JHEP Reports最新文献

{"title":"SBRT for bridging and downstaging HCC before transplant","authors":"Zhihao Li ,&nbsp;Michael Yan ,&nbsp;Marco P.A.W. Claasen ,&nbsp;Luckshi Rajendran ,&nbsp;Christian T.J. Magyar ,&nbsp;Saheli Saha ,&nbsp;Cameron Lee ,&nbsp;Nazia Selzner ,&nbsp;Elmar Jaeckel ,&nbsp;Anand Ghanekar ,&nbsp;Mark Cattral ,&nbsp;Blayne A. Sayed ,&nbsp;Markus Selzner ,&nbsp;Ian McGilvray ,&nbsp;Chaya Shwaartz ,&nbsp;Trevor Reichman ,&nbsp;Grainne M. O’Kane ,&nbsp;Arndt Vogel ,&nbsp;Robert C. Grant ,&nbsp;Tae Kyoung Kim ,&nbsp;Gonzalo Sapisochin","doi":"10.1016/j.jhepr.2025.101451","DOIUrl":"10.1016/j.jhepr.2025.101451","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Stereotactic body radiotherapy (SBRT) has emerged as a bridging/downstaging therapy for patients with hepatocellular carcinoma (HCC) awaiting liver transplantation (LT). This study evaluates the safety and outcomes of the use of SBRT in such patients.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted from 2004 to 2019 on 88 adult patients with HCC receiving SBRT as bridging/downstaging therapy. Endpoints, included treatment-related toxicities, liver function decline, and LT probability post SBRT, were analyzed using competing risk analysis.</div></div><div><h3>Results</h3><div>SBRT was used for bridging in 58 (66%) patients and downstaging in 30 (34%). Most patients had compensated liver function pre-SBRT and were treated with a median SBRT dose of 36 Gy in six fractions. Toxicities were mild (58% grade 1, 2% grade 2, and no grade 3 toxicities). Of the patients, 23% experienced a decline in liver function within 6 months post SBRT. The probability of LT post SBRT was 30% at 6 months, 61% at 1 year, and 73% at 2 years. Key predictors of LT post SBRT included model for end-stage liver disease (MELD) score, alpha-fetoprotein (AFP) level, and number and total tumor volume of HCC lesions. Overall, 61 (69%) patients underwent LT at a median of 6.3 months (IQR: 3.1–10.0) post SBRT, with major complications reported in 26% and an in-hospital mortality of 3%. Overall and recurrence-free survival at 1, 3, and 5 years post transplant were 88%, 83%, and 83% and 83%, 75%, 73%, respectively. The cumulative incidence of recurrence was significantly higher in the downstaging group compared with the bridging group (15%, 23%, and 32% <em>vs.</em> 7%, 15%, and 17% at 1, 3, and 5 years, respectively). Explant pathology revealed a 25% complete pathological response rate (bridging, 30%; downstaging, 12%).</div></div><div><h3>Conclusions</h3><div>Our results showed that SBRT is a safe and effective bridging therapy for HCC. However, its role in downstaging is limited by lower response rates and higher recurrence, emphasizing the importance of patient selection.</div></div><div><h3>Impact and implications</h3><div>SBRT is an emerging therapy for patients with HCC awaiting LT, with limited data available on its safety and efficacy. Our study provides crucial insights for physicians and researchers, demonstrating that SBRT is a safe and effective option for bridging patients with HCC to transplantation. These findings are important for optimizing treatment strategies and providing patients with additional therapeutic options while awaiting transplantation. However, the lower response rates and higher recurrence in the downstaging group highlight the need for further research to improve patient selection and tailor treatments for optimal outcomes.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 8","pages":"Article 101451"},"PeriodicalIF":9.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of liver biopsy size on MASLD fibrosis assessment by second-harmonic generation/two-photon excitation fluorescence microscopy","authors":"Daniel T. Field ,&nbsp;Yayun Ren ,&nbsp;Kutbuddin Akbary ,&nbsp;Elaine Chng ,&nbsp;Dean Tai ,&nbsp;Nikolai V. Naoumov ,&nbsp;David E. Kleiner ,&nbsp;Jonathan A. Fallowfield ,&nbsp;Timothy J. Kendall ,&nbsp;Arun J. Sanyal","doi":"10.1016/j.jhepr.2025.101449","DOIUrl":"10.1016/j.jhepr.2025.101449","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) is a prognostic indicator and clinical trial efficacy endpoint. Second-harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy images unstained tissue sections and, when integrated with artificial intelligence models, generates a continuous fibrosis value (qFibrosis) and ordinal qFibrosis stage. The impact of biopsy size and location on the accuracy of these approaches has not been assessed in MASLD, leaving quality assurance procedures undefined.</div></div><div><h3>Methods</h3><div>One unstained section each from 100 hepatectomy/explant MASLD cases, 20 of each pathologist-assigned Non-alcoholic Steatohepatitis Clinical Research Network (NASH-CRN) fibrosis stage (F0–F4), were used to create virtual core biopsies by cropping regions from within the whole parent section. Regions varied in length (5–30 mm) with a fixed width of 0.9 mm, width (0.5–1.3 mm) with a fixed length of 15 mm, or position within the whole parent section. SHG/TPEF was used, and the qFibrosis continuous value and stage of the virtual core biopsies were determined for comparison with those of the whole parent section.</div></div><div><h3>Results</h3><div>The qFibrosis continuous value and stage correlated strongly with pathologist-assigned NASH-CRN stage (r_s = 0.92). Increasing the length and width of virtual biopsies increased the correlation between the qFibrosis continuous value and the agreement with the qFibrosis stage of the whole parent section, stabilising between 20–26 mm in length and 0.9 mm in width. The position within the tissue did not influence qFibrosis metrics.</div></div><div><h3>Conclusions</h3><div>Longer (&gt;20 mm) and wider (&gt;0.9 mm) biopsies provide more accurate fibrosis assessment using SHG/TPEF. Biopsy position and orientation do not influence accuracy.</div></div><div><h3>Impact and implications</h3><div>Fibrosis assessment is an important prognostic indicator and clinical trial endpoint in metabolic dysfunction-associated steatotic liver disease, but liver biopsy sampling variation quality assurance has not been investigated for second-harmonic generation/two-photon excitation fluorescence (SHG/TPEF) microscopy quantification of fibrosis. Longer (&gt;20 mm) and wider (&gt;0.9 mm) biopsies allow for more accurate digital assessment of fibrosis. Clinical trials should incorporate suitable protocols to verify biopsy sizes that optimise digital fibrosis assessment using SHG/TPEF.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 8","pages":"Article 101449"},"PeriodicalIF":9.5,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144572227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between stage migration and overall survival after radiation-based therapies in patients with hepatocellular carcinoma","authors":"Suraj Pai ,&nbsp;Amit G. Singal ,&nbsp;Shengchen Hao ,&nbsp;Sruthi Yekkaluri ,&nbsp;Anjana Pillai ,&nbsp;Andrew M. Moon ,&nbsp;Ted K. Yanagihara ,&nbsp;Nima Kokabi ,&nbsp;Jane Brown ,&nbsp;Vir J. Kalaria ,&nbsp;Michael C. Mohnasky ,&nbsp;Jonathan Melendez-Torres ,&nbsp;Muhammad M. Tahir ,&nbsp;Aamir Ali ,&nbsp;Muhammad S. Malik ,&nbsp;Isaiah Brown ,&nbsp;Mikin V. Patel ,&nbsp;Jared Christensen ,&nbsp;Theodore Lawrence ,&nbsp;Mishal Mendiratta-Lala ,&nbsp;Neehar D. Parikh","doi":"10.1016/j.jhepr.2025.101434","DOIUrl":"10.1016/j.jhepr.2025.101434","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Stereotactic body radiation therapy (SBRT) and transarterial radioembolization (TARE) are common locoregional therapies for hepatocellular carcinoma (HCC). However, lack of surrogate endpoints has limited the feasibility of conducting comparative effectiveness clinical trials.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective cohort study of adult patients with HCC who received SBRT or TARE as initial treatment between 2008 and 2019. We excluded those with Barcelona Clinic Liver Cancer (BCLC) stage D disease. The primary outcome was overall survival, with transplantation as a competing risk. The independent variable of interest was stage migration to a more advanced BCLC stage (<em>e.g.</em> BCLC stage B → C) within 6 months of treatment. Survival analysis was completed using Kaplan–Meier, and multivariable Cox proportional hazard models were used to identify predictors of survival.</div></div><div><h3>Results</h3><div>We included 257 patients with a median age of 65 years; 77% male and 66% White. Most (75%) had Child–Pugh class A cirrhosis. Stage migration within 6 months was observed in 45 (18%) patients. Patients who experienced stage migration within 6 months of receiving SBRT or TARE had significantly shorter survival than those without stage migration (median 192 days [IQR 108–397 days]) median <em>vs.</em> 1,259 days [IQR 591–2,135 days], respectively; <em>p</em> &lt;0.001). In multivariable analysis, stage migration was significantly associated with worse survival (hazard ratio: 5.1, 95% CI: 4.3–6.0), however the correlation between stage migration and survival was not sufficient for surrogacy. The results were consistent in an independent external validation cohort and in relevant subgroup analyses.</div></div><div><h3>Conclusions</h3><div>Stage migration at 6 months is associated with overall survival in patients with HCC undergoing SBRT or TARE.</div></div><div><h3>Impact and implications</h3><div>Stage migration in patients with receiving hepatocellular carcinoma (HCC) treatment is a multi-faceted measure of tumor function, functional status, and liver function. In this study we were able to show that worsening Barcelona Clinic Liver Cancer stage within 6 months of receipt of radiation treatment is associated with overall survival. Stage migration could be further explored as an endpoint in future clinical trials in patients with HCC receiving radiation therapies.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 7","pages":"Article 101434"},"PeriodicalIF":9.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritising viral hepatitis elimination to prevent hepatocellular carcinoma: A public health approach for effective preventive hepatology","authors":"Dana Ivancovsky Wajcman ,&nbsp;Aina Nicolàs ,&nbsp;Camila A. Picchio ,&nbsp;Lena van Selm ,&nbsp;Geoffrey Dusheiko ,&nbsp;Zobair M. Younossi ,&nbsp;John F. Dillon ,&nbsp;Saleh A. Alqahtani ,&nbsp;Homie Razavi ,&nbsp;Massimo G. Colombo ,&nbsp;Achim Kautz ,&nbsp;Gregory J. Dore ,&nbsp;Jeffrey V. Lazarus","doi":"10.1016/j.jhepr.2025.101436","DOIUrl":"10.1016/j.jhepr.2025.101436","url":null,"abstract":"<div><div>Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, accounting for about 70-80% of cases globally. The hepatitis B and C viruses (HBV and HCV) account for approximately 70% of all HCC cases worldwide, with variation across geographic regions. While progress has been made in achieving some of the World Health Organization's viral hepatitis elimination targets set for 2030, considerable action is still needed to achieve global viral hepatitis elimination. Although numerous viral hepatitis prevention strategies, including vaccination against HBV, have proven successful, considerable gaps and challenges remain in their implementation. Likewise, monitoring for additional risk factors for HCC continues to be insufficient. This is particularly important given that the burden of viral hepatitis is further compounded by the high and rising prevalence of steatotic liver disease (formerly called fatty liver disease), a growing global concern and a major HCC driver. A more comprehensive approach to HCC prevention is critical and we propose an evolving narrative which emphasises an expanded understanding of “preventive hepatology” as a framework. Preventive hepatology recognises that the growing burden of liver cancer, mainly HCC, can be effectively addressed through the prevention and treatment of viral hepatitis, with additional, targeted preventive measures being applicable for populations at risk, through screening and surveillance. A more holistic approach to HCC prevention should include primary prevention strategies for the early detection and timely treatment of viral hepatitis and steatotic liver disease. It should also include HCC surveillance among people living with chronic viral hepatitis infection, particularly those living with cirrhosis, those cured of HCV, and the management of additional risk factors associated with other HCC aetiologies.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 8","pages":"Article 101436"},"PeriodicalIF":9.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifaximin in the spotlight: Are we ready to target the microbiome?","authors":"Florent Artru ,&nbsp;Virginia Hernández-Gea","doi":"10.1016/j.jhepr.2025.101360","DOIUrl":"10.1016/j.jhepr.2025.101360","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101360"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to ‘Cholangiocarcinoma across England: Temporal changes in incidence, survival and routes to diagnosis by region and level of socioeconomic deprivation’ [JHEP Reports 6 (2024) 100983]","authors":"Daniela Tataru ,&nbsp;Shahid A. Khan ,&nbsp;Roger Hill ,&nbsp;Helen Morement ,&nbsp;Kwok Wong ,&nbsp;Lizz Paley ,&nbsp;Mireille B. Toledano","doi":"10.1016/j.jhepr.2025.101326","DOIUrl":"10.1016/j.jhepr.2025.101326","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101326"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “A comment on <Association of physical activity, including amount and maintenance, with the risk of HCC among patients with type 2 diabetes>”","authors":"Mi Na Kim","doi":"10.1016/j.jhepr.2025.101333","DOIUrl":"10.1016/j.jhepr.2025.101333","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101333"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “Changing epidemiology of hepatocellular carcinoma in the Mediterranean area: A challenge for surveillance?”","authors":"Margarita Sala ,&nbsp;María Varela","doi":"10.1016/j.jhepr.2025.101445","DOIUrl":"10.1016/j.jhepr.2025.101445","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 7","pages":"Article 101445"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Copyright and information","authors":"","doi":"10.1016/S2589-5559(25)00119-3","DOIUrl":"10.1016/S2589-5559(25)00119-3","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101442"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board page","authors":"","doi":"10.1016/S2589-5559(25)00117-X","DOIUrl":"10.1016/S2589-5559(25)00117-X","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101440"},"PeriodicalIF":9.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}