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Clinical and Molecular Hepatology Feb 2023Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing... (Review)
Review
Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing cause of HCC worldwide. Accordingly, professional society guidelines recommend HCC surveillance in patients with cirrhosis from any etiology, and some may consider it beneficial in subgroups with non-cirrhotic NAFLD at higher risk for HCC. Notably, patients with NAFLD-related HCC are more likely to have HCC diagnosed at more advanced stages and have poorer outcomes when compared to other etiologies, and suboptimal effectiveness of HCC surveillance programs is a major culprit. In this review, we summarize the current guidelines for HCC surveillance and discuss its benefits versus potential harms for NAFLD patients. We also address the unique challenges of HCC surveillance in NAFLD, including higher proportion of NAFLD-related HCC without cirrhosis, poor recognition of at-risk patients, lack of consensus regarding the value of surveillance in non-cirrhotic NAFLD, subpar effectiveness of surveillance tools related to NAFLD phenotype, and preponderant surveillance underuse among NAFLD patients. Finally, we examine the effectiveness of currently used surveillance tools (i.e., ultrasound and alpha fetoprotein) and outline future perspectives including emerging risk stratification tools, imaging surveillance strategies (e.g., abbreviated magnetic resonance imaging protocols), blood-based biomarkers (e.g., GALAD and circulating tumor DNA panels), and interventions to improve surveillance adherence.
Topics: Humans; Carcinoma, Hepatocellular; Non-alcoholic Fatty Liver Disease; Liver Neoplasms; Risk Factors; Liver Cirrhosis; Fibrosis
PubMed: 36103899
DOI: 10.3350/cmh.2022.0247 -
Critical Reviews in Oncology/hematology Sep 2018Radiofrequency ablation (RFA) is an effective local treatment for curative intent in patients with cirrhosis of the liver and hepatocellular carcinoma (HCC) with... (Review)
Review
Radiofrequency ablation (RFA) is an effective local treatment for curative intent in patients with cirrhosis of the liver and hepatocellular carcinoma (HCC) with diameter <3 cm. Several meta-analyses have shown that RFA and surgical resection are comparable in terms of their impact on overall survival. The only clinical data available on markers that are predictive of recurrence and survival after RFA treatment are based on retrospective observational studies. Prospective randomized trials are thus needed to further research in this area. In the present review we analyzed a number of clinical factors that are considered to predict recurrence or survival in HCC patients treated with RFA. We also discussed in detail the circulating biomarkers investigated to date, together with their potential to predict prognosis and recurrence after RFA therapy. Overall survival rates of patients with HCC are significantly affected by liver function, defined as Child-Pugh class, high baseline serum alpha-fetoprotein levels, and the presence of portosystemic collaterals. However, the development of local tumor progression does not significantly affect overall survival. This result is achieved by the effective therapies in patients who relapse after treatment with RFA. For this reason there is an urgent need to identify new circulating biomarkers.
Topics: Biomarkers; Carcinoma, Hepatocellular; Catheter Ablation; Humans; Liver Neoplasms; Neoplasm Recurrence, Local; Survival Rate; Treatment Outcome
PubMed: 30097237
DOI: 10.1016/j.critrevonc.2018.06.017 -
Oncotarget Dec 2016The platelet-to-lymphocyte ratio (PLR) is reported to be a prognostic factor in multiple malignancies. The aim of this study was to assess its prognostic value in... (Meta-Analysis)
Meta-Analysis Review
The platelet-to-lymphocyte ratio (PLR) is reported to be a prognostic factor in multiple malignancies. The aim of this study was to assess its prognostic value in hepatocellular carcinoma (HCC). We performed comprehensive searches of electronic databases for relevant studies. A total of eleven studies comprising 2,507 patients were included. Elevated PLR was significantly associated with poor overall survival (OS) (HR = 1.78; 95% CI = 1.36-2.34; P < 0.001) and disease-free survival (DFS)/recurrence-free survival (RFS) (HR = 1.82; 95% CI = 1.56-2.13; P < 0.001). The findings from most subgroup analyses were consistent with those from the overall analysis. In addition, a high PLR correlated with tumor size > 3 cm, TNM stage, lymph node metastasis, distant metastasis, and vascular invasion. We therefore conclude that elevated pretreatment PLR may be predicative of a poor prognosis in patients with HCC.
Topics: Adult; Aged; Aged, 80 and over; Blood Platelets; Carcinoma, Hepatocellular; Chi-Square Distribution; Disease Progression; Disease-Free Survival; Female; Humans; Liver Neoplasms; Lymphatic Metastasis; Lymphocyte Count; Lymphocytes; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Odds Ratio; Platelet Count; Predictive Value of Tests; Risk Factors; Time Factors; Treatment Outcome; Tumor Burden; Young Adult
PubMed: 27833084
DOI: 10.18632/oncotarget.13244 -
Frontiers in Bioscience (Landmark... Jan 2019Hepatocellular Carcinoma (HCC) is a leading cause of cancer related death worldwide with a relatively poor survival rate. Aside from liver resection and subsequent... (Review)
Review
Hepatocellular Carcinoma (HCC) is a leading cause of cancer related death worldwide with a relatively poor survival rate. Aside from liver resection and subsequent transplant, the most effective and leading curative measure for HCC is the chemotherapeutic, sorafenib, a multi-kinase inhibitor used for treatment of late stage HCC. However, the effects of sorafenib are short lived due to the liver's rapid acquisition of Multi-Drug Resistance (MDR). MicroRNAs (miRNAs) have emerged as critical regulatory molecules for almost every biochemical pathway in an organism. The development and progression of HCC and acquired MDR are critically influenced by miRNAs through regulation of key genes in cell regulatory pathways. This review explores the involvement of miRNAs in development of HCC and their role in key signaling pathways for MDR in HCC.
Topics: Animals; Antineoplastic Agents; Carcinoma, Hepatocellular; Drug Resistance, Neoplasm; Gene Expression Regulation, Neoplastic; Humans; Liver Neoplasms; MicroRNAs; Signal Transduction; Sorafenib
PubMed: 30468672
DOI: 10.2741/4734 -
Scientific Reports Mar 2021Circular RNA (circRNA) is a type of non-coding RNA known to affect cancer-related micro RNAs and various transcription factors. circRNA has promise as a cancer-related... (Clinical Trial)
Clinical Trial
Circular RNA (circRNA) is a type of non-coding RNA known to affect cancer-related micro RNAs and various transcription factors. circRNA has promise as a cancer-related biomarker because its circular structure affords high stability. We found using high-throughput sequencing that seven candidate circRNAs (hsa_circ_0041150, hsa_circ_0025624, hsa_circ_0001020, hsa_circ_0028129, hsa_circ_0008558, hsa_circ_0036683, hsa_circ_0058087) were downregulated in HCC. The expression of these circRNAs was examined by quantitative PCR in 233 sets of HCC and matched background normal liver tissues, and correlations between candidate circRNA expression and prognosis were evaluated. The results of quantitative PCR showed that expression of hsa_circ_0041150, hsa_circ_0001020 and hsa_circ_0008558 was significantly lower in HCC than in background normal liver tissues. Kaplan-Meier analysis revealed that low expression of hsa_circ_0001020, hsa_circ_0036683, and hsa_circ_0058087 was associated with poor recurrence-free (RFS) and overall survival (OS) in HCC. Additionally, multivariate analysis revealed that low hsa_circ_0036683 expression was a significant prognostic factor, independent from other clinicopathological features, for inferior RFS and OS. There was no significant association between the expression of these circRNAs and hepatitis B/C status or cirrhosis. This study therefore identified circRNAs as potential prognostic markers for patients who undergo curative surgery for HCC and highlighted hsa_circ_0036683 as the most useful biomarker.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Disease-Free Survival; Female; Genome-Wide Association Study; Humans; Liver Neoplasms; Male; Middle Aged; RNA, Circular; RNA, Neoplasm; Retrospective Studies; Survival Rate
PubMed: 33727578
DOI: 10.1038/s41598-021-85237-y -
Cancer Imaging : the Official... Mar 2017Treatment options for hepatocellular carcinoma have evolved over recent years. Interventional radiologists and surgeons can offer curative treatments for early stage... (Review)
Review
Treatment options for hepatocellular carcinoma have evolved over recent years. Interventional radiologists and surgeons can offer curative treatments for early stage tumours, and locoregional therapies can be provided resulting in longer survival times. Early diagnosis with screening ultrasound is the key. CT and MRI are used to characterize lesions and determine the extent of tumour burden. Imaging techniques are discussed in this article as the correct imaging protocols are essential to optimise successful detection and characterisation. After treatment it is important to establish regular imaging follow up with CT or MRI as local residual disease can be easily treated, and recurrence elsewhere in the liver is common.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Neoplasm Recurrence, Local; Tomography, X-Ray Computed; Ultrasonography
PubMed: 28259177
DOI: 10.1186/s40644-017-0110-z -
Journal of B.U.ON. : Official Journal... 2018Metastases to the liver from colorectal cancer (CRC) are common, and only a minority of patients are candidates for upfront surgery at the initial diagnosis. Carefully... (Review)
Review
Metastases to the liver from colorectal cancer (CRC) are common, and only a minority of patients are candidates for upfront surgery at the initial diagnosis. Carefully selected patients can achieve long-term survival from surgery with curative intent. Unfortunately, the risk of recurrence remains substantial after liver resection. In order to reduce the risk of relapse and improve the outcomes, the role of neoadjuvant chemotherapy has been assessed for resectable colorectal liver metastases (CRLM) with an improvement in progression-free survival (PFS). In particular, this approach seems to be more beneficial for resectable patients with risk factors associated with unfavorable prognosis. However, controversies still remain as to whether neoadjuvant chemotherapy would bring long-term survival benefit for patients with resectable CRLM, along with the main challenge in identifying those who can benefit greatly from this approach due to lack of well documented selection criteria for patient stratification. In addition, no evidence directly addresses whether targeted agents such as cetuximab and bevacizumab should be offered with chemotherapy in the preoperative setting of resectable patients, despite that these aggressive strategies could result in high response rates. To offer the reader an insight into these complex and unresolved issues we will give an overview of three hot topics related to neoadjuvant chemotherapy for initially resectable CRLM.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Chemotherapy, Adjuvant; Colorectal Neoplasms; Disease-Free Survival; Hepatectomy; Humans; Liver Neoplasms; Neoadjuvant Therapy; Neoplasm Recurrence, Local; Prognosis
PubMed: 29745068
DOI: No ID Found -
Chinese Medical Journal Jun 2024In humans, the liver is a central metabolic organ with a complex and unique histological microenvironment. Hepatocellular carcinoma (HCC), which is a highly aggressive... (Review)
Review
In humans, the liver is a central metabolic organ with a complex and unique histological microenvironment. Hepatocellular carcinoma (HCC), which is a highly aggressive disease with a poor prognosis, accounts for most cases of primary liver cancer. As an emerging hallmark of cancers, metabolic reprogramming acts as a runaway mechanism that disrupts homeostasis of the affected organs, including the liver. Specifically, rewiring of the liver metabolic microenvironment, including lipid metabolism, is driven by HCC cells, propelling the phenotypes of HCC cells, including dissemination, invasion, and even metastasis in return. The resulting formation of this vicious loop facilitates various malignant behaviors of HCC further. However, few articles have comprehensively summarized lipid reprogramming in HCC metastasis. Here, we have reviewed the general situation of the liver microenvironment and the physiological lipid metabolism in the liver, and highlighted the effects of different aspects of lipid metabolism on HCC metastasis to explore the underlying mechanisms. In addition, we have recapitulated promising therapeutic strategies targeting lipid metabolism and the effects of lipid metabolic reprogramming on the efficacy of HCC systematical therapy, aiming to offer new perspectives for targeted therapy.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Lipid Metabolism; Tumor Microenvironment; Neoplasm Metastasis
PubMed: 38738689
DOI: 10.1097/CM9.0000000000003144 -
Cellular and Molecular Life Sciences :... Nov 2019Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with a high mortality rate. Its dismal prognosis is attributed to late diagnosis, high... (Review)
Review
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with a high mortality rate. Its dismal prognosis is attributed to late diagnosis, high risk of recurrence and drug resistance. To improve the survival of patients with HCC, new approaches are required for early diagnosis, real-time monitoring and effective treatment. Exosomes are small membranous vesicles released by most cells that contain biological molecules and play a great role in intercellular communication under physiological or pathological conditions. In cancer, exosomes from tumor cells or non-tumor cells can be taken up by neighboring or distant target cells, and the cargoes in exosomes are functional to modulate the behaviors of tumors or reshape tumor microenvironment (TME). As essential components, non-coding RNAs (ncRNAs) are selectively enriched in exosomes, and exosomal ncRNAs participate in regulating specific aspects of tumor development, including tumorigenesis, tumor metastasis, angiogenesis, immunomodulation and drug resistance. Besides, dysregulated exosomal ncRNAs have emerged as potential biomarkers, and exosomes can serve as natural vehicles to deliver tumor-suppressed ncRNAs for treatment. In this review, we briefly summarize the biology of exosomes, the functions of exosomal ncRNAs in HCC development and their potential clinical applications, including as biomarkers and therapeutic tools.
Topics: Animals; Biomarkers, Tumor; Carcinoma, Hepatocellular; Drug Delivery Systems; Exosomes; Gene Expression Regulation, Neoplastic; Genetic Therapy; Humans; Liver Neoplasms; Molecular Targeted Therapy; RNA, Neoplasm; RNA, Untranslated
PubMed: 31300868
DOI: 10.1007/s00018-019-03215-0 -
Journal of General Internal Medicine May 2022
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Neoplasm Invasiveness
PubMed: 35031948
DOI: 10.1007/s11606-021-07346-8