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Chinese Clinical Oncology Oct 2018Fibrolamellar hepatocellular carcinoma (FLHCC) is a primary liver tumor. It is a pathologically distinct variety of hepatocellular carcinoma (HCC). The term... (Review)
Review
Fibrolamellar hepatocellular carcinoma (FLHCC) is a primary liver tumor. It is a pathologically distinct variety of hepatocellular carcinoma (HCC). The term 'fibrolamellar' is derived from the presence of thick fibrous collagen bands surrounding the tumor cells. It is a relatively rare tumor of unknown biology. It has a distinctive predilection for adolescents and young adults with no underlying liver disease or cirrhosis. FLHCC patients have higher incidence of lymph node involvement than conventional HCC patients probably owing to larger median tumor size at presentation. Most cases present at an advanced stage at the time of initial diagnosis, however, curative intent treatment options can still be offered to up to 70% of patients. Surgery (resection/liver transplantation) is the current mainstay of treatment and remains the only potentially curative option. As recurrences are common, alternative therapies are under investigation. FLHCCs have traditionally been considered less chemo-responsive than their conventional HCC counterparts, but in advanced cases multimodality treatments can be effective. Compared to stage-matched non-cirrhotic patients with HCC, patients with FLHCC do not have a favourable prognosis and do not respond differently to treatment. The survival advantage observed in FLHCC over conventional HCC is most likely due to younger age at presentation and absence of cirrhosis.
Topics: Biomarkers, Tumor; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Neoplasm Staging; Prognosis
PubMed: 30395718
DOI: 10.21037/cco.2018.08.08 -
Journal of Hepatology Dec 2020Assessing the balance between survival and recurrence after transplantation for secondary liver tumours should be based on the type of cancer in question. For... (Review)
Review
Assessing the balance between survival and recurrence after transplantation for secondary liver tumours should be based on the type of cancer in question. For neuroendocrine liver metastases, high recurrence rates are clearly related to reduced long-term survival. For colorectal liver metastases, experience to date indicates that pulmonary recurrence alone has a modest impact on survival outcomes. Further studies focusing on this group of patients will be important for the development of this field of transplant oncology. Liver transplantation for secondary liver tumours should be implemented in accordance with stringent transplant criteria and preferably in the context of prospective trials. Expansion of the donor pool by utilising extended criteria donors and partial liver transplantation could be considered for this indication.
Topics: Humans; Liver Neoplasms; Liver Transplantation; Neoplasm Recurrence, Local; Patient Selection; Risk Assessment; Survival Analysis
PubMed: 32896581
DOI: 10.1016/j.jhep.2020.08.015 -
Journal of B.U.ON. : Official Journal... 2016Purpose: The fifth most common cancer of the gastrointestinal system is liver cancer. It is also one of the most common cancers worldwide. The available treatment... (Review)
Review
Purpose: The fifth most common cancer of the gastrointestinal system is liver cancer. It is also one of the most common cancers worldwide. The available treatment options include surgery, percutaneous ablation, and liver transplantation. Some of the latest modalities for the management of hepatocellular carcinoma (HCC) are radiofrequency ablation, trans-arterial chemoembolization, radioembolization and systemic targeted agents like sorafenib. The process of choice of a particular treatment modality in HCC depends on the tumor stage, patient performance status and liver function reserve. In the recent past with progress in research, the short-term survival of HCC has improved but recurrent disease remains a fundamental problem as the pathogenesis of HCC is a multistep and complex process. The present review is focused on recent advances in the management of HCC. This review will also provide an insight on the upcoming latest modalities including the emerging role of hepatoma-derived growth factor (HDGF) overexpression in liver fibrosis and carcinogenesis.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Neoplasm Staging; Treatment Outcome
PubMed: 27273938
DOI: No ID Found -
American Society of Clinical Oncology... 2017Advanced hepatocellular carcinoma (HCC) has presented a therapeutic challenge. Despite its heterogeneity, which is partially related to its various etiologies, it... (Review)
Review
Advanced hepatocellular carcinoma (HCC) has presented a therapeutic challenge. Despite its heterogeneity, which is partially related to its various etiologies, it frequently arises in a background of chronic inflammation, which makes it a potentially excellent candidate for immunotherapeutic approaches. There is evidence of antitumor immunity in HCC as manifested by the cell infiltrate and its association with prognosis, the presence of tumor-associated antigens, and the reports of immune-mediated spontaneous regressions. However, both the liver itself and the tumor environment possess a diverse armamentarium of mechanisms that suppress antitumor immunity. Here, we describe the rationale for immunotherapy in HCC and discuss the emerging clinical data from various immunotherapeutic approaches including checkpoint inhibition, cell therapy, oncolytic viral therapy, and various combinatorial approaches. We also highlight the potential for various modalities to be adapted across different stages of the disease.
Topics: Antigens, Neoplasm; Carcinoma, Hepatocellular; Cell Cycle Checkpoints; Combined Modality Therapy; Humans; Immunotherapy; Liver Neoplasms; Oncolytic Virotherapy
PubMed: 28561676
DOI: 10.1200/EDBK_175230 -
Experimental and Clinical... Mar 2017Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to... (Review)
Review
Primary liver cancer is the fifth most common cancer overall and the second most common cause of cancer mortality worldwide. Hepatocellular carcinoma accounts for up to 90% of all primary hepatic malignancies and represents a major international health problem. It is a complex and heterogeneous malignancy, frequently occurs in the setting of a chronically diseased organ, and has multiple confounding factors. Liver transplant for hepatocellular carcinoma has been established as a standard treatment in selected patients. Liver resection and locoregional therapies could be other options for treatment. Pathologic evaluation of hepatocellular carcinoma is a complicated process that includes tumor grading and evaluation of microvascular invasion. Although macrovascular invasion can be detected with imaging techniques, microvascular invasion is diagnosed pathologically. Pathologic evaluation provides additional information about the tumor biology, using immunohistochemical and molecular methods to predict patient outcomes. Hepatocellular carcinoma requires a multidisciplinary approach to determine the most appropriate treatment, as well as requires accurate timing of various treatments for optimal outcomes.
Topics: Biomarkers, Tumor; Carcinoma, Hepatocellular; Humans; Immunohistochemistry; Liver Neoplasms; Liver Transplantation; Neoplasm Grading; Neoplasm Invasiveness; Predictive Value of Tests; Treatment Outcome
PubMed: 28301999
DOI: 10.6002/ect.TOND16.L12 -
World Journal of Gastroenterology Nov 2014Liver regeneration after major surgery may activate occult micrometastases and facilitate tumor growth, leading to liver tumor recurrence. Molecular changes during liver... (Review)
Review
Liver regeneration after major surgery may activate occult micrometastases and facilitate tumor growth, leading to liver tumor recurrence. Molecular changes during liver regeneration can provide a microenvironment that stimulates intrahepatic tumor propagation through alterations in cellular signaling pathways, where activation and proliferation of mature hepatocytes, hepatic progenitor cells, non-parenchymal liver cells might favor both liver regeneration and tumor growth. This review highlights recent advances of tumor growth and development in the regenerating liver, possible mechanisms and clinical implications.
Topics: Animals; Carcinoma, Hepatocellular; Catheter Ablation; Cell Proliferation; Colorectal Neoplasms; Hepatectomy; Humans; Liver Neoplasms; Liver Regeneration; Neoplasm Micrometastasis; Neoplasm Recurrence, Local; Neoplastic Stem Cells; Risk Assessment; Risk Factors; Signal Transduction; Time Factors; Treatment Outcome; Tumor Microenvironment
PubMed: 25473170
DOI: 10.3748/wjg.v20.i43.16167 -
Cells Jan 2019Autophagy is an evolutionary conserved intracellular mechanism which helps eukaryotic cells in maintaining their metabolic state to afford high-efficiency energy... (Review)
Review
Autophagy is an evolutionary conserved intracellular mechanism which helps eukaryotic cells in maintaining their metabolic state to afford high-efficiency energy requirements. In the physiology of a normal liver and the pathogenesis of liver diseases, autophagy plays a crucial role. Autophagy has been found to be both upregulated and downregulated in different cancers providing the evidence that autophagy plays a dual role in suppressing and promoting cell survival. Hepatocellular carcinoma (HCC) is the most common primary liver cancer and the major leading cause of cancer mortality worldwide. In light of its high complexity and poor prognosis, it is essential to improve our understanding of autophagy's role in HCC. In this review, we summarize the dual mechanism of autophagy in the development of HCC and elucidate the currently used therapeutic strategies for anti-HCC therapy.
Topics: Autophagy; Carcinoma, Hepatocellular; Homeostasis; Humans; Liver; Liver Neoplasms; Neoplasm Metastasis
PubMed: 30695997
DOI: 10.3390/cells8020091 -
International Journal of Molecular... Aug 2023Hepatocellular carcinoma (HCC) accounts for 7% of all malignancies and about 90% of all primary liver malignancies, making it the most common type of malignant liver...
Hepatocellular carcinoma (HCC) accounts for 7% of all malignancies and about 90% of all primary liver malignancies, making it the most common type of malignant liver neoplasm [...].
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms
PubMed: 37628717
DOI: 10.3390/ijms241612536 -
World Journal of Gastroenterology Nov 2014It is well recognized that one cause of chronic liver disease and hepatocellular carcinoma (HCC) is alcohol consumption. Research in Italy and the United States... (Review)
Review
It is well recognized that one cause of chronic liver disease and hepatocellular carcinoma (HCC) is alcohol consumption. Research in Italy and the United States concludes that the most common cause of HCC (responsible for 32% to 45% of HCC) is alcohol. It has recently been shown that a significant relationship between alcohol intake, metabolic changes, and hepatitis virus infection does exist. Alcohol may be a factor in the development of HCC via direct (genotoxic) and indirect mechanisms (cirrhosis). There is only one way of diagnosing HCC, which is early identification through surveillance, when curative treatments become possible. After stopping alcohol intake the risk of liver cancer decreases by 6% to 7% a year, and an estimated time period of 23 years is also needed. Therefore, surveillance is also important in former drinkers and, in our opinion, independently from the presence of compensated cirrhosis. In cases of very early stage (VES) and early stage with portal hypertension, liver transplantation is the optimal option; and in cases of associated disease, percutaneous ethanol injections, radiofrequency and microwave ablation are the ideal treatments. Despite the possibility of detecting microvascular invasion with HR, several studies and some randomized controlled trials revealed that overall survival and DSF rates in patients with VES HCC are much the same after ablation and HR. Therefore, ablation can be regarded as a first-line choice for patients with VES HCC. It is important to emphasize that the choice of treatment should be weighed carefully in the context of a multidisciplinary cancer team.
Topics: Ablation Techniques; Alcohol Abstinence; Alcohol Drinking; Animals; Carcinoma, Hepatocellular; Early Detection of Cancer; Hepatectomy; Humans; Liver Neoplasms; Liver Transplantation; Neoplasm Staging; Predictive Value of Tests; Risk Assessment; Risk Factors; Risk Reduction Behavior; Time Factors; Treatment Outcome; Tumor Burden
PubMed: 25473148
DOI: 10.3748/wjg.v20.i43.15943 -
European Radiology Apr 2024Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and a leading cause of cancer related death worldwide. Current guidelines for the... (Review)
Review
Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and a leading cause of cancer related death worldwide. Current guidelines for the noninvasive diagnosis of HCC are provided by the European Association for the Study of the Liver (EASL), the American Association for the Study of Liver Diseases (AASLD) which endorsed the Liver Imaging Reporting and Data System (LI-RADS) algorithm, the Korean Liver Cancer Association-National Cancer Center (KLCA-NCC), and the Asian-Pacific Association for the Study of the Liver (APASL). These allow the diagnosis of HCC in high-risk patients in the presence of typical imaging features on contrast-enhanced CT, MRI, or contrast-enhanced ultrasound. Size, non-rim arterial phase hyperenhancement, non-peripheral washout, enhancing capsule, and growth are major imaging features and they should be combined for the diagnosis of HCC. This article provides concise and relevant practice recommendations aimed at general radiologist audience, summarizing the best practice and informing on the essential imaging criteria for the diagnosis of HCC, while also discussing the high-risk population criteria, imaging modalities, and imaging features according to the current guidelines. KEY POINTS: • Noninvasive diagnosis of hepatocellular carcinoma (HCC) can be provided only in patients at high risk. • Contrast-enhanced CT or MRI are the first-line imaging exams for the diagnosis of HCC. • Major imaging features should be combined to provide the diagnosis of definitive HCC.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Tomography, X-Ray Computed; Contrast Media; Magnetic Resonance Imaging; Retrospective Studies; Sensitivity and Specificity
PubMed: 38379018
DOI: 10.1007/s00330-024-10606-w