Hepatology Research最新文献

{"title":"Prognostic performance of a two-step method using the Fibro-Scope system for metabolic dysfunction-associated steatotic liver disease.","authors":"Yuya Seko, Kanji Yamaguchi, Toshihide Shima, Saiyu Tanaka, Takao Shirono, Yusuke Takahashi, Kento Takeuchi, Seita Kataoka, Michihisa Moriguchi, Takeshi Okanoue, Yoshito Itoh","doi":"10.1111/hepr.14121","DOIUrl":"https://doi.org/10.1111/hepr.14121","url":null,"abstract":"<p><strong>Aim: </strong>Fibro-Scope is an artificial intelligence/neural network system for the noninvasive diagnosis of hepatic fibrosis in patients with metabolic dysfunction-associated steatotic liver disease. We aimed to examine the diagnostic performance of a two-step method that used the Fibrosis-4 (FIB-4) index and Fibro-Scope system for the assessment of Japanese patients with metabolic dysfunction-associated steatotic liver disease.</p><p><strong>Methods: </strong>We analyzed a longitudinal study cohort of 796 Japanese patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease during a follow-up period of 6.4 years. The predictive performance of the two-step method of FIB-4 index and Fibro-Scope for liver-related events and prognostic performance of that were assessed in the patients.</p><p><strong>Results: </strong>In the 796 patients, by classifying the intermediate zone, defined by FIB-4 index 1.30-2.67, using the Fibro-Scope, the final classification was 69.6% low risk, 28.3% high risk, and 2.1% in the middle-risk group. The sensitivity and specificity for predicting advanced fibrosis (≥F3) was 84.0% and 84.0%. During the follow-up period, 52 (6.5%) patients developed liver-related events and 35 died. Multivariate analysis revealed that high-risk patients derived from the two-step method had hazard ratios of 30.1 or the development of liver-related events and 7.8 for outcome.</p><p><strong>Conclusions: </strong>The two-step method using the FIB-4 index and Fibro-Scope contributed to improving the diagnostic performance by picking up high-risk patients from those classified as intermediate risk with the FIB-4 index. This noninvasive method, which uses a blood sample is a cost-effective screening method, is suitable for clinical practice in Japan.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the nervous system in liver diseases","authors":"Boris Mravec,&nbsp;Maria Szantova","doi":"10.1111/hepr.14125","DOIUrl":"10.1111/hepr.14125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>The nervous system significantly participates in maintaining homeostasis, and modulating repair and regeneration processes in the liver. Moreover, the nervous system also plays an important role in the processes associated with the development and progression of liver disease, and can either potentiate or inhibit these processes. The aim of this review is to describe the mechanisms and pathways through which the nervous system influences the development and progression of liver diseases, such as alcohol-associated liver disease, nonalcoholic fatty liver disease, cholestatic liver disease, hepatitis, cirrhosis, and hepatocellular carcinoma. Possible therapeutic implications based on modulation of signals transduction between the nervous system and the liver are also discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"54 11","pages":"970-980"},"PeriodicalIF":3.9,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world trends in acute viral hepatitis in Japan: A nationwide questionnaire-based survey.","authors":"Kazuya Okushin, Tatsuya Kanto, Masaaki Korenaga, Kazuhiko Ikeuchi, Toshiyuki Kishida, Akira Kado, Mitsuhiro Fujishiro, Takeya Tsutsumi, Tomoyuki Takura, Hiroshi Yotsuyanagi","doi":"10.1111/hepr.14123","DOIUrl":"https://doi.org/10.1111/hepr.14123","url":null,"abstract":"<p><strong>Aim: </strong>The actual incidence of acute viral hepatitis in Japan remains unclear. We aimed to investigate trends in the incidence of acute hepatitis B and C infections in Japan.</p><p><strong>Methods: </strong>A nationwide, multicenter, retrospective questionnaire-based survey was conducted. Participating hospitals received questionnaires through nationwide geographically distributed regional core centers certified as specialists in hepatitis treatment. The questionnaire included hospital size and the number of patients diagnosed with acute hepatitis B or C during each fiscal year (FY) from 2015 to 2022. The sex distribution in each FY was also documented. Comparisons were made before and during the COVID-19 era (2015-2019 vs. 2020-2022), and between populous and non-populous prefectures.</p><p><strong>Results: </strong>Responses to the questionnaires were obtained from 127 institutions in 29 prefectures covering eight regions in Japan. A median of 127.0 patients with acute hepatitis B (interquartile range [IQR] 106.5-131.8 patients) were reported during each FY, and the incidence significantly decreased during the fiscal years 2020-2022 compared with the fiscal years 2015-2020 (median 96.0 [IQR 91.0-103.0] patients vs. 131.0 [IQR 128.0-134.0] patients; p = 0.03). A median of 10.0 (IQR, 7.8-13.5) patients were reported with acute hepatitis C during each FY. The proportions of men in acute hepatitis B and C were significantly higher in populous prefectures.</p><p><strong>Conclusions: </strong>Populous prefectures had a higher proportion of men among viral hepatitis patients than non-populous prefectures. Estimating the high-risk populations in each area could provide insights to advance the elimination of viral hepatitis.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"c-Met inhibitor upregulates E-cadherin, which is lost in portal vein tumor thrombus of hepatocellular carcinoma.","authors":"Satoru Abe, Yoshinori Inagaki, Takashi Kokudo, Akinori Miyata, Yujiro Nishioka, Akihiko Ichida, Junichi Kaneko, Nobuhisa Akamatsu, Yoshikuni Kawaguchi, Kiyoshi Hasegawa","doi":"10.1111/hepr.14120","DOIUrl":"https://doi.org/10.1111/hepr.14120","url":null,"abstract":"<p><strong>Aim: </strong>Portal vein tumor thrombus (PVTT) in hepatocellular carcinoma (HCC) is an essential therapeutic and prognostic factor. E-cadherin plays a crucial role in adhesive properties and intercellular interaction in various cancer tissues, including HCC, but the expression profile and functional contribution of E-cadherin in PVTT remain unknown. This study aimed to analyze the expression of E-cadherin in the main tumor tissue and PVTT tissue of HCC, and evaluate the functional roles of E-cadherin in PVTT formation.</p><p><strong>Methods: </strong>A retrospective analysis was performed using the medical records of patients who underwent liver resection for HCC with PVTT, analyzing tissue specimens from 1995 to 2016. E-cadherin expression is evaluated using immunohistochemistry and western blot. The study also uses a c-Met inhibitor to explore its impact on E-cadherin expression in vitro and in vivo using cell lines and a tumor xenograft mouse model.</p><p><strong>Results: </strong>The results revealed a reduced E-cadherin expression in PVTT tissue than in the main tumor tissue. The inhibition of c-Met activation, frequently detected in HCC, upregulated E-cadherin expression in HCC cell lines. Furthermore, treatment with c-Met inhibitors induced changes in epithelial morphology, and inhibited migration and invasion of HCC cell lines.</p><p><strong>Conclusions: </strong>This study demonstrates the downregulation of E-cadherin in PVTT, and underscores the potential of c-Met inhibition in upregulating E-cadherin and inhibiting metastatic behavior. Understanding the significance of E-cadherin and c-Met in HCC progression provides a foundation for future clinical investigations into the therapeutic effects of c-Met inhibitors on PVTT in HCC patients.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distribution of Fibrosis-4 index and vibration-controlled transient elastography-derived liver stiffness measurement for patients with metabolic dysfunction-associated steatotic liver disease in health check-up.","authors":"Yuji Ogawa, Wataru Tomeno, Yasushi Imamura, Masaru Baba, Takato Ueno, Takashi Kobayashi, Michihiro Iwaki, Asako Nogami, Takaomi Kessoku, Yasushi Honda, Kazuo Notsumata, Hirotoshi Fujikawa, Megumi Kaai, Kento Imajo, Miwa Kawanaka, Hideyuki Hyogo, Mitsurou Hisatomi, Mamiko Takeuchi, Taku Hakamada, Takashi Honda, Miwa Tatsuta, Asahiro Morishita, Shigeru Mikami, Ken Furuya, Noriaki Manabe, Tomoari Kamada, Takumi Kawaguchi, Masato Yoneda, Satoru Saito, Atsushi Nakajima","doi":"10.1111/hepr.14117","DOIUrl":"https://doi.org/10.1111/hepr.14117","url":null,"abstract":"<p><strong>Aims: </strong>The multisociety consensus nomenclature has introduced steatotic liver disease (SLD) with diverse subclassifications, which are metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated steatotic liver disease (MetALD), alcohol-associated liver disease (ALD), specific etiology, and cryptogenic. We investigated their prevalence, as per the new definition, in individuals undergoing health check-ups. Additionally, we analyzed the distribution of Fibrosis-4 (FIB-4) index and vibration-controlled transient elastography (VCTE)-derived liver stiffness measurement (LSM) for MASLD.</p><p><strong>Methods: </strong>In this cross-sectional study, 6530 subjects undergoing a health check-up in Japan were included. Conventional B-mode ultrasound was carried out on all 6530 subjects, and those with MASLD underwent VCTE.</p><p><strong>Results: </strong>The prevalence of SLD was 39.5%, comprising MASLD 28.7%, MetALD 8.6%, ALD 1.2%, specific etiology SLD 0.3%, and cryptogenic SLD 0.7%. Subjects with VCTE-derived LSM ≥8 kPa constituted 2.1% of MASLD. FIB-4 ≥1.3 showed that the sensitivity, specificity, positive predictive value (PPV), and negative predictive value for diagnosing VCTE-derived LSM ≥8 kPa were 60.6%, 77.0%, 5.3%, and 98.9%, respectively. The referral rate to specialists was 23.8% using FIB-4 ≥1.30. \"FIB-4 ≥1.3 in subjects <65 years and FIB-4 ≥2.0 in subjects ≥65 years\" showed higher PPV (6.7%) and lower referral rate (17.1%) compared with FIB-4 ≥1.3, but the sensitivity (54.5%) did not show adequate diagnostic capability as a noninvasive test for diagnosing VCTE-derived LSM ≥8 kPa.</p><p><strong>Conclusions: </strong>Acknowledging the selection bias in hepatology centers, we undertook this prospective health check-up study. Although the FIB-4 index proves to be a convenient marker, it might not perform well as a primary screening tool for liver fibrosis in the general population (UMIN Clinical Trials Registry No. UMIN000035188).</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent acute kidney injury: Postoperative impact and predictors in patients undergoing liver resection.","authors":"Shunsuke Doi, Satoshi Yasuda, Minako Nagai, Kota Nakamura, Yasuko Matsuo, Taichi Terai, Yuichiro Kohara, Takeshi Sakata, Masayuki Sho","doi":"10.1111/hepr.14119","DOIUrl":"https://doi.org/10.1111/hepr.14119","url":null,"abstract":"<p><strong>Aim: </strong>Persistent acute kidney injury (AKI) has not been investigated in patients undergoing liver resection. We aimed to identify the predictors of persistent AKI, its effect on postoperative outcomes and long-term renal function in patients following liver resection, and its impact on survival in patients with hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>We examined 990 patients who underwent liver resection, including a subgroup analysis of 384 patients with curative resection for initial HCC. Persistent AKI was defined as residual impairment of serum creatinine ≥ 0.3 mg/dL or ≥50% from baseline 1 month after surgery.</p><p><strong>Results: </strong>The persistent AKI group had significantly worse postoperative outcomes, including overall morbidity, major morbidity, longer hospital stay, and 90-day mortality. In the subgroup analysis of patients with HCC, persistent AKI was associated with a significantly poorer overall survival (OS) rate (p < 0.001), and the multivariate analysis confirmed persistent AKI as an independent poor prognostic factor for OS (p = 0.005). The long-term postoperative estimated glomerular filtration rate decline was significantly greater in the persistent AKI group than in the no AKI and transient AKI groups (p < 0.001 for both). Chronic kidney disease, albumin-bilirubin grade ≥2, and anatomical resection were independent predictors of persistent AKI (p = 0.001, p = 0.039, and p = 0.015, respectively).</p><p><strong>Conclusions: </strong>Persistent AKI adversely affects postoperative outcomes and long-term renal function in patients undergoing liver resection. Furthermore, it is associated with poor prognosis in patients with HCC. Therapeutic strategies to prevent persistent AKI are critical for improving postoperative outcomes in these patients.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for the diagnosis and treatment of idiopathic portal hypertension, extrahepatic portal obstruction, and Budd–Chiari syndrome in Japan","authors":"Yoshihiro Furuichi,&nbsp;Masayoshi Kage,&nbsp;Masayuki Ohta,&nbsp;Satoko Ohfuji,&nbsp;Hideyuki Sasaki,&nbsp;Hisashi Hidaka,&nbsp;Hiroshi Yoshida,&nbsp;Tatsuya Kanto,&nbsp;Hironori Kusano,&nbsp;Tomohiko Akahoshi,&nbsp;Katsutoshi Obara,&nbsp;Makoto Hashizume,&nbsp;Yukio Kuniyoshi,&nbsp;Takumi Kawaguchi,&nbsp;Hironao Okubo,&nbsp;Tsuyoshi Ishikawa,&nbsp;Masashi Hirooka,&nbsp;Yasuko Iwakiri,&nbsp;Masaki Nio,&nbsp;Atsushi Tanaka","doi":"10.1111/hepr.14118","DOIUrl":"10.1111/hepr.14118","url":null,"abstract":"<p>This is the English version of the guidelines for the diagnosis and treatment of idiopathic portal hypertension, extrahepatic portal obstruction, and Budd–Chiari syndrome, which were established and revised in 2018 by the Aberrant Portal Hemodynamics Study Group under the jurisdiction of the Ministry of Health, Labor, and Welfare in Japan. These guidelines are excerpts, and the full version consists of 86 clinical questions and explanations, totaling 183 pages in Japanese.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"54 11","pages":"952-969"},"PeriodicalIF":3.9,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between antibiotic use and cardiovascular diseases in metabolic dysfunction-associated steatotic liver disease: A nationally representative retrospective cohort study.","authors":"Ju Hyun Kang, Sun Jae Park, Seogsong Jeong, Young Jun Park, Hye Jun Kim, Jihun Song, Jiwon Choi, Sangwoo Park, Jaewon Kim, Hyeokjong Lee, Jooyoung Chang, Joung Sik Son, Sang Min Park","doi":"10.1111/hepr.14115","DOIUrl":"https://doi.org/10.1111/hepr.14115","url":null,"abstract":"<p><strong>Aim: </strong>Various subcategories for steatotic liver disease (SLD) were proposed globally. Previous studies suggested a heightened risk of cardiovascular diseases (CVD) with prolonged antibiotic exposure and metabolic dysfunction-associated SLD (MASLD), respectively. This study investigates the impact of antibiotic usage on CVD in MASLD patients.</p><p><strong>Methods: </strong>From the Korean National Health Insurance Service database, 276 520 adults aged 40 and older were included. Antibiotic exposure was defined by the cumulative prescription days and the number of classes. Participants were categorized into no SLD and MASLD groups. Hepatic steatosis was defined by using the fatty liver index ≥60. From 2013 to 2019, 16 197 CVD cases were recorded. A multivariate Cox model, adjusting for covariates, assessed adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk associated with MASLD and antibiotic prescriptions.</p><p><strong>Results: </strong>The group with ≥91 days of antibiotics prescribed and MASLD showed a significantly increased risk of CVD (aHR, 1.56; 95% CI, 1.39-1.74) compared with antibiotic non-users without SLD. Furthermore, the group with ≥4 classes of antibiotics prescribed and MASLD had an elevated risk of CVD (aHR, 1.49; 95% CI, 1.34-1.66) compared with antibiotic non-users without SLD. Consistent results were observed in several sensitivity analyses.</p><p><strong>Conclusions: </strong>Our study identified prolonged antibiotic exposure may be a factor that increases the risk of CVD in MASLD patients. These findings suggest an epidemiological basis for the therapeutic application of antibiotics in MASLD patients, and emphasize the need for further studies to deepen the understanding of these intricate relationships.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal splenic artery embolization for treatment of refractory ascites, a single-center experience.","authors":"Abdul Rehman Mustafa, Raneem Atta, Russell P Goodman, Vincent Wu, Zubin Irani, Omar Zurkiya, Emily D Bethea, Kei Yamada, Eric P Wehrenberg-Klee","doi":"10.1111/hepr.14116","DOIUrl":"https://doi.org/10.1111/hepr.14116","url":null,"abstract":"<p><strong>Aim: </strong>Refractory ascites from portal hypertension can be managed with regular large-volume paracentesis (LVP) or transjugular intrahepatic portosystemic shunt (TIPS). Large-volume paracentesis is clinically unsatisfactory and many patients are ineligible or relatively contraindicated for TIPS or Denver shunt. Proximal splenic artery embolization (PSAE) using coils or plugs reduces but does not completely stop splenic arterial inflow, differing from distal splenic artery embolization techniques. By reducing splenic arterial inflow, splenic vein outflow is also decreased, lowering portal pressure and thus treating refractory ascites.</p><p><strong>Methods: </strong>In this institutional review board-approved single-center retrospective study, electronic medical records were reviewed to obtain demographics and baseline clinical and laboratory data, paracentesis data before and after PSAE, PSAE procedural details, and follow-up imaging up to 12 months post-PSAE. Mixed-effects models were used for statistical analysis.</p><p><strong>Results: </strong>Ten patients with LVP-dependent ascites meeting inclusion criteria underwent PSAE for refractory ascites from 2017 to 2024. Prior to PSAE, four patients had TIPS, three had liver transplants, and the remaining three were neither TIPS nor transplant candidates. In the month before PSAE, patients averaged 3.8 ± 1.7 paracentesis sessions, draining a total of 20.84 ± 10.39 L of fluid monthly. Post-PSAE, the number of paracentesis sessions decreased to 2.1 ± 2.7, 1.0 ± 1.7, 0.4 ± 1.1, and 0.0 ± 0.0 at 1, 3, 6, and 12 months, respectively (p = 0.03). Corresponding ascitic volume drained decreased to 8.7 ± 10.3, 2.7 ± 6.4, 2.0 ± 5.4, and 0.0 ± 0.0 L (p = 0.01). Over the 12-month follow-up period, 6 of 10 patients became LVP-independent.</p><p><strong>Conclusion: </strong>Proximal splenic artery embolization can improve refractory ascites in certain patients with portal hypertension, thus providing safe and effective treatment as an alternative to TIPS.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A classification model for resectability in hepatocellular carcinoma patients.","authors":"Ikuo Nakamura, Tomoaki Yoh, Takashi Nishimura, Masayuki Okuno, Tomohiro Okamoto, Hideaki Sueoka, Kenjiro Iida, Masaharu Tada, Takamichi Ishii, Satoru Seo, Yasuhiro Fujimoto, Hiroko Iijima, Seiko Hirono, Etsuro Hatano","doi":"10.1111/hepr.14108","DOIUrl":"https://doi.org/10.1111/hepr.14108","url":null,"abstract":"<p><strong>Aim: </strong>Some patients undergoing liver resection for hepatocellular carcinoma (HCC) have poor outcomes. Therefore, we aimed to propose a new resectability classification for patients with HCC.</p><p><strong>Methods: </strong>We classified patients into three categories: resectable (R), borderline resectable (BR), and unresectable (UR). Patients (n = 409) who underwent hepatectomy for HCC were assigned to the non-UR (R and BR classes combined; n = 285) and UR-HCC classes (n = 68; training cohort). Patient characteristics in the BR-HCC and R-HCC groups were compared. The new criteria were tested in a validation cohort (n = 295).</p><p><strong>Results: </strong>Of the 285 patients, 229 and 56 were classified into the R- and BR-HCC classes, respectively, using macrovascular invasion, tumor size, and future liver remnant/modified albumin-bilirubin scores. Patients with BR-HCC demonstrated significantly worse progression-free and overall survival (p < 0.0001 and p < 0.0001, respectively) than patients with R-HCC in the training cohort. Similar results were observed in the validation cohort. Multivariate analysis of the non-UR-HCC group in the training cohort revealed that the tumor number and BR-HCC were independent predictive factors for poor overall survival.</p><p><strong>Conclusions: </strong>This classification can help select patients with BR-HCC for preoperative treatment before considering surgery.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}