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The Netherlands Journal of Medicine Jul 2014Hepatocellular carcinoma (HCC) is rare in the Netherlands, even though the incidence has increased quite sharply in recent years. Standard treatment options consist of... (Review)
Review
UNLABELLED
Hepatocellular carcinoma (HCC) is rare in the Netherlands, even though the incidence has increased quite sharply in recent years. Standard treatment options consist of surgery, orthotopic liver transplantation, radiofrequency ablation, transarterial chemoembolisation (TACE) and systemic therapy with sorafenib. The consensus-based Dutch HCC guideline, established in 2013, serves to guide surveillance, diagnosis and treatment options: Surveillance should be performed by ultrasound at six-month intervals in well-defined cirrhotic patients and in selected high-risk hepatitis B carriers; A nodule > 1 cm in cirrhotic patients with arterial hypervascularity and venous or delayed phase washout at four-phase CT or MRI scan establishes the diagnosis of HCC; In patients with HCC without underlying cirrhosis, resection should be considered regardless of tumour size; In cirrhotic HCC patients, tumour stage, severity of underlying cirrhosis, and performance status determine treatment options. The algorithm of the Barcelona Clinic Liver Cancer (BCLC) staging system should be followed; Patients with Child-Pugh A-B cirrhosis (CP < 8 points) and performance status 0-2 are candidates for any active treatment other than transplantation; In early stage HCC (BCLC stage 0 or A, compensated cirrhosis without portal hypertension) surgical resection, liver transplantation, or radiofrequency ablation should be considered; In intermediate stage HCC (BCLC stage B) TACE and÷ or radiofrequency ablation should be considered; In advanced stage HCC (BCLC stage C) sorafenib should be considered.
CONCLUSION
The Dutch HCC guideline offers advice for surveillance, diagnosis and treatment of HCC.
Topics: Carcinoma, Hepatocellular; Early Detection of Cancer; Epidemiological Monitoring; Female; Guidelines as Topic; Humans; Liver Cirrhosis; Liver Neoplasms; Male; Neoplasm Staging; Netherlands
PubMed: 25319854
DOI: No ID Found -
Clinical and Molecular Hepatology Oct 2020
Topics: Carcinoma, Hepatocellular; Hepatectomy; Humans; Liver Neoplasms; Neoplasm Recurrence, Local; Prognosis
PubMed: 32951413
DOI: 10.3350/cmh.2020.0208 -
Asian Journal of Surgery May 2024Hepatectomy is widely considered a potential treatment for hepatocellular carcinoma (HCC). Unfortunately, one-third of HCC patients have tumor recurrence within 2 years... (Review)
Review
Hepatectomy is widely considered a potential treatment for hepatocellular carcinoma (HCC). Unfortunately, one-third of HCC patients have tumor recurrence within 2 years after surgery (early recurrence), accounting for more than 60% of all recurrence patients. Early recurrence is associated with a worse prognosis. Previous studies have shown that microvascular invasion (MVI) is one of the key factors for early recurrence and poor prognosis in patients with HCC after surgery. This paper reviews the latest literature and summarizes the predictors of MVI, the correlation between MVI and early recurrence, the identification of suspicious nodules or subclinical lesions, and the treatment strategies for MVI-positive HCC. The aim is to explore the management of patients with MVI-positive HCC.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Neoplasm Recurrence, Local; Hepatectomy; Neoplasm Invasiveness; Microvessels; Prognosis; Time Factors
PubMed: 38443255
DOI: 10.1016/j.asjsur.2024.02.115 -
Seminars in Liver Disease Feb 2013Several advances in recent years have led to improved surveillance, diagnostic, and treatment options for hepatocellular carcinoma (HCC). Despite these advances, care... (Review)
Review
Several advances in recent years have led to improved surveillance, diagnostic, and treatment options for hepatocellular carcinoma (HCC). Despite these advances, care for this malignancy remains suboptimal, in part because of poor adherence to established guidelines. When diagnosed at an early stage, outcomes for HCC are positive; however, use of appropriate screening techniques and surveillance of at risk patients is still not widely employed. Although a multidisciplinary care team is considered an essential part of successful HCC treatment, fewer than half of the patients with HCC in the United States receive multidisciplinary care. The current suboptimal utilization of potentially curative treatments, including those recommended by treatment guidelines, can be linked to the absence of multidisciplinary care. Additionally, the lack of prognostic and predictive biomarkers for HCC remains challenging, particularly as therapeutic approaches in advanced disease evolve to the use of molecularly targeted agents. Much research is currently focused on the identification of biomarkers for HCC, but improvements in adherence to guidelines for surveillance and appropriate use of available therapies is necessary before care for patients with HCC will improve.
Topics: Biomarkers, Tumor; Carcinoma, Hepatocellular; Combined Modality Therapy; Early Detection of Cancer; Humans; Liver Neoplasms; Neoplasm Staging; Patient Care Team; Precision Medicine; Predictive Value of Tests; Prognosis
PubMed: 23457036
DOI: 10.1055/s-0033-1333633 -
Cirugia Y Cirujanos 2022This study aims to investigate the relationship between the pre-operative indocyanine green (ICG) test, the chemotherapy-associated liver injury (CALI), and the...
OBJECTIVE
This study aims to investigate the relationship between the pre-operative indocyanine green (ICG) test, the chemotherapy-associated liver injury (CALI), and the development of severe post-operative complications (POC) in patients operated of colorectal liver metastases (CRLMs).
MATERIALS AND METHODS
Sixty-nine patients previously treated with chemotherapy and submitted to liver resection for CRLM were retrospectively studied. Two pathologists independently reviewed the pathological specimens and assessed the presence of CALI. The correlation between ICG clearance and specific pathological features was analyzed. In addition, a logistic regression analysis was performed to seek for pre-operative factors associated with severe complications.
RESULTS
After a mean of 10.6 (± 7.5) chemotherapy cycles, 44 patients (63.8%) developed CALI. ICG retention rate at 15 min (ICG-R15) was not statistically different between patients with and without CALI and it could only discriminate the presence of centrilobular fibrosis. Rate of severe complications was almost 6-fold in patients with CALI compared to patients without CALI (p = 0.024). ICG-R15 ≥ 10% was the only independent risk factor associated with severe POC at multivariable logistic regression (OR = 4.075 95% CI: 1.077-15.422, p = 0.039).
CONCLUSIONS
Pre-operative ICG clearance test, although not useful to identify patients with hepatic drug toxicity, is a strong predictor for the development of severe post-hepatectomy complications.
Topics: Colorectal Neoplasms; Hepatitis; Humans; Indocyanine Green; Liver Neoplasms; Postoperative Complications; Retrospective Studies
PubMed: 35636939
DOI: 10.24875/CIRU.21000313 -
BioMed Research International 2015We would like to highlight the application of natural products to hepatocellular carcinoma (HCC). We will focus on the natural products known as flavonoids, which target... (Review)
Review
We would like to highlight the application of natural products to hepatocellular carcinoma (HCC). We will focus on the natural products known as flavonoids, which target this disease at different stages of hepatocarcinogenesis. In spite of the use of chemotherapy and radiotherapy in treating HCC, patients with HCC still face poor prognosis because of the nature of multidrug resistance and toxicity derived from chemotherapy and radiotherapy. Flavonoids can be found in many vegetables, fruits, and herbal medicines that exert their different anticancer effects via different intracellular signaling pathways and serve as antioxidants. In this review, we will discuss seven common flavonoids that exert different biological effects against HCC via different pathways.
Topics: Carcinoma, Hepatocellular; Drug Resistance, Multiple; Drug Resistance, Neoplasm; Flavonoids; Humans; Liver Neoplasms; Signal Transduction
PubMed: 26858957
DOI: 10.1155/2015/840542 -
Journal of Experimental & Clinical... Jun 2020Hepatocellular carcinoma (HCC) is one of the most common malignancies today. Patients suffer from HCC since its high malignancy and limited treatment means. With the... (Review)
Review
Hepatocellular carcinoma (HCC) is one of the most common malignancies today. Patients suffer from HCC since its high malignancy and limited treatment means. With the development of genetic research, new therapeutic strategy comes up in the way of gene editing. Clustered regularly interspaced short palindromic repeat/CRISPR-associated nuclease 9 (CRISPR/Cas9) was discovered as an immune sequence in bacteria and archaea. After artificial transformation and follow-up research, it is widely used as a gene editing tool. In this review, the development of CRISPR/Cas9 is summarized in retrospect. Through the evaluation of novel research in HCC, it is concluded that CRISPR/Cas9 would promote cancer research and provide a new tool for genetic treatment in prospect.
Topics: Animals; CRISPR-Cas Systems; Carcinoma, Hepatocellular; Gene Editing; Genetic Therapy; Humans; Liver Neoplasms; Neoplasm Proteins
PubMed: 32487115
DOI: 10.1186/s13046-020-01603-0 -
World Journal of Gastroenterology Jun 2005To establish a model of drug-resistant neoplasms using a nude mice model, orthotopic transplantation of liver neoplasm and sporadic abdominal chemotherapy.
AIM
To establish a model of drug-resistant neoplasms using a nude mice model, orthotopic transplantation of liver neoplasm and sporadic abdominal chemotherapy.
METHODS
Hepatocellular carcinoma cells HepG2 were cultured and injected subdermally to form the tumor-supplying mice. The orthotopic drug-resistant tumors were formed by implanting the tumor bits under the envelope of the mice liver and induced by abdominal chemotherapy with Pharmorubicin. Physical examination, ultrasonography, spiral CT and visual inspection were used to examine tumor progression. RT-PCR and immunohistochemistry were used to detect expression of mdr1 mRNA and its encoded protein p-glycoprotein (p-gp). Tc-99m sestamibi scintigraphy was performed by obtaining planar abdominal images at 20 min after injection, and the liver/heart ratios were calculated.
RESULTS
Post-implantation mortality was 0% (0/25), tumor implantation success was 90% (22/25), and the rate of implanting successfully for the second time was 100% (3/3). Tumor induction using Pharmorubicin was 80% (16/20). The mdr1 mRNA expression of the induced group was 23 times higher than that of the control group, and p-gp protein expression was 13-fold higher compared to the control group. The liver/heart ratio (as assessed in vivo, using Tc-99m radiography) was decreased significantly in the induced group as compared to the control group.
CONCLUSION
We have established an in vivo model of mdr1 in nude mice by orthotopic transplantation of liver neoplasm coupled to chemotherapy. We propose that identification of drug resistance as characterized by decreased 99mTc-ppm radiography due to enhanced clearance by p-gp may be useful in detecting in vivo drug resistance, as well as a useful tool in designing more effective therapies.
Topics: ATP Binding Cassette Transporter, Subfamily B, Member 1; Animals; Carcinoma, Hepatocellular; Cell Line, Tumor; Disease Models, Animal; Gene Expression Regulation, Neoplastic; Liver Neoplasms, Experimental; Mice; Mice, Nude; Neoplasm Transplantation; Radiopharmaceuticals; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon
PubMed: 15948235
DOI: 10.3748/wjg.v11.i22.3335 -
Cells Jan 2021Hepatocellular carcinoma (HCC) is one of the most diagnosed malignancies and a leading cause of cancer-related mortality globally. This is exacerbated by its highly...
Hepatocellular carcinoma (HCC) is one of the most diagnosed malignancies and a leading cause of cancer-related mortality globally. This is exacerbated by its highly aggressive phenotype, and limitation in early diagnosis and effective therapies. The SUMO-activating enzyme subunit 1 (SAE1) is a component of a heterodimeric small ubiquitin-related modifier that plays a vital role in SUMOylation, a post-translational modification involving in cellular events such as regulation of transcription, cell cycle and apoptosis. Reported overexpression of in glioma in a stage-dependent manner suggests it has a probable role in cancer initiation and progression. In this study, hypothesizing that is implicated in HCC metastatic phenotype and poor prognosis, we analyzed the expression of in several cancer databases and to unravel the underlying molecular mechanism of SAE1-associated hepatocarcinogenesis. Here, we demonstrated that is over-expressed in HCC samples compared to normal liver tissue, and this observed overexpression is stage and grade-dependent and associated with poor survival. The receiver operating characteristic analysis of in TCGA-LIHC patients ( = 421) showed an AUC of 0.925, indicating an excellent diagnostic value of in HCC. Our protein-protein interaction analysis for SAE1 showed that SAE1 interacted with and activated oncogenes such as , , and , while simultaneously inhibiting tumor suppressors including , , and . Immunohistochemical staining and clinicopathological correlate analysis of SAE1 in our TMU-SHH HCC cohort ( = 54) further validated the overexpression of SAE1 in cancerous liver tissues compared with 'normal' paracancerous tissue, and high SAE1 expression was strongly correlated with metastasis and disease progression. The oncogenic effect of upregulated is associated with dysregulated cancer metabolic signaling. In conclusion, the present study demonstrates that SAE1 is a targetable cancer metabolic biomarker with high potential diagnostic and prognostic implications for patients with HCC.
Topics: Biomarkers, Tumor; Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Neoplasm Proteins; Ubiquitin-Activating Enzymes
PubMed: 33477333
DOI: 10.3390/cells10010178 -
Pathologica Feb 2022Pediatric solid neoplasms are rare and very different from those observed in adults. The majority of them are referred to as embryonal because they arise as a result of... (Review)
Review
New insights in gastrointestinal "pediatric" neoplasms in adult patients: pancreatoblastoma, hepatoblastoma and embryonal sarcoma of the liver. A practical approach by GIPPI-GIPAD Groups.
Pediatric solid neoplasms are rare and very different from those observed in adults. The majority of them are referred to as embryonal because they arise as a result of alterations in the processes of organogenesis or normal growth and are characterized by proliferation of primitive cells, reproducing the corresponding tissue at various stages of embryonic development. This review will focus on embryonal gastrointestinal pediatric neoplasms in adult patients, including pancreatoblastoma, hepatoblastoma, and embryonal sarcoma of the liver. Although they are classically considered pediatric neoplasms, they may (rarely) occur in adult patients. Hepatoblastoma represents the most frequent liver neoplasm in the pediatric population, followed by hepatocellular carcinoma and embryonal sarcoma of the liver; while pancreatoblastoma is the most common malignant pancreatic tumor in childhood. Both in children and adults, the mainstay of treatment is complete surgical resection, either up front or following neoadjuvant chemotherapy. Unresectable and/or metastatic neoplasms may be amenable to complete delayed surgery after neoadjuvant chemotherapy. However, these neoplasms display a more aggressive behavior and overall poorer prognosis in adults than in children, probably because they are diagnosed in later stages of diseases.
Topics: Child; Female; Hepatoblastoma; Humans; Liver Neoplasms; Pancreatic Neoplasms; Pregnancy; Sarcoma
PubMed: 35212317
DOI: 10.32074/1591-951X-559