Hepatic Oncology最新文献

{"title":"Locoregional therapy patterns and healthcare economic burden of patients with hepatocellular carcinoma in the USA.","authors":"Abdalla Aly,&nbsp;Melissa Lingohr-Smith,&nbsp;Jay Lin,&nbsp;Brian Seal","doi":"10.2217/hep-2021-0001","DOIUrl":"https://doi.org/10.2217/hep-2021-0001","url":null,"abstract":"<p><strong>Aim: </strong>To examine the locoregional therapy (LRT) patterns and the healthcare economic burden of patients with hepatocellular carcinoma (HCC) in the USA.</p><p><strong>Patients & methods: </strong>Patients with newly diagnosed HCC were identified from the MarketScan^® databases (1 July 2015-31 May 2018). The LRTs received and all-cause and HCC-related healthcare costs were measured.</p><p><strong>Results: </strong>Among 2101 patients with HCC, most received embolization therapy as their first LRT treatment (57.8%, n = 1215); 17.1% (n = 360) received ablative therapy and 8.7% (n = 182) radiation therapy; 16.4% (n = 344) received multiple LRTs. After patients received their first LRT treatment, total all-cause healthcare costs averaged $20,316 per patient per month; 70.7% ($14,359) were HCC related.</p><p><strong>Conclusion: </strong>Among newly diagnosed HCC patients treated with LRT in the USA, the economic burden is high.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 3","pages":"HEP37"},"PeriodicalIF":5.0,"publicationDate":"2021-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/00/hep-08-37.PMC8369525.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39336543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare histologic subtype of hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma: report of a case.","authors":"Numbereye Numbere,&nbsp;Dongwei Zhang,&nbsp;Diana Agostini-Vulaj","doi":"10.2217/hep-2020-0027","DOIUrl":"https://doi.org/10.2217/hep-2020-0027","url":null,"abstract":"<p><p>Worldwide, primary liver cancer is the fourth leading cause of cancer mortality. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Sarcomatoid hepatocellular carcinoma (SHC) is a rare subtype of HCC with conventional HCC admixed with areas with sarcomatoid morphology. SHC is an aggressive, rapidly growing tumor with unfavorable prognosis. Pedunculated SHC is an uncommon presentation of SHC. Due to its rarity, much remains unknown about the etiopathogenesis, molecular underpinnings, and treatment of SHC. We present a case of an exophytic SHC arising in a background of cirrhosis in an older adult. A resection was performed, but the patient subsequently developed multiple additional intrahepatic metastatic lesions necessitating further treatment with chemotherapy.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 2","pages":"HEP33"},"PeriodicalIF":5.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e0/ef/hep-08-33.PMC8162176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39060451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the mechanism behind the progression of NAFLD to hepatocellular carcinoma.","authors":"Pierre Nahon, Manon Allaire, Jean-Charles Nault, Valérie Paradis","doi":"10.2217/hep-2020-0017","DOIUrl":"10.2217/hep-2020-0017","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) developed in non-alcoholic fatty liver disease (NAFLD) individuals presents substantial clinical and biological characteristics, which remain to be elucidated. Its occurrence in noncirrhotic patients raises issues regarding surveillance strategies, which cannot be considered as cost-effective given the high prevalence of obesity and metabolic syndrome, and furthermore delineates specific oncogenic process that could be targeted in the setting of primary or secondary prevention. In this context, the identification of a genetic heterogeneity modulating HCC risk as well as specific biological pathways have been made possible through genome-wide association studies, development of animal models and in-depth analyses of human samples at the pathological and genomic levels. These advances must be confirmed and pursued to pave the way for personalized management of NAFLD-related HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 4","pages":"HEP36"},"PeriodicalIF":1.2,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/c4/hep-07-36.PMC7907968.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25445416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B-related hepatocellular carcinoma and stress: untangling the host immune response from clinical outcomes.","authors":"Peter D Block, Brianna Shinn, Jin Hyang Kim, Hie-Won Hann","doi":"10.2217/hep-2020-0028","DOIUrl":"10.2217/hep-2020-0028","url":null,"abstract":"<p><p>Chronic hepatitis B virus (HBV) infection is a major public health challenge on the global scale. Affecting hundreds of millions worldwide, HBV is a leading risk factor for hepatocellular carcinoma (HCC). Clinical outcomes from chronic HBV infection are varied and appear to be influenced by a complex and dysregulated host immune response. In turn, much attention has been given to the immunologic response to HBV in an effort to identify host factors that lead to the development of HCC. However, the role of nonimmunologic host factors, such as chronic stress, in HBV-related HCC is poorly defined. Indeed, a growing appreciation for the effects of stress on chronic liver diseases raises the question of its role in chronic HBV infection. In this light, the present review will untangle the roles of key host factors in HBV-related HCC with an emphasis on chronic stress as a viable contributor. First discussed is the interplay of stress, inflammation and chronic liver disease. The host immune response's role as a driver of HBV-related HCC is then reviewed, allowing for a close exploration of the effects of stress on immune function in chronic hepatitis B and as a potential risk factor for HBV-related HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 1","pages":"HEP35"},"PeriodicalIF":5.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/59/hep-08-35.PMC7907965.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25453630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotrophin, a pro-peptide of Type VI collagen, is a biomarker of survival in cirrhotic patients with hepatocellular carcinoma.","authors":"Diana Julie Leeming, Signe Holm Nielsen, Roslyn Vongsuvanh, Pruthviraj Uchila, Mette Juul Nielsen, Alexander L Reese-Petersen, David van der Poorten, Mohammed Eslam, Detlef Schuppan, Morten Asser Karsdal, Jacob George","doi":"10.2217/hep-2020-0030","DOIUrl":"10.2217/hep-2020-0030","url":null,"abstract":"<p><strong>Aim: </strong>Type VI collagen, is emerging as a signaling collagen originating from different types of fibroblasts. A specific fragment of Type VI collagen, the pro-peptide, is also known as the hormone endotrophin. We hypothesized that this fibroblast hormone would be of particular relevance in cancer types with a high amount of fibrosis activity, namely for outcome in hepatocellular carcinoma (HCC) cirrhotic patients.</p><p><strong>Patients & methods: </strong>Plasma C6M, PRO-C6 and alphafeto-protein (AFP) were assessed in 309 patients with mixed etiologies (hepatitis C, hepatitis B, alcohol and nonalcoholic fatty liver) diagnosed as cirrhotics, cirrhotics with HCC, noncirrhotics and healthy controls. Progression-free survival and overall survival (OS) data were collected up to 6120 days after diagnosis. The ability of each marker to predict survival was investigated.</p><p><strong>Results & conclusion: </strong>The level of endotrophin assessed by PRO-C6 was able to separate healthy controls, noncirrhotics and cirrhotics from HCC (p < 0.05-0.0001). Both endotrophin and C6M provided value in the prediction of OS in cirrhotic patients with HCC. In the multivariate analysis for identifying HCC, in patients with high endotrophin (highest quartile) and that were positive for AFP (≥20 IU/ml), the hazard ratio for predicting OS was increased from 3.7 (p = 0.0006) to 14.4 (p = 0.0001) when comparing with AFP positive as a stand-alone marker. In conclusion, plasma levels for markers of Type VI collagen remodeling were associated with survival in cirrhotic patients with HCC. A combination of AFP with endotrophin improved the prognostic value compared with AFP alone for predicting OS in cirrhotic patients with HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 2","pages":"HEP32"},"PeriodicalIF":5.0,"publicationDate":"2020-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/96/hep-08-32.PMC8162185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39060450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon-occluded chemoembolization for hepatocellular carcinoma: a prospective study of safety, feasibility and outcomes.","authors":"Ana-Maria Bucalau,&nbsp;Illario Tancredi,&nbsp;Martina Pezzullo,&nbsp;Raphael Leveque,&nbsp;Simona Picchia,&nbsp;Jean-Luc Van Laethem,&nbsp;Gontran Verset","doi":"10.2217/hep-2020-0022","DOIUrl":"https://doi.org/10.2217/hep-2020-0022","url":null,"abstract":"<p><strong>Aim: </strong>Evaluation of safety and efficacy of selective balloon-occluded transarterial chemoembolization using polyethylene glycol embolizing microspheres in patients with hepatocellular carcinoma.</p><p><strong>Materials & methods: </strong>Twenty-four consecutive patients were included in this monocentric prospective trial. Adverse events were evaluated at 24 h and 1 month. Imaging response according to modified response evaluation criteria in solid tumors was assessed at 1, 3 and 6 months.</p><p><strong>Results: </strong>The median time of follow-up was of 22.8 months (interquartile range (IQR) 17.38-26.22). Clinical grade 1/2 toxicities (0% >grade 2) were reported in 25.7% of patients, with abdominal pain being the most frequent complication (17.1%). No 30-days mortalities or liver decompensation were observed. The 1-month follow-up MRI showed an overall response rate of 74.3%.</p><p><strong>Conclusion: </strong>Balloon-occluded transarterial chemoembolization was shown to be safe and effective.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 1","pages":"HEP31"},"PeriodicalIF":5.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25445417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cirrhotomimetic hepatocellular carcinoma: experience of a single institution and review of the literature.","authors":"Meng-Jun Xiong,&nbsp;Chirag R Patel,&nbsp;Upender Manne,&nbsp;Sameer Al Diffalha","doi":"10.2217/hep-2020-0015","DOIUrl":"https://doi.org/10.2217/hep-2020-0015","url":null,"abstract":"<p><p>Cirrhotomimetic hepatocellular carcinoma is a recognized pattern exhibiting cirrhosis-like growth and a reputation for evading pretransplant detection. Five cases encountered from our institution were retrospectively reviewed. Clinicopathologic and literature reviews were performed. All five patients were male, aged 50-66. Diffuse, innumerable nodules were seen grossly, exhibiting predominantly well-to-moderate differentiation with pseudoglandular and trabecular patterns microscopically. By immunohistochemistry, the tumor was diffusely positive for Glypican-3, showed sinusoidal capillarization by CD34 and slightly increased MIB-1 proliferation index. At up to 3.25 years of follow-up, our cohort of cirrhotomimetic hepatocellular carcinoma had no recurrence in 60% (3/5), solitary recurrence in 20% (1/5) and one patient had died of disease in 20% (1/5). Literature review suggests that these tumors recurred at a frequency of 50% (19 of 38 patients).</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"8 1","pages":"HEP28"},"PeriodicalIF":5.0,"publicationDate":"2020-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25445415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards precision medicine in colorectal cancer liver metastases.","authors":"Juan Manuel O'Connor,&nbsp;Fernando Sanchez Loria","doi":"10.2217/hep-2020-0011","DOIUrl":"https://doi.org/10.2217/hep-2020-0011","url":null,"abstract":"Colorectal cancer (CRC) is a prevalent disease globally; it is the third leading cause in cancer incidence and the second cause of cancer-related death worldwide [1]. According to the data published by GLOBOCAN 2018 CRC incidence rates in developed countries are approximately threefold higher than in transitioning countries; however, CRC related mortality rates do not differ significantly due to the fact that average case fatality is higher in lower human developments index settings. Liver is the most common site of metastasis from colorectal cancers (50–60% of the cases). Close to a third of patients have liver metastases either at the time of diagnosis (synchronous in 1/3 of cases) or during the disease course (metachronous in 2/3 of cases) [2]. The approach to the treatment of liver metastases from CRC includes surgical resection, in various modalities, some examples are one-stage hepatectomy, two-stage hepatectomy (TSH) with portal vein ligation or embolization, TSH with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) [3] or ultrasound guided one stage hepatectomy associated with or without ablating methods such as radiofrequency ablation or microwave ablation [4] and systemic treatment, with different chemotherapy protocols in combination with biological agents, such as antiangiogenic therapy or I-EGFR (panitumumab or cetuximab). The strategic alliance between the surgical oncologist and the medical oncologist has been defined through the International Consensus Meeting (Expert Group on OncoSurgery management of Liver Metastases) published in 2012 [5]. One of the most important issues is to define the resectability criteria, which have varied over time as well as the timing of chemotherapy, either neoadjuvant, perioperative or postresection of metastases, with a pseudoadjuvant criteria. The most important issue in almost all cases is multidisciplinary work to guarantee the best therapeutic results and survival benefits for the individual patient. Specialized hospitals with multidisciplinary tumor boards including radiologists, pathologists, oncologists and liver surgeons show better resectability and survival rates than general hospitals or nonspecialized centers. Five year survival has increased from less than 8%, with palliative chemotherapy, to 25–40% using multimodal management including chemotherapy and surgical procedures [6]. On the other hand, resectability criteria have been defined on the basis of technical and oncologic data, the latter according to the presence or lack of extrahepatic disease and progression of disease after systemic treatment, both variables are associated with poor prognosis [7]. There is growing interest in directly assessing tumor biology by molecular profiling and integrating biomarkers into prognostication systems [8]. The KRAS gene has been extensively studied, as there was found to be a high concordance of KRAS status between primary CRC and colorectal liver metastases,","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP29"},"PeriodicalIF":5.0,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38245787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.2217/hep-2020-0999e1","DOIUrl":"https://doi.org/10.2217/hep-2020-0999e1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2217/hep-2020-0006.].</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP30"},"PeriodicalIF":5.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/7c/hep-07-30.PMC7399610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is hepatocellular carcinoma surveillance in high-risk populations effective?","authors":"Kristeen Onyirioha, Sukul Mittal, Amit G Singal","doi":"10.2217/hep-2020-0012","DOIUrl":"10.2217/hep-2020-0012","url":null,"abstract":"<p><p>Several professional societies recommend hepatocellular carcinoma (HCC) surveillance in high-risk patients including patients with cirrhosis from any etiology and subsets of noncirrhotic chronic hepatitis B virus infection. The efficacy of HCC surveillance to increase early detection and improve survival has been demonstrated in a large randomized controlled trial among hepatitis B virus patients and several cohort studies among those with cirrhosis. However, the effectiveness on HCC surveillance, when applied in clinical practice, is lower due to low utilization of HCC surveillance among at-risk patients, poorer test performance given operator dependency and differences in patient characteristics, and downstream process failures such as treatment delays. Interventions to increase surveillance utilization and improve surveillance test performance should improve surveillance effectiveness in the future.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP25"},"PeriodicalIF":5.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/a6/hep-07-25.PMC7399579.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}