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Macrovascular invasion

Ayse Selcan Koc, Hilmi Erdem Sumbul
BACKGROUND: Carotid intima media thickness (C-IMT) and aortic IMT (A-IMT) increase in adult and pediatric patients with diabetes mellitus (DM), respectively. In both age groups IMT is used for early detection of macrovascular complications. In adult DM patients, A-IMT is still not a routine examination and is not used frequently. We aimed to determine whether there is an increase in A-IMT values measured from abdominal aorta besides traditional C-IMT in patients with type II DM and to determine parameters closely related to A-IMT in the same patient group...
June 12, 2018: Cardiovascular Ultrasound
M C Pavel, S Sanchez Cabus, G Crespo, J Ferrer, C Fondevila, J Fuster, J C Garcia-Valdecasas
BACKGROUND AND AIMS: In the context of the shortage of donors, adult living donor liver transplantation (aLDLT) represents a feasible alternative for patients within as well as beyond the Milan criteria. METHODS: From 2001, we performed 42 aLDLTs for hepatocellular carcinoma (HCC). Sixteen of the recipients were within the Milan criteria, whereas 26 fulfilled the Barcelona-Clinic Liver Cancer Group (BCLC) expanded criteria (1 tumor ≤7 cm, 5 tumors ≤3 cm, or tumors 3 ≤5 cm without macrovascular invasion or down-staging to Milan after loco-regional therapies)...
June 2018: Transplantation Proceedings
Lily Wu, Peter Swan, John McCall, Edward Gane, Andrew Holden, Stephen Merrilees, Stephen Munn, Peter Johnston, Adam Bartlett
BACKGROUND: potentially curative treatment options for hepatocellular carcinoma (HCC) include liver transplantation (LT), liver resection (LR) and thermal ablation (TA). Long term intent-to-treat (ITT) analysis from a single-centre using all three modalities contemporaneously has not been published. METHODS: An ITT analysis was undertaken of all patients with HCC listed for LT, or have undergone LR or TA. RESULTS: 444 patients were identified; 145 were listed for LT (121 underwent LT), 190 underwent LR and 109 underwent TA...
May 26, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Jinbin Chen, Shixun Lu, Yaojun Zhang, Li Xu, Jiancong Chen, Juncheng Wang, Minshan Chen, Rongxin Zhang, Zhongguo Zhou
Background: Sorafenib has been recommended as the standard therapy for advanced HCC with extrahepatic metastasis. The purpose of this retrospective study was to investigate the difference in overall survival (OS) between treatments with sorafenib combined with regional therapies versus sorafenib monotherapy in hepatocellular carcinoma (HCC) patients with pulmonary oligometastases. Methods: The study retrospectively enrolled 95 consecutive patients who underwent sorafenib therapy. A combined group (CG) of 40 patients received regional therapy in addition to sorafenib, and a monotherapy group (MG) of 55 patients received only sorafenib...
2018: Journal of Cancer
Teiji Kuzuya, Masatoshi Ishigami, Yoji Ishizu, Takashi Honda, Kazuhiko Hayashi, Tetsuya Ishikawa, Isao Nakano, Yoshiki Hirooka, Hidemi Goto
OBJECTIVES: The aim of this study was to investigate the prognostic factors associated with postprogression survival (PPS) in advanced hepatocellular carcinoma (HCC) patients treated with sorafenib, who were not eligible for second-line treatment with regorafenib. METHODS: A total of 103 patients with radiological confirmation of progressive disease (PD) were enrolled. RESULTS: The median PPS (n = 67) was 6.1 months. Significant and independent prognostic factors at initial radiological PD associated with good PPS were an Eastern Cooperative Oncology Group Performance Status (ECOG-PS) score of 0, the absence of macrovascular invasion (MVI), and time to progression (TTP) ≥4 months...
May 3, 2018: Oncology
K Yozgatli, J D Lefrandt, M J Noordzij, P H N Oomen, T Brouwer, J Jager, M Castro Cabezas, A J Smit
AIM: The United Kingdom Prospective Diabetes Study (UKPDS) study showed that glycaemic control (HbA1c ) can predict vascular complications in Type 2 diabetes mellitus. The Diabetes Control and Complications Trial (DCCT) study showed that accumulation of advanced glycation end products (AGEs) from skin biopsies predicts vascular complications in Type 1 diabetes. Previously, we showed that tissue AGEs can be measured non-invasively using skin autofluorescence (SAF). The aim of this study was to compare the predictive value of HbA1c and SAF for new macrovascular events and microvascular complications in people with Type 2 diabetes...
April 23, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Mohamed Abo El-Asrar, Eman Abdel Rahman Ismail, Rasha Adel Thabet, Ashraf Sayed Kamel, Sameh NehmedAllah
BACKGROUND: Type 1 diabetes mellitus (T1DM) is associated with serious micro-vascular and macro-vascular complications. Osteopontin (OPN) has emerged as a strong predictor of incipient diabetic nephropathy and a first-ever cardiovascular event in adults with T1DM. OPN is linked to coronary atherosclerosis in type 2 diabetes. The aim of the study was to test the hypothesis that OPN could be a potential marker for micro-vascular complications in children and adolescents with T1DM and we assessed its relation to carotid and aortic intima media thickness (CIMT and AIMT) as non-invasive index for subclinical atherosclerosis...
April 23, 2018: Pediatric Diabetes
Kenichiro Kodama, Tomokazu Kawaoka, Hiroshi Aikata, Shinsuke Uchikawa, Yuki Inagaki, Masahiro Hatooka, Kei Morio, Takashi Nakahara, Eisuke Murakami, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Keiichi Masaki, Yoji Honda, Nami Mori, Shintaro Takaki, Keiji Tsuji, Hirotaka Kohno, Hiroshi Kohno, Takashi Moriya, Michihiro Nonaka, Hideyuki Hyogo, Yasuyuki Aisaka, Kazuaki Chayama
BACKGROUND AND AIM: Sorafenib is the standard treatment for patients with advanced hepatocellular carcinoma (HCC) with distant metastasis, unresectable HCC, and HCC refractory to transcatheter arterial chemoembolization (TACE) or with macroscopic vascular invasion (MVI). Also, hepatic arterial infusion chemotherapy (HAIC) has been used for advanced HCC in Southeast and East Asian countries. However, clearer information is needed for choosing appropriately between these therapies. METHODS: The subjects were 391 HAIC and 431 sorafenibs administered at our hospital and related hospitals...
April 12, 2018: Journal of Gastroenterology and Hepatology
Hans-Christian Pommergaard, Andreas A Rostved, René Adam, Lau C Thygesen, Mauro Salizzoni, Miguel A Gómez Bravo, Daniel Cherqui, Franco Filipponi, Karim Boudjema, Vincenzo Mazzaferro, Olivier Soubrane, Juan C García-Valdecasas, Joan F Prous, Antonio D Pinna, John O'Grady, Vincent Karam, Christophe Duvoux, Allan Rasmussen
BACKGROUND: Studies suggest that vascular invasion may be a superior prognostic marker compared with traditional selection criteria, e.g. Milan criteria. This study aimed to investigate the prognostic value of micro and macrovascular invasion in a large database material. METHODS: Patients liver transplanted for HCC and cirrhosis registered in the European Liver Transplant Registry (ELTR) database were included. The association between the Milan criteria, Up-to-seven criteria and vascular invasion with overall survival and HCC specific survival was investigated with univariate and multivariate Cox regression analyses...
April 2, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Wei Zhang, Chang Liu, Yifei Tan, Li Jiang, Lunan Yan, Jiayin Yang, Tianfu Wen
BACKGROUND: Hepatocellular carcinoma (HCC) in adolescent and younger adult (AYA) patients is usually diagnosed at an advanced stage such that curative treatments are often not possible. The aimed of this study was to compare the outcome of attempted curative treatment, liver resection (LR) versus transarterial chemoembolization (TACE), in AYA patients presenting with intermediate or advanced HCC defined by the Barcelona Clinic Liver Cancer (BCLC) stage B and C. METHODS: All AYA patients diagnosed with BCLC stage B or C HCC undertaking LR (n = 276) and TACE (n = 136) were included in our study...
March 28, 2018: International Journal of Surgery
P Cascales-Campos, L A Martinez-Insfran, P Ramirez, D Ferreras, M R Gonzalez-Sanchez, F Sanchez-Bueno, R Robles, J A Pons, A Capel, P Parrilla
BACKGROUND: The outcome of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) is excellent if it is performed within the Milan criteria (ie, single tumor less than 5 cm or 3 tumors less than 3 cm each one and no macrovascular invasion). However, after a few studies, it has become possible to have a similar survival expanding those criteria. The aim of this study is to evaluate the survival of patients with advanced HCC who, after downstaging, did not met the Milan criteria although they were within the "up to seven" benchmark, and were transplanted at our center in the last 5 years...
March 2018: Transplantation Proceedings
Wei Gan, Jin-Long Huang, Mei-Xia Zhang, Yi-Peng Fu, Yong Yi, Chu-Yu Jing, Jia Fan, Jian Zhou, Shuang-Jian Qiu
BACKGROUND: There is currently no established model for predicting the recurrence of hepatocellular carcinoma (HCC) in patients with negative alpha-fetoprotein (AFP) after curative resection. Therefore, the objective of this study was to establish a nomogram to identify the risk of recurrence in AFP-negative (<or = 20 ng/mL) patients with HCC. METHODS: A retrospective study was conducted to establish the recurrence-free survival (RFS) nomogram in a training cohort of 326 AFP-negative HCC patients...
March 24, 2018: Journal of Surgical Oncology
Yong-Cheng Liu, Yi-Ze Mao, Jun-Cheng Wang, Jun Wang, Xiang-Ming Lao, Min-Shan Chen, Sheng-Ping Li
BACKGROUND: Diaphragmatic resection is not common in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). This study aims to evaluate retrospectively the clinical characteristics and surgical results of HCC patients undergoing hepatectomy plus diaphragmatic resection. METHODS: Between January 2000 and December 2013, 52 HCC patients underwent curative resections combined with diaphragmatic resection, with 11 patients had pathological diaphragmatic invasion (DI), 41 patients had diaphragmatic fibrous adhesion (DFA)...
May 2018: International Journal of Surgery
Fabiana Blanco, Suvi E Heinonen, Erika Gurzeler, Lisa M Berglund, Anna-Maria Dutius Andersson, Olga Kotova, Ann-Cathrine Jönsson-Rylander, Seppo Ylä-Herttuala, Maria F Gomez
AIMS: Despite vast clinical experience linking diabetes and atherosclerosis, the molecular mechanisms leading to accelerated vascular damage are still unclear. Here, we investigated the effects of nuclear factor of activated T-cells inhibition on plaque burden in a novel mouse model of type 2 diabetes that better replicates human disease. METHODS & RESULTS: IGF-II/LDLR-/- ApoB100/100 mice were generated by crossbreeding low-density lipoprotein receptor-deficient mice that synthesize only apolipoprotein B100 (LDLR-/- ApoB100/100 ) with transgenic mice overexpressing insulin-like growth factor-II in pancreatic β cells...
March 1, 2018: Diabetes & Vascular Disease Research
David E Kaplan, Rajni Mehta, Kathryn D'Addeo, Terence P Gade, Tamar H Taddei
PURPOSE: The impact of transarterial chemoembolization after initiation of sorafenib (SOR) has not been prospectively compared with SOR alone in unresectable hepatocellular carcinoma (HCC). The objective of this study was to assess whether SOR + transarterial chemoembolization provides benefit over SOR alone in this setting. MATERIALS AND METHODS: A retrospective cohort study with propensity matching using data from patients prescribed SOR for HCC at Veterans Health Administration hospitals from 2007 to 2015...
April 2018: Journal of Vascular and Interventional Radiology: JVIR
Yoshiyuki Wada, Yuko Takami, Hajime Matsushima, Masaki Tateishi, Tomoki Ryu, Munehiro Yoshitomi, Taisei Matsumura, Hideki Saitsu
Background Sorafenib is a standard therapy for advanced hepatocellular carcinoma (HCC), whereas radiotherapy is effective for local control of extrahepatic spread (EHS) or macrovascular invasion (MVI). This study investigated the safety and efficacy of this combined therapy to treat advanced HCC. Methods This retrospective study reviewed 62 patients with advanced-stage HCC with EHS or MVI who received sorafenib therapy, excluding the patients with only lung metastases. Results Of the 62 patients, 15 were treated using the combined therapy of sorafenib and radiotherapy (group RS), and 47 were treated with sorafenib monotherapy (group S)...
December 27, 2017: Internal Medicine
Y K Wang, X Y Bi, Z Y Li, H Zhao, J J Zhao, J G Zhou, Z Huang, Y F Zhang, M X Li, X Chen, X L Wu, R Mao, X H Hu, H J Hu, J M Liu, J Q Cai
Objective: To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy. Methods: A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis...
December 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
G K Glantzounis, A Paliouras, M-C Stylianidi, H Milionis, P Tzimas, D Roukos, G Pentheroudakis, E Felekouras
BACKGROUND: The ideal management for patients with intermediate and advanced stage hepatocellular carcinoma (HCC) is controversial. The main purpose of this systematic review is to examine the role of liver resection in patients with intermediate stage HCC (multinodular HCCs) and in advanced stage HCC [mainly patients with portal vein tumor thrombosis (PVTT)]. METHODS: A systematic search of the literature was performed in Pud Med and the Cochrane Library from 01...
February 2018: European Journal of Surgical Oncology
Charlotte E Costentin, Cristina R Ferrone, Ronald S Arellano, Suvranu Ganguli, Theodore S Hong, Andrew X Zhu
Background: Tumoral macrovascular invasion (MVI) of hepatic and/or portal vein branches is a common phenomenon in hepatocellular carcinoma (HCC) and is associated with poorer prognosis when compared to HCC without MVI. Summary: Current international guidelines for the management of HCC recommend sorafenib as the only treatment option in case of MVI. Despite guideline recommendations, several alternative options have been tested to manage HCC with MVI: surgery, transarterial chemoembolization, external or internal radiation, hepatic arterial infusion chemotherapy, percutaneous treatment, cryotherapy, or the combination of two or more of these strategies, with or without sorafenib...
November 2017: Liver Cancer
Rohan C Siriwardana, Madunil A Niriella, Anuradha Dassanayake, Dileepa Ediriweera, Bhagya Gunetilleke, Thenuka Sivasundaram, Janaka de Silva
INTRODUCTION: Non-alcoholic fatty liver disease is a leading cause for hepatocellular carcinoma (HCC) in Sri Lanka. Diabetes mellitus, alcohol abuse, and liver inflammation are known to increase the risk of HCC. The present study evaluates serum ferritin levels in a cohort of patients with non-viral HCC (nvHCC). METHODOLOGY: Consecutive patients with nvHCC presenting to the Colombo North Liver transplant Service, Ragama, from January 2012 to July 2013 were investigated...
November 2017: Liver Cancer
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