Hepatic Oncology最新文献

{"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}

{"title":"Risk assessment criteria in liver transplantation for hepatocellular carcinoma: proposal to improve transplant oncology.","authors":"John C McVey,&nbsp;Kazunari Sasaki,&nbsp;Daniel J Firl","doi":"10.2217/hep-2020-0003","DOIUrl":"https://doi.org/10.2217/hep-2020-0003","url":null,"abstract":"<p><p>Liver transplantation for hepatocellular carcinoma has proved to be a highly effective cure if the right patient can be selected. Milan criteria has traditionally guided physicians toward appropriate liver allocation but changes in clinical practice, patient populations and recent developments in biomarkers are decreasing Milan criteria's utility. At the same time, the literature has flooded with a diversity of new criteria that demonstrate strong predictive power and are better suited for current clinical practice. In this article, the utility of newly proposed criteria will be reviewed and important issues to improve future criteria will be addressed in hopes of opening a discussion on how key questions surrounding criteria for liver transplantation of hepatocellular carcinoma can be answered.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP26"},"PeriodicalIF":5.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246903","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":"Epidemiologic, humanistic and economic burden of hepatocellular carcinoma in the USA: a systematic literature review.","authors":"Abdalla Aly,&nbsp;Sarah Ronnebaum,&nbsp;Dipen Patel,&nbsp;Yunes Doleh,&nbsp;Fernando Benavente","doi":"10.2217/hep-2020-0024","DOIUrl":"10.2217/hep-2020-0024","url":null,"abstract":"<p><strong>Aim: </strong>To describe the epidemiologic, humanistic and economic burdens of hepatocellular carcinoma (HCC) in the USA.</p><p><strong>Materials & methods: </strong>Studies describing the epidemiology and economic burden from national cohorts, any economic models, or any humanistic burden studies published 2008-2018 were systematically searched.</p><p><strong>Results: </strong>HCC incidence was 9.5 per 100,000 person-years in most recent data, but was ∼100-times higher among patients with hepatitis/cirrhosis. Approximately a third of patients were diagnosed with advanced disease. Patients with HCC experienced poor quality of life. Direct costs were substantial and varied based on underlying demographics, disease stage and treatment received. Between 25-77% of patients did not receive surgical, locoregional or systemic treatment.</p><p><strong>Conclusion: </strong>Better treatments are needed to extend survival and improve quality of life for patients with HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP27"},"PeriodicalIF":5.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246904","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":"Long-lasting remission in a metastatic hepatocellular carcinoma patient after combined regorafenib therapy and surgery.","authors":"Elisabetta Goio,&nbsp;Luca Ielasi,&nbsp;Francesca Benevento,&nbsp;Matteo Renzulli,&nbsp;Francesco Tovoli","doi":"10.2217/hep-2020-0014","DOIUrl":"https://doi.org/10.2217/hep-2020-0014","url":null,"abstract":"<p><strong>Aims: </strong>The therapeutic scenario of systemic treatments for hepatocellular carcinoma (HCC) is rapidly changing. There is much interest in the possibility of combining new therapies with surgery, but clinical data is lacking. We aimed to provide an example of such integration.</p><p><strong>Patients & methods: </strong>We report a patient with metastatic HCC who received regorafenib in the setting of the RESORCE trial.</p><p><strong>Results: </strong>A brilliant response led to a tumor downstaging and a subsequent adrenal metastasectomy with radical intent.</p><p><strong>Conclusions: </strong>New agents will change the therapeutic perspectives in advanced HCC and lead to a higher rate of objective responses, with possibilities of associating systemic therapy and surgery. Thus, the management of HCC will require more and more of an integrated, multidisciplinary and personalized approach.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 3","pages":"HEP24"},"PeriodicalIF":5.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38246901","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":"Recent advances of GOLM1 in hepatocellular carcinoma.","authors":"Jiuliang Yan,&nbsp;Binghai Zhou,&nbsp;Hui Li,&nbsp;Lei Guo,&nbsp;Qinghai Ye","doi":"10.2217/hep-2020-0006","DOIUrl":"https://doi.org/10.2217/hep-2020-0006","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is one of the most common liver malignancies and is a leading cause of cancer-related deaths. Most HCC patients are diagnosed at an advanced stage and current treatments show poor therapeutic efficacy. It is particularly urgent to explore early diagnosis methods and effective treatments of HCC. There are a growing number of studies that show GOLM1 is one of the most promising markers for early diagnosis and prognosis of HCC. It is also involved in immune regulation, activation and degradation of intracellular signaling factors and promotion of epithelial-mesenchymal transition. GOLM1 can promote HCC progression and metastasis. The understanding of the GOLM1 regulation mechanism may provide new ideas for the diagnosis, monitoring and treatment of HCC.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 2","pages":"HEP22"},"PeriodicalIF":5.0,"publicationDate":"2020-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38144706","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":"The future of liver transplantation: an interview with Pierre-Alain Clavien.","authors":"Pierre-Alain Clavien","doi":"10.2217/hep-2020-0021","DOIUrl":"https://doi.org/10.2217/hep-2020-0021","url":null,"abstract":"<p><p>In this interview, we catch up with <i>Hepatic Oncology</i> board member Pierre-Alain Clavien to discuss his involvement in the development of an integrated perfusion machine capable of preserving livers outside of the body for up to 1 week. The development could have huge implications for the future of liver transplantation as it is hoped it could allow more patients access to vital transplants.</p>","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 2","pages":"HEP23"},"PeriodicalIF":5.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38144707","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":"HCC occurrence after DAA treatments: molecular tools to assess the post-treatment risk and surveillance.","authors":"Devis Pascut,&nbsp;Muhammad Yogi Pratama,&nbsp;Claudio Tiribelli","doi":"10.2217/hep-2020-0010","DOIUrl":"https://doi.org/10.2217/hep-2020-0010","url":null,"abstract":"The perspective of hepatitis C virus (HCV) therapy has dramatically changed over the years after the introduction of direct-acting antiviral (DAA) therapy, which increased the sustainable viral response rate (SVR) up to 90% with better tolerance and effectiveness in clinical practice as compared with interferon-based regimens [1]. However, despite the excellent efficacy and extensive studies, alarming reports from two retrospective studies, conducted in 2016 in Spain and Italy [2,3], suggested an increased risk of hepatocellular carcinoma (HCC) occurrence and recurrence after DAA treatment in patients, triggering the debate on the safety profile of DAA and its correlation to HCC development. Nonetheless, some criticisms regarding the absence of control groups, sample size or short-follow-up periods have been raised in some studies. A meta-analysis conducted by Waziry et al. in 2017 estimated no significant HCC occurrence cases in both DAA-treated or interferon-treated patients following SVR [4]. Indeed, several reports underlined the efficacy of DAA in significantly reducing the risk of HCC in patients with SVR as compared with those with either treatment failure or no treatment [1,5,6]. However, what emerges from those studies is that the DAA-induced SVR reduces the risk of HCC occurrence, without eliminating it. This includes patients with other risk factors, such as age, gender and cirrhosis. In particular, patients with cirrhosis with long exposure to the virus, can still be considered at risk, even after the achievement of SVR. Hamdane et al. described how epigenetic alterations induced by chronic HCV infection persist even after viral clearance and were further associated with HCC risk [7]. Liver alteration was also evident in early studies conducted by Kono et al., observing sustained abnormal ALT and AFP levels, especially in F3–F4 patients (F3: severe fibrosis, characterized by fibrotic bridging across lobules, between portal areas and between portal areas and central veins; F4: cirrhosis), even after the achievement of SVR. Multivariate analysis identified pre-treatment low albumin levels and fibrosis 4 (FIB-4) index as independent predictive factors for the sustained AFP after SVR. At the same time, the fatty liver presence was associated with both sustained abnormal AFP and ALT levels after SVR [8] suggesting that the persistence of hepatocyte damage and regeneration mechanisms might lead to HCC development. The oxidative stress present in the fatty liver might also be responsible for DNA damage that foster carcinogenesis [8]. Confirming the results of Kono et al., Watanabe et al. identified FIB-4 index ≥4.0 and albumin ≤3.8 g/dl at the beginning of DAA treatment and a FIB-4 index ≥4.0 and AFP ≥6.0 at the end of DAA treatment as independent predictors for HCC occurrence [9]. Moreover, despite the correlation between HCC risk with fibrosis index, recent data suggested the presence of liver steatosis in HCV patients as a major predictor","PeriodicalId":44854,"journal":{"name":"Hepatic Oncology","volume":"7 2","pages":"HEP21"},"PeriodicalIF":5.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2217/hep-2020-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38144705","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}