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Sunyoung Lee, Matthew Loecher, Renuka Iyer
Hepatocellular carcinoma (HCC) is the fastest growing malignancy in the United States in relation to mortality. HCC relies on a complex immunosuppressive network to modify the host immune system and evade destruction. Intrinsic to the liver's function and anatomy, native hepatic and immune cells produce many inhibitory cytokines that promote tolerogenicity and limit immune response. Since the introduction of sorafenib in 2008, no treatment has been able to demonstrate improved survival in patients with advanced HCC post disease progression treated with sorafenib...
February 2018: Journal of Gastrointestinal Oncology
Yan Hu, Yalan Liu, Hongcheng Shi
RATIONALE: Castleman disease is a rare lymphoproliferative disorder which etiology is unknown. It is divided into 2 subtypes: the plasma cell variant and the hyaline vascular variant. The most common site is the hilum of the lungs and mediastinum. Castleman disease is often ignored by clinicians because of not frequently encountering in clinical and the lower uptake of F-FDG. Here, we report a case of hepatocellular carcinoma accompanied by Castleman disease in the hilum of the liver, which was misdiagnosed as the lymph node metastasis in F-FDG PET/CT imaging...
March 2018: Medicine (Baltimore)
Jinfeng Wang, Huacun Shi, Guang Yang, Guangjie Han, Man Zhao, Xiaoling Duan, Lili Mi, Xin Han, Ning Li, Jianfei Shi, Xiaolei Yin, Fei Yin
The aim of the present study was to evaluate the efficacy and safety of a combination of intra-arterial and intravenous chemotherapy in the treatment of unresectable, advanced gastric cancer, and assess which patients are likely to benefit from combined treatment. The clinical data of 128 patients diagnosed with unresectable, advanced gastric cancer at The Fourth Hospital of Hebei Medical University (Shijiazhuang, China) from January 2009 to September 2012 were retrospectively analyzed. The patients were divided into two groups as follows: Those who received regional intra-arterial chemoembolization plus systemic chemotherapy (combined group; n=62) and those who received systemic chemotherapy only (venous group; n=66)...
April 2018: Oncology Letters
Moon Hyung Choi, Ga Eun Park, Soon Nam Oh, Michael Yong Park, Sung Eun Rha, Young Joon Lee, Seung Eun Jung, Joon-Il Choi
RATIONALE AND OBJECTIVES: To evaluate the reproducibility of Modified Response Evaluation Criteria in Solid Tumors (mRECIST) for hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE) using multiphasic computed tomography. MATERIALS AND METHODS: The institutional review board approved this retrospective study. We evaluated 97 patients who underwent TACE (60 conventional TACE [cTACE] and 37 drug-eluting bead TACE [DEB-TACE]) for HCC from 2010 to 2014...
March 16, 2018: Academic Radiology
Brian C Baumann, Jenny Wei, John P Plastaras, John N Lukens, Nevena Damjanov, Maarouf Hoteit, Christine Hsu, Matthew Levine, Jeffrey Mondschein, Gregory Nadolski, Kim Olthoff, Kim A Reiss, Mark Rosen, Evan Siegelman, James M Metz, Edgar Ben-Josef
OBJECTIVES: Stereotactic body radiotherapy (SBRT) is potentially curative treatment for small hepatocellular carcinomas (HCC), but data are limited on its efficacy and toxicity. We hypothesized that SBRT can achieve excellent local control (LC) with acceptable toxicity treating HCC lesions, even in advanced cirrhosis. MATERIALS AND METHODS: Thirty-seven nonmetastatic HCC patients received SBRT to 43 lesions between October 2012 and April 2016. Median dose was 50 Gy/5 fractions...
March 16, 2018: American Journal of Clinical Oncology
Tokio Higaki, Osamu Aramaki, Masamichi Moriguchi, Hisashi Nakayama, Yutaka Midorikawa, Tadatoshi Takayama
Conventional regimens for unresectable intrahepatic cholangiocarcinoma are considered of limited effectiveness. To evaluate the efficacy and toxicity of combination chemotherapy with hepatic arterial infusion of IA-call (a fine-powder formulation of cisplatin) plus oral S-1 in patients with unresectable intrahepatic cholangiocarcinoma. The clinicopathological data and long-term outcome of 12 patients who were received with IA-call plus S-1 were compared with those of 16 patients who were received other treatments, such as radiation therapy, trans-arterial chemoembolization, and systemic chemotherapy...
2018: Bioscience Trends
Qiang Xu, Youhua Huang, Hongjian Shi, Qian Song, Yuanfeng Xu
PURPOSE: To compare sunitinib vs sorafenib plus transarterial chemoembolization (TACE) for inoperable hepatocellular carcinoma (HCC) patients. METHODS: From January 2010 to December 2016, 104 patients with inoperable stage III HCC were included and randomly divided into two groups. Patients in the sunitinib+TACE (SU+TACE) group received sunitinib orally 37.5 mg daily, while patients in the sorafenib+TACE (SO+TACE) group received sorafenib 400 mg twice daily. The two groups were given sunitinib or sorafenib on an interrupted schedule, with a 4-7 days interval before or after TACE sessions...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Souheil Saddekni, Amr Soliman Moustafa, Sherif Moawad, Khalid Mahmoud, Basant Farouk Hamed, Ahmed Kamel Abdel-Aal
We report a case of an 81-year-old woman with multifocal hepatocellular carcinoma who underwent transarterial chemoembolization. The patient had significant superior mesenteric artery (SMA) ostial stenosis, which led to retrograde flow in the retroportal artery to the SMA. The authors adopted several approaches to avoid potential nontarget embolization that might result from the change in the hemodynamics in the hepatoenteric arteries by initially stenting the SMA ostial stenosis as well as the use of the Surefire infusion system and balloon occlusion for delivery of chemoembolization material to tumors in the hepatic lobes...
February 2018: Radiology Case Reports
Ryu Sasaki, Naota Taura, Yuri Miyazoe, Shinobu Yamamichi, Suguru Nakashiki, Mio Yamashima, Tomoyuki Suehiro, Takuya Honda, Hidetaka Shibata, Eisuke Ozawa, Satoshi Miuma, Yuko Akazawa, Hisamitsu Miyaaki, Takehiro Matsumoto, Kazuhiko Nakao, Kazuto Ashizawa
OBJECTIVE: Arterial ketone bodies, which reflect liver function, have been investigated. However, the relationship between venous ketone bodies and hepatocellular carcinoma (HCC) is unclear. We investigated whether prognosis of patients with HCC after transcatheter arterial chemoembolization (TACE) was associated with venous blood ketone bodies. METHODS: Sixty-eight patients with HCC who underwent TACE were recruited for this study. The venous blood ketone body levels were measured 1 d before (pretreatment) and 7 d after TACE (posttreatment)...
February 5, 2018: Nutrition
Aaron Abajian, Nikitha Murali, Lynn Jeanette Savic, Fabian Max Laage-Gaupp, Nariman Nezami, James S Duncan, Todd Schlachter, MingDe Lin, Jean-François Geschwind, Julius Chapiro
PURPOSE: To use magnetic resonance (MR) imaging and clinical patient data to create an artificial intelligence (AI) framework for the prediction of therapeutic outcomes of transarterial chemoembolization by applying machine learning (ML) techniques. MATERIALS AND METHODS: This study included 36 patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization. The cohort (age 62 ± 8.9 years; 31 men; 13 white; 24 Eastern Cooperative Oncology Group performance status 0, 10 status 1, 2 status 2; 31 Child-Pugh stage A, 4 stage B, 1 stage C; 1 Barcelona Clinic Liver Cancer stage 0, 12 stage A, 10 stage B, 13 stage C; tumor size 5...
March 14, 2018: Journal of Vascular and Interventional Radiology: JVIR
Myung Han Hyun, Young-Sun Lee, Ji Hoon Kim, Chan Uk Lee, Young Kul Jung, Yeon Seok Seo, Hyung Joon Yim, Jong Eun Yeon, Kwan Soo Byun
According to the American Association for the Study of Liver Disease treatment guidelines for hepatocellular carcinoma (HCC), the role of surgery has been expanded beyond the Barcelona Clinic Liver Cancer (BCLC) algorithm. We compared primary hepatectomy (PH) with transarterial chemoembolization (TACE) in patients with intermediate to advanced (BCLC stage-B/C) stage HCC to determine the current evidence. Through database search, we included 18 high-quality studies (1 randomized controlled trial [RCT], 5 propensity-score matching non-randomized comparative trials [NRCT], and 12 NRCTs) that compared survival outcomes of 5,986 patients after PH and TACE...
March 15, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Sang Min Yoon, Baek-Yeol Ryoo, So Jung Lee, Jong Hoon Kim, Ji Hoon Shin, Ji Hyun An, Han Chu Lee, Young-Suk Lim
Importance: Patients with hepatocellular carcinoma showing macroscopic vascular invasion have a poor prognosis. Sorafenib is the sole treatment option for these patients, with unsatisfactory response and survival benefit. Combined treatment with transarterial chemoembolization (TACE) plus external beam radiotherapy (RT) has shown promising results for these patients in observational studies. Objective: To evaluate the efficacy and safety of TACE plus RT compared with sorafenib for patients with hepatocellular carcinoma and macroscopic vascular invasion...
March 15, 2018: JAMA Oncology
Jennifer Gill, Andrei Baiceanu, Paul J Clark, Andrew Langford, Julianah Latiff, Pei-Ming Yang, Eric M Yoshida, Panos Kanavos
AIM: To better understand the hepatocellular carcinoma (HCC) patient journey, we conducted a patient survey across 13 countries. METHODS: The survey included closed- and open-ended questions developed using an iterative process to gather information on demographics, diagnosis and treatment. Patients self-selected or were directed to the online survey by their doctor. RESULTS: A total of 256 patients completed the survey. More than two-thirds (68%) felt they did not receive enough information about HCC at diagnosis...
March 15, 2018: Future Oncology
Hiroto Matsuda, Satoshi Tamada, Minoru Kato, Akira Yamamoto, Taro Iguchi, Tatsuya Nakatani
A 73-year-old woman with chief complaint of macroscopic hematuria was diagnosed as having left renal tumor with pancreatic invasion. Nephrectomy was performed. Pathological diagnosis was clear cell carcinoma, pT3a. Three months after the operation, liver metastasis appeared and sunitinib was started. Most of the liver metastases disappeared; however, a new lesion appeared, and sunitinib was switched to axitinib, which was effective on the residual lesion, but the new lesion had poor response. Transarterial chemoembolization was performed to treat the liver metastases, and all metastatic lesions disappeared...
March 2018: Urology Case Reports
Caoye Wang, Zhengqiang Yang, Jinguo Xia, Weiping Wang, Wenhua Chen, Qi Wang
Bronchobiliary fistula (BBF) is a rare condition, defined as an abnormal communication between the bronchial system and the biliary tree. Patients with this condition usually present with massive biliptysis, and the mortality rate is high. BBF has been reported to occur in patients with congenital conditions, complications of trauma, hepatic abscesses and biliary tract obstruction (surgical as well as non-surgical). However, to the best of our knowledge, BBF as a complication of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) has not been reported to date...
April 2018: Molecular and Clinical Oncology
Sebastian Buschauer, Andreas Koch, Philipp Wiggermann, Martina Müller, Claus Hellerbrand
Transarterial chemoembolization (TACE) is an established therapeutic approach for the treatment of hepatocellular carcinoma (HCC). Although patients who undergo TACE may have prolonged survival, there are indications that the malignancy of residual HCC tissue can increase subsequent to the procedure. Although hypoxia, which occurs during TACE due to ischemia, is known to contribute to angiogenesis, little is known with regard to the undesirable effects of chemotherapeutic agents on residual HCC cells. Doxorubicin is one of the most commonly used drugs in TACE...
April 2018: Oncology Letters
Zhenwei Peng, Mengchao Wei, Shuling Chen, Manxia Lin, Chunlin Jiang, Jie Mei, Bin Li, Yu Wang, Jiaping Li, Xiaoyan Xie, Ming Kuang
OBJECTIVES: To compare retrospectively the efficacy of transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) (TACE-RFA) with that of repeat hepatectomy in the treatment of initial recurrent hepatocellular carcinoma (HCC) after hepatectomy by propensity score matching (PSM). METHODS: From September 2006 to June 2015, 186 patients who underwent TACE-RFA (n=107) or repeat hepatectomy (n=79) for recurrent HCC ≤ 5.0 cm were included. The overall survival (OS) and disease-free survival (DFS) were compared...
March 13, 2018: European Radiology
Safi Dokmak, Béatrice Aussilhou, Tiziana Marchese, Nizar Kardoun, François Cauchy, Anne Sophie Schneck, Olivier Soubrane
BACKGROUND: Hepatocellular carcinoma (HCC) can be complicated by major vascular invasion, and resection can be beneficial in some patients.1 Some of these patients are traditionally operated under total vascular exclusion (TVE), refrigeration, extracorporeal circulatory bypass, and cardiac surgery, with high morbidity and mortality.2 However, HCC thrombi are not adherent to the venous wall, and with advances in surgical techniques, resection can be simplified and performed during short-duration TVE alone...
March 13, 2018: Annals of Surgical Oncology
Chun Han Nigel Tan, Yue Yu, Yan Rui Nicholas Tan, Boon Leng Kieron Lim, Shridhar Ganpathi Iyer, Krishnakumar Madhavan, Alfred Wei Chieh Kow
Backgrounds/Aims: Liver Transplantation (LT) is a recognized treatment for Hepatocellular Carcinoma (HCC). The role of Bridging Therapies (BT) remains controversial. Methods: From January 2001 to October 2012, 192 patients were referred to the National University Hospital, Singapore for consideration of LT for HCC. Sixty-five patients (33.8%) were found suitable for transplant and were placed on the waitlist. Analysis was performed in these patients. Results: The most common etiology of HCC was Hepatitis B (n=28, 43...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
H Abdella, M K Shaker, Iman Fawzy Montasser, M Sobhi, H Aly, A Sayed, S Saleh, A El Dorry
BACKGROUND/AIM: Portal vein tumor thrombosis (PVTT) is a common complication in hepatocellular carcinoma (HCC) and it was considered a relative contraindication for transarterial chemoembolization (TACE) by many centers. This study aimed to assess the outcomes after TACE in patients with branch PVT regarding Child classification, radiological response, and 1-year survival. METHODS: Thirty HCC patients (24 male, 6 females) Child A cirrhotics with branch PVT underwent TACE...
March 13, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
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