Liver Cancer最新文献

{"title":"Guidelines for the Diagnosis and Treatment of Primary Liver Cancer (2022 Edition).","authors":"Jian Zhou,&nbsp;Huichuan Sun,&nbsp;Zheng Wang,&nbsp;Wenming Cong,&nbsp;Mengsu Zeng,&nbsp;Weiping Zhou,&nbsp;Ping Bie,&nbsp;Lianxin Liu,&nbsp;Tianfu Wen,&nbsp;Ming Kuang,&nbsp;Guohong Han,&nbsp;Zhiping Yan,&nbsp;Maoqiang Wang,&nbsp;Ruibao Liu,&nbsp;Ligong Lu,&nbsp;Zhenggang Ren,&nbsp;Zhaochong Zeng,&nbsp;Ping Liang,&nbsp;Changhong Liang,&nbsp;Min Chen,&nbsp;Fuhua Yan,&nbsp;Wenping Wang,&nbsp;Jinlin Hou,&nbsp;Yuan Ji,&nbsp;Jingping Yun,&nbsp;Xueli Bai,&nbsp;Dingfang Cai,&nbsp;Weixia Chen,&nbsp;Yongjun Chen,&nbsp;Wenwu Cheng,&nbsp;Shuqun Cheng,&nbsp;Chaoliu Dai,&nbsp;Wengzhi Guo,&nbsp;Yabing Guo,&nbsp;Baojin Hua,&nbsp;Xiaowu Huang,&nbsp;Weidong Jia,&nbsp;Qiu Li,&nbsp;Tao Li,&nbsp;Xun Li,&nbsp;Yaming Li,&nbsp;Yexiong Li,&nbsp;Jun Liang,&nbsp;Changquan Ling,&nbsp;Tianshu Liu,&nbsp;Xiufeng Liu,&nbsp;Shichun Lu,&nbsp;Guoyue Lv,&nbsp;Yilei Mao,&nbsp;Zhiqiang Meng,&nbsp;Tao Peng,&nbsp;Weixin Ren,&nbsp;Hongcheng Shi,&nbsp;Guoming Shi,&nbsp;Ming Shi,&nbsp;Tianqiang Song,&nbsp;Kaishan Tao,&nbsp;Jianhua Wang,&nbsp;Kui Wang,&nbsp;Lu Wang,&nbsp;Wentao Wang,&nbsp;Xiaoying Wang,&nbsp;Zhiming Wang,&nbsp;Bangde Xiang,&nbsp;Baocai Xing,&nbsp;Jianming Xu,&nbsp;Jiamei Yang,&nbsp;Jianyong Yang,&nbsp;Yefa Yang,&nbsp;Yunke Yang,&nbsp;Shenglong Ye,&nbsp;Zhenyu Yin,&nbsp;Yong Zeng,&nbsp;Bixiang Zhang,&nbsp;Boheng Zhang,&nbsp;Leida Zhang,&nbsp;Shuijun Zhang,&nbsp;Ti Zhang,&nbsp;Yanqiao Zhang,&nbsp;Ming Zhao,&nbsp;Yongfu Zhao,&nbsp;Honggang Zheng,&nbsp;Ledu Zhou,&nbsp;Jiye Zhu,&nbsp;Kangshun Zhu,&nbsp;Rong Liu,&nbsp;Yinghong Shi,&nbsp;Yongsheng Xiao,&nbsp;Lan Zhang,&nbsp;Chun Yang,&nbsp;Zhifeng Wu,&nbsp;Zhi Dai,&nbsp;Minshan Chen,&nbsp;Jianqiang Cai,&nbsp;Weilin Wang,&nbsp;Xiujun Cai,&nbsp;Qiang Li,&nbsp;Feng Shen,&nbsp;Shukui Qin,&nbsp;Gaojun Teng,&nbsp;Jiahong Dong,&nbsp;Jia Fan","doi":"10.1159/000530495","DOIUrl":"https://doi.org/10.1159/000530495","url":null,"abstract":"<p><strong>Background: </strong>Primary liver cancer, of which around 75-85% is hepatocellular carcinoma in China, is the fourth most common malignancy and the second leading cause of tumor-related death, thereby posing a significant threat to the life and health of the Chinese people.</p><p><strong>Summary: </strong>Since the publication of Guidelines for Diagnosis and Treatment of Primary Liver Cancer in China in June 2017, which were updated by the National Health Commission in December 2019, additional high-quality evidence has emerged from researchers worldwide regarding the diagnosis, staging, and treatment of liver cancer, that requires the guidelines to be updated again. The new edition (2022 Edition) was written by more than 100 experts in the field of liver cancer in China, which not only reflects the real-world situation in China but also may reshape the nationwide diagnosis and treatment of liver cancer.</p><p><strong>Key messages: </strong>The new guideline aims to encourage the implementation of evidence-based practice and improve the national average 5-year survival rate for patients with liver cancer, as proposed in the \"Health China 2030 Blueprint.\"</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"405-444"},"PeriodicalIF":13.8,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival Trends in Sorafenib for Advanced Hepatocellular Carcinoma: A Reconstructed Individual Patient Data Meta-Analysis of Randomized Trials.","authors":"Darren Jun Hao Tan, Ansel Shao Pin Tang, Wen Hui Lim, Cheng Han Ng, Benjamin Nah, Clarissa Fu, Jieling Xiao, Benjamin Koh, Phoebe Wen Lin Tay, Eunice X Tan, Margaret Teng, Nicholas Syn, Mark D Muthiah, Nobuharu Tamaki, Sung Won Lee, Beom Kyung Kim, Thomas Yau, Arndt Vogel, Rohit Loomba, Daniel Q Huang","doi":"10.1159/000529824","DOIUrl":"10.1159/000529824","url":null,"abstract":"<p><strong>Background: </strong>Emerging data suggest that outcomes for advanced hepatocellular carcinoma (HCC) treated with sorafenib may have improved over time. We aimed to provide robust, time-to-event estimates of survival outcomes for sorafenib in advanced HCC.</p><p><strong>Summary: </strong>In this systematic review and individual patient data meta-analysis of randomized-controlled trials (RCTs), we searched MEDLINE and Embase from inception till September 2022 for RCTs that provided data for overall survival (OS) and progression-free survival (PFS) for sorafenib monotherapy as first-line systemic therapy for advanced HCC. We performed a pooled analysis using reconstructed individual participant data from published Kaplan-Meier curves to obtain robust estimates for OS and PFS. Of 1,599 articles identified, 29 studies (5,525 patients) met the inclusion criteria. Overall, the median OS was 10.4 (95% CI: 9.6-11.4) months. Median OS increased over time, from 9.8 (95% CI: 8.8-10.7) months in studies before 2015 to 13.4 (95% CI: 11.03-15.24) months in studies from 2015 onwards (<i>p</i> < 0.001). OS did not differ by trial phase, geographical region, or study design. The overall median PFS was 4.4 (95% CI: 3.9-4.8) months, but PFS did not improve over time. Sensitivity analysis of studies from 2015 and onwards to account for the introduction of direct-acting antivirals determined that hepatitis C virus was associated with reduced mortality (<i>p</i> < 0.001). There was minimal heterogeneity in the estimates for OS (all <i>I</i>² ≤ 33).</p><p><strong>Key messages: </strong>Survival outcomes for sorafenib in advanced HCC have improved over time. These data have important implications for clinical trial design.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"445-456"},"PeriodicalIF":11.6,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Resection or Radiofrequency Ablation for Small Hepatocellular Carcinoma.","authors":"Yoshikuni Kawaguchi,&nbsp;Ryosuke Tateishi,&nbsp;Norihiro Kokudo,&nbsp;Kiyoshi Hasegawa","doi":"10.1159/000530300","DOIUrl":"https://doi.org/10.1159/000530300","url":null,"abstract":"Not applicable","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"494-496"},"PeriodicalIF":13.8,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definitive Liver Radiotherapy for Intrahepatic Cholangiocarcinoma with Extrahepatic Metastases.","authors":"Brian De, Rituraj Upadhyay, Kaiping Liao, Tiffany Kumala, Christopher Shi, Grace Dodoo, Joseph Abi Jaoude, Kelsey L Corrigan, Gohar S Manzar, Kathryn E Marqueen, Vincent Bernard, Sunyoung S Lee, Kanwal P S Raghav, Jean-Nicolas Vauthey, Ching-Wei D Tzeng, Hop S Tran Cao, Grace Lee, Jennifer Y Wo, Theodore S Hong, Christopher H Crane, Bruce D Minsky, Grace L Smith, Emma B Holliday, Cullen M Taniguchi, Albert C Koong, Prajnan Das, Milind Javle, Ethan B Ludmir, Eugene J Koay","doi":"10.1159/000530134","DOIUrl":"10.1159/000530134","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor-related liver failure (TRLF) is the most common cause of death in patients with intrahepatic cholangiocarcinoma (ICC). Though we previously showed that liver radiotherapy (L-RT) for locally advanced ICC is associated with less frequent TRLF and longer overall survival (OS), the role of L-RT for patients with extrahepatic metastatic disease (M1) remains undefined. We sought to compare outcomes for M1 ICC patients treated with and without L-RT.</p><p><strong>Methods: </strong>We reviewed ICC patients that found to have M1 disease at initial diagnosis at a single institution between 2010 and 2021 who received L-RT, matching them with an institutional cohort by propensity score and a National Cancer Database (NCDB) cohort by frequency technique. The median biologically effective dose was 97.5 Gy (interquartile range 80.5-97.9 Gy) for L-RT. Patients treated with other local therapies or supportive care alone were excluded. We analyzed survival with Cox proportional hazard modeling.</p><p><strong>Results: </strong>We identified 61 patients who received L-RT and 220 who received chemotherapy alone. At median follow-up of 11 months after diagnosis, median OS was 9 months (95% confidence interval [CI] 8-11) and 21 months (CI: 17-26) for patients receiving chemotherapy alone and L-RT, respectively. TRLF was the cause of death more often in the patients who received chemotherapy alone compared to those who received L-RT (82% vs. 47%; <i>p</i> = 0.001). On multivariable propensity score-matched analysis, associations with lower risk of death included duration of upfront chemotherapy (hazard ratio [HR] 0.82; <i>p</i> = 0.005) and receipt of L-RT (HR: 0.40; <i>p</i> = 0.002). The median OS from diagnosis for NCDB chemotherapy alone cohort was shorter than that of the institutional L-RT cohort (9 vs. 22 months; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>For M1 ICC, L-RT associated with a lower rate of death due to TRLF and longer OS versus those treated with chemotherapy alone. Prospective studies of L-RT in this setting are warranted.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 3","pages":"198-208"},"PeriodicalIF":11.6,"publicationDate":"2023-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/2f/lic-2023-0012-0003-530134.PMC10427952.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surveillance, Diagnosis, and Treatment Outcome of Hepatocellular Carcinoma in Japan: 2023 Update.","authors":"Masatoshi Kudo","doi":"10.1159/000530079","DOIUrl":"10.1159/000530079","url":null,"abstract":"","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 2","pages":"95-102"},"PeriodicalIF":11.6,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/56/ad/lic-0012-0095.PMC10267513.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9654522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin-Bilirubin Grade Analyses of Atezolizumab plus Bevacizumab versus Sorafenib in Patients with Unresectable Hepatocellular Carcinoma: A Post Hoc Analysis of the Phase III IMbrave150 Study.","authors":"Masatoshi Kudo,&nbsp;Richard S Finn,&nbsp;Ann-Lii Cheng,&nbsp;Andrew X Zhu,&nbsp;Michel Ducreux,&nbsp;Peter R Galle,&nbsp;Naoya Sakamoto,&nbsp;Naoya Kato,&nbsp;Michitaka Nakano,&nbsp;Jing Jia,&nbsp;Arndt Vogel","doi":"10.1159/000529996","DOIUrl":"https://doi.org/10.1159/000529996","url":null,"abstract":"<p><strong>Introduction: </strong>Atezolizumab + bevacizumab showed survival benefit in patients with unresectable hepatocellular carcinoma (HCC) versus sorafenib in the Phase III IMbrave150 study. This exploratory analysis examined the prognostic impact of a baseline albumin-bilirubin (ALBI) score.</p><p><strong>Methods: </strong>Patients with treatment-naïve unresectable HCC, ≥1 measurable untreated lesion, and Child-Pugh class A liver function were randomized 2:1 to receive atezolizumab 1,200 mg + bevacizumab 15 mg/kg every 3 weeks or sorafenib 400 mg twice daily. Overall survival (OS) and progression-free survival (PFS) were assessed in the intention-to-treat population by ALBI/modified (m)ALBI grade. Time to deterioration (TTD; defined as time to 0.5-point increase from the baseline ALBI score over 2 visits or death) of liver function and safety were investigated.</p><p><strong>Results: </strong>Of 501 enrolled patients, 336 were randomized to receive atezolizumab + bevacizumab (ALBI grade [G] 1: <i>n</i> = 191; G2: <i>n</i> = 144 [mALBI G2a: <i>n</i> = 72, G2b: <i>n</i> = 72]; missing ALBI grade: <i>n</i> = 1) and 165 to sorafenib (ALBI G1: <i>n</i> = 87; G2: <i>n</i> = 78 [mALBI G2a: <i>n</i> = 37; G2b: <i>n</i> = 41]). Median follow-up was 15.6 months. OS and PFS improved with atezolizumab + bevacizumab versus sorafenib in patients with ALBI G1 (OS HR: 0.50 [95% CI: 0.35, 0.72]; PFS HR: 0.61 [95% CI: 0.45, 0.82]). In patients with ALBI G2 or mALBI G2a or G2b, PFS was numerically longer with atezolizumab + bevacizumab versus sorafenib, but no OS benefit was seen. Median TTD in the intention-to-treat population was 10.2 months (95% CI: 8.0, 11.0) with atezolizumab + bevacizumab versus 8.6 months (95% CI: 6.2, 11.8) with sorafenib (HR: 0.82 [95% CI: 0.65, 1.03]). Safety profiles of atezolizumab and bevacizumab were consistent with previous analyses, regardless of ALBI grade.</p><p><strong>Conclusion: </strong>ALBI grade appeared to be prognostic for outcomes with both atezolizumab + bevacizumab and sorafenib treatment in patients with HCC. Atezolizumab + bevacizumab preserved liver function for a numerically longer duration than sorafenib.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"479-493"},"PeriodicalIF":13.8,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"APPLE News","authors":"","doi":"10.1159/000529383","DOIUrl":"https://doi.org/10.1159/000529383","url":null,"abstract":"<br />Liver Cancer 2023;12:93–93","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"7 1","pages":""},"PeriodicalIF":13.8,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138526674","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":"Pembrolizumab as Second-Line Therapy for Advanced Hepatocellular Carcinoma: Longer Term Follow-Up from the Phase 3 KEYNOTE-240 Trial.","authors":"Philippe Merle, Masatoshi Kudo, Julien Edeline, Mohamed Bouattour, Ann-Lii Cheng, Stephen L Chan, Thomas Yau, Marcelo Garrido, Jennifer Knox, Bruno Daniele, Valeriy Breder, Ho Yeong Lim, Sadahisa Ogasawara, Stéphane Cattan, Yee Chao, Abby B Siegel, Iván Martinez-Forero, Ziwen Wei, Chih-Chin Liu, Richard S Finn","doi":"10.1159/000529636","DOIUrl":"10.1159/000529636","url":null,"abstract":"<p><strong>Introduction: </strong>KEYNOTE-240 showed a favorable benefit/risk profile for pembrolizumab versus placebo in patients with sorafenib-treated advanced hepatocellular carcinoma (HCC); however, prespecified statistical significance criteria for overall survival (OS) and progression-free survival (PFS) superiority were not met at the final analysis. Outcomes based on an additional 18 months of follow-up are reported.</p><p><strong>Methods: </strong>Adults with sorafenib-treated advanced HCC were randomized 2:1 to pembrolizumab 200 mg intravenously every 3 weeks or placebo. Dual primary endpoints were OS and PFS assessed per RECIST v1.1 by blinded independent central review (BICR). Secondary endpoints included objective response rate (ORR), assessed per RECIST v1.1 by BICR, and safety.</p><p><strong>Results: </strong>413 patients were randomized (pembrolizumab, <i>n</i> = 278; placebo, <i>n</i> = 135). As of July 13, 2020, median (range) time from randomization to data cutoff was 39.6 (31.7-48.8) months for pembrolizumab and 39.8 (31.7-47.8) months for placebo. Estimated OS rates (95% CI) were 17.7% (13.4-22.5%) for pembrolizumab and 11.7% (6.8-17.9%) for placebo at 36 months. The estimated PFS rate (95% CI) for pembrolizumab was 8.9% (5.3-13.6%) and 0% for placebo at 36 months. ORR (95% CI) was 18.3% (14.0-23.4%) for pembrolizumab and 4.4% (1.6-9.4%) for placebo. Immune-mediated hepatitis events did not increase with follow-up. No viral hepatitis flare events were reported.</p><p><strong>Conclusion: </strong>With extended follow-up, pembrolizumab continued to maintain improvement in OS and PFS and was associated with a consistent adverse event profile compared with placebo in patients with sorafenib-treated advanced HCC. Although KEYNOTE-240 did not meet prespecified statistical significance criteria at the final analysis, these results together with the antitumor activity of second-line pembrolizumab observed in KEYNOTE-224 and the statistically significant and clinically meaningful OS and PFS benefits of second-line pembrolizumab in patients from Asia observed in KEYNOTE-394 reinforce the clinical activity of pembrolizumab in previously treated patients with advanced HCC.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 4","pages":"309-320"},"PeriodicalIF":11.6,"publicationDate":"2023-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intrahepatic External Beam Radiotherapy in Advanced Hepatocellular Carcinoma Patients Treated with Tyrosine Kinase Inhibitors.","authors":"Myung Ji Goh,&nbsp;Hee Chul Park,&nbsp;Jeong Il Yu,&nbsp;Wonseok Kang,&nbsp;Geum-Youn Gwak,&nbsp;Yong-Han Paik,&nbsp;Joon Hyeok Lee,&nbsp;Kwang Cheol Koh,&nbsp;Seung Woon Paik,&nbsp;Dong Hyun Sinn,&nbsp;Moon Seok Choi","doi":"10.1159/000529635","DOIUrl":"https://doi.org/10.1159/000529635","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate whether concurrent use of intrahepatic external beam radiotherapy (EBRT) is a viable option for patients with advanced hepatocellular carcinoma (HCC) undergoing tyrosine kinase inhibitor (TKI) therapy.</p><p><strong>Methods: </strong>A total of 453 patients with Barcelona Clinic Liver Cancer stage C (BCLC C) HCC, who started first-line treatment with TKI with intrahepatic EBRT (TKI + RT, <i>n</i> = 97) or TKI without intrahepatic EBRT (TKI, <i>n</i> = 356) were analyzed. The overall survival (OS) and progression-free survival (PFS) were compared in the overall cohort, patients who received at least 8 weeks of TKI treatment and a propensity score-matched cohort.</p><p><strong>Results: </strong>OS and PFS were better in those treated with TKI + RT than TKI (8.6 vs. 4.4 months and 4.5 vs. 2.3 months, respectively, with <i>p</i> < 0.001). Of note, the TKI + RT group demonstrated significantly longer time to intrahepatic tumor progression. In subgroup analysis, TKI + RT led to better OS than TKI in all subgroups and PFS was significantly improved in patients without extrahepatic metastasis and those with portal vein invasion. There was no significant difference in treatment discontinuation due to adverse events between the TKI + RT and TKI groups (32.0% vs. 37.9%, <i>p</i> = 0.34). Furthermore, patients treated with TKI + RT showed better liver function preservation over time compared to TKI without intrahepatic EBRT. Comparable treatment outcomes were observed between patients who received at least 8 weeks of TKI treatment and the propensity score-matched cohort.</p><p><strong>Conclusion: </strong>Concurrent intrahepatic EBRT targeting the liver and/or macrovascular invasion can be a viable option to improve outcomes of BCLC stage C patients receiving TKI therapy with an aim to control intrahepatic progression and preserving the liver function.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"467-478"},"PeriodicalIF":13.8,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Smoking Cessation and the Risk of Cholangiocarcinoma and Ampulla of Vater Cancer: A Nationwide Cohort Study.","authors":"Joo-Hyun Park,&nbsp;Jung Yong Hong,&nbsp;Kyungdo Han","doi":"10.1159/000529609","DOIUrl":"https://doi.org/10.1159/000529609","url":null,"abstract":"<p><strong>Introduction: </strong>The association between smoking cessation and intrahepatic and extrahepatic cholangiocarcinoma (iCCA and eCCA) risk is unclear. Furthermore, the association in individuals with preexisting risk factors is unknown. We aimed to investigate the association between smoking status (especially smoking cessation) and CCA risk according to individuals' glycemic status.</p><p><strong>Methods: </strong>In this nationwide cohort study, 9,520,629 adults without cancer who underwent national health screening by the Korean National Health Insurance Service in 2009 were followed up through 2018. The hazard ratios (HRs) and 95% confidence intervals (CIs) for CCA were estimated after adjusting for potential confounders.</p><p><strong>Results: </strong>During the 78.3 person-years of follow-up, 16,236 individuals were newly diagnosed with CCA. Quitters had a significantly lower risk of iCCA and eCCA compared to current smokers in all glycemic status groups (all <i>p</i> < 0.01). The HRs (95% CIs) for iCCA in current smokers and quitters were 1.33 (1.24-1.43) versus 0.98 (0.90-1.06) in individuals with normoglycemia, 1.49 (1.37-1.63) versus 1.17 (1.06-1.28) in individuals with prediabetes, and 2.15 (1.96-2.37) versus 1.58 (1.42-1.75) in individuals with diabetes, compared to never-smokers with normoglycemia. Current smokers with diabetes or prediabetes had a synergistically increased risk of iCCA (all <i>p</i> < 0.01). However, quitters with diabetes and prediabetes had an iCCA risk comparable to that of never-smokers. Analysis of eCCA yielded similar results. Smoking was not independently associated with the risk of the ampulla of Vater cancer. However, smoking combined with diabetes or prediabetes was associated with an increased risk of the ampulla of Vater cancer (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Smoking cessation was associated with a reduced risk of CCA, despite the synergistically increased risk in current smokers with diabetes and prediabetes. Our findings suggest a crucial opportunity to reduce the risk of CCA. More individualized and intensive cancer prevention education is needed against CCA.</p>","PeriodicalId":18156,"journal":{"name":"Liver Cancer","volume":"12 5","pages":"457-466"},"PeriodicalIF":13.8,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71412866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}