostic_procedure 3533 3537 CEUS E84 Diagnostic_procedure:T155 T156 Diagnostic_procedure 3614 3616 MR E85 Diagnostic_procedure:T156 T157 Sign_symptom 3657 3662 tumor E86 Sign_symptom:T157 T158 Therapeutic_procedure 3693 3701 ablation E87 Therapeutic_procedure:T158 T159 Detailed_description 3687 3692 laser R81 MODIFY Arg1:T159 Arg2:E87 T160 Date 3510 3517 2nd day E88 Date:T160 #5 AnnotatorNotes E88 postoperative? T161 Date 3732 3744 3 days later E89 Date:T161 T162 Diagnostic_procedure 3745 3749 CEUS E90 Diagnostic_procedure:T162 T163 Sign_symptom 3785 3791 lesion E91 Sign_symptom:T163 T164 Severity 3779 3784 minor R82 MODIFY Arg1:T164 Arg2:E91 T165 Therapeutic_procedure 3887 3895 ablation E92 Therapeutic_procedure:T165 T166 Detailed_description 3405 3408 2nd R83 MODIFY Arg1:T166 Arg2:E80 T167 Detailed_description 3683 3686 3rd R84 MODIFY Arg1:T167 Arg2:E87 T168 Detailed_description 3883 3886 4th R85 MODIFY Arg1:T168 Arg2:E92 T169 Date 3965 3977 3 days later E93 Date:T169 T170 Diagnostic_procedure 4017 4019 CT E94 Diagnostic_procedure:T170 T171 Sign_symptom 4073 4081 necrosis E95 Sign_symptom:T171 T172 Sign_symptom 4049 4053 mass E96 Sign_symptom:T172 T173 Biological_structure 4033 4048 retroperitoneal R86 MODIFY Arg1:T173 Arg2:E96 R87 MODIFY Arg1:E96 Arg2:E94 T174 Date 4100 4127 After the following 1 month E97 Date:T174 T175 Diagnostic_procedure 4145 4147 MR E98 Diagnostic_procedure:T175 T176 Sign_symptom 4171 4195 signal of tumor necrosis E99 Sign_symptom:T176 T177 Date 4238 4252 Until 5 months E100 Date:T177 T178 Diagnostic_procedure 4272 4274 CT E101 Diagnostic_procedure:T178 T179 Sign_symptom 4286 4291 tumor E102 Sign_symptom:T179 * OVERLAP E1 E2 E3 R88 AFTER Arg1:E3 Arg2:E5 * OVERLAP E5 E6 R89 BEFORE Arg1:E5 Arg2:E7 * OVERLAP E7 E8 R90 BEFORE Arg1:E8 Arg2:E9 * OVERLAP E9 E10 E11 E12 E13 E14 R91 BEFORE Arg1:E14 Arg2:E15 * OVERLAP E15 E16 E17 R92 AFTER Arg1:E17 Arg2:E18 * OVERLAP E18 E20 E22 E23 E24 R93 BEFORE Arg1:E24 Arg2:E25 * OVERLAP E25 E26 E27 E28 E29 E30 E31 E32 R94 BEFORE Arg1:E32 Arg2:E36 * OVERLAP E36 E37 E38 E40 E41 E43 E42 E45 R95 BEFORE Arg1:E45 Arg2:E46 R96 AFTER Arg1:E46 Arg2:E47 * OVERLAP E47 E48 R97 BEFORE Arg1:E48 Arg2:E49 * OVERLAP E49 E50 E51 E52 E53 E54 E60 E61 E62 R98 BEFORE Arg1:E62 Arg2:E63 * OVERLAP E63 E64 E65 T180 Date 2866 2874 next day E103 Date:T180 R99 BEFORE Arg1:E65 Arg2:E103 * OVERLAP E103 E66 E68 R100 BEFORE Arg1:E68 Arg2:E70 * OVERLAP E70 E69 E71 E72 E73 E74 E75 R101 BEFORE Arg1:E75 Arg2:E77 * OVERLAP E77 E76 E78 E79 R102 BEFORE Arg1:E79 Arg2:E80 * OVERLAP E80 E82 E83 R103 BEFORE Arg1:E83 Arg2:E88 * OVERLAP E88 E84 E104 E85 E86 T181 Coreference 3552 3556 they E104 Coreference:T181 R104 IDENTICAL Arg1:E104 Arg2:E82 R105 BEFORE Arg1:E86 Arg2:E87 R106 BEFORE Arg1:E87 Arg2:E89 * OVERLAP E89 E90 E91 R107 BEFORE Arg1:E91 Arg2:E92 R108 BEFORE Arg1:E92 Arg2:E93 * OVERLAP E93 E94 E96 E95 R109 BEFORE Arg1:E95 Arg2:E97 * OVERLAP E97 E98 E99 E105 T182 Sign_symptom 4219 4227 problems E105 Sign_symptom:T182 A4 POLARITY E105 MAYBE_POS R110 BEFORE Arg1:E105 Arg2:E100 * OVERLAP E100 E101 E102 E106 E56 E55 T183 Sign_symptom 4316 4326 recurrence E106 Sign_symptom:T183 A5 POLARITY E106 MAYBE_NEG