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hepatocellular carcinoma & liver transplantation

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https://www.readbyqxmd.com/read/27911488/hepatocellular-carcinoma-as-an-emerging-morbidity-in-the-thalassemia-syndromes-a-comprehensive-review
#1
REVIEW
Hassan M Moukhadder, Racha Halawi, Maria Domenica Cappellini, Ali T Taher
The incidence of hepatocellular carcinoma (HCC) in patients with thalassemia is on the rise. The 2 well recognized HCC risk factors in thalassemia are iron overload and chronic viral infection with hepatitis C. The carcinogenicity of iron is related to its induction of oxidative damage, which results in genotoxicity, and to immunologic dysregulation, which attenuates cancer immune surveillance. Chronic hepatitis B and C infections lead to necroinflammation, which can prompt progression to HCC, but an independent role of hepatitis B virus in hepatic carcinogenesis among patients with thalassemia has not been demonstrated...
December 1, 2016: Cancer
https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#2
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27905019/multi-disciplinary-concurrent-management-of-recurrent-hepatocellular-therapy-is-superior-to-sequential-therapy
#3
Tyler D Fields, Prejesh Philips, Charles R Scoggins, Cliff Tatum, Lawrence Kelly, Kelly M McMasters, Robert C G Martin
BACKGROUND: Recurrent hepatocellular carcinoma after a patient's initial therapy, whether it is transplantation, resection, or ablation, remains a challenging clinical problem. Since recurrence occurs in 70% of all initially treated disease within 5 years, optimal management to treat this recurrence is needed. Currently, a bias exists toward mono-therapy (i.e., ablation alone, hepatic arterial therapy alone, or sorafenib therapy alone) instead of concurrent sequential therapy-as is common in other primary and metastatic disease to the liver...
November 30, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27904861/a-recent-advance-in-image-guided-locoregional-therapy-for-hepatocellular-carcinoma
#4
REVIEW
Yaoping Shi, Bo Zhai
BACKGROUND: Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third most common cause of cancer-related deaths. Hepatic resection and liver transplantation are considered to be the preferred treatment for HCC. However, as novel therapeutic options such as image-guided locoregional therapies have emerged and been refined, the manner in which HCC is treated has changed dramatically compared with what it was considered just 2 decades earlier. SUMMARY: This study reviews the current results of various image-guided locoregional therapies for treating HCC, especially focusing on thermal ablative and transarterial techniques...
October 2016: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/27900445/bridging-locoregional-therapy-prolongs-survival-in-patients-listed-for-liver-transplant-with-hepatocellular-carcinoma
#5
Minzhi Xing, Sonali Sakaria, Renumathy Dhanasekaran, Samir Parekh, James Spivey, Stuart J Knechtle, Di Zhang, Hyun S Kim
BACKGROUND AND AIMS: To evaluate the long-term survival benefit of bridging locoregional therapy (LRT) prior to orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC) within Milan criteria. METHODS: Our transplant center registry was studied for all HCC patients within the Milan criteria who were listed for OLT from 1998 to 2013. Baseline clinical characteristics and median overall survival (OS) were calculated and stratified by LRT, OLT status, and wait times...
November 29, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27899961/the-ras-raf-mek-erk-signaling-pathway-and-its-role-in-the-occurrence-and-development-of-hcc
#6
Lei Li, Guo-Dong Zhao, Zhe Shi, Li-Li Qi, Li-Yuan Zhou, Ze-Xian Fu
Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide and has a very poor prognosis. Its occurrence has been on the increase in recent years. Surgical resection and liver transplantation are the primary methods of treatment for HCC patients, but can only be applied to 15% of patients. The median survival time of unresectable or metastasizing HCC patients is only a few months. Existing systemic treatment methods are not effective for advanced HCC patients and a new method of treatment is needed for these patients...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27895416/practice-guidelines-for-the-pathological-diagnosis-of-primary-liver-cancer-2015-update
#7
REVIEW
Wen-Ming Cong, Hong Bu, Jie Chen, Hui Dong, Yu-Yao Zhu, Long-Hai Feng, Jun Chen, Guideline Committee
In 2010, a panel of Chinese pathologists reported the first expert consensus for the pathological diagnosis of primary liver cancers to address the many contradictions and inconsistencies in the pathological characteristics and diagnostic criteria for PLC. Since then considerable clinicopathological studies have been conducted globally, prompting us to update the practice guidelines for the pathological diagnosis of PLC. In April 18, 2014, a Guideline Committee consisting of 40 specialists from seven Chinese Societies (including Chinese Society of Liver Cancer, Chinese Anti-Cancer Association; Liver Cancer Study Group, Chinese Society of Hepatology, Chinese Medical Association; Chinese Society of Pathology, Chinese Anti-Cancer Association; Digestive Disease Group, Chinese Society of Pathology, Chinese Medical Association; Chinese Society of Surgery, Chinese Medical Association; Chinese Society of Clinical Oncology, Chinese Anti-Cancer Association; Pathological Group of Hepatobiliary Tumor and Liver Transplantation, Chinese Society of Pathology, Chinese Medical Association) was created for the formulation of the first guidelines for the standardization of the pathological diagnosis of PLC, mainly focusing on the following topics: gross specimen sampling, concepts and diagnostic criteria of small hepatocellular carcinoma (SHCC), microvascular invasion (MVI), satellite nodules, and immunohistochemical and molecular diagnosis...
November 14, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27895394/concise-review-interferon-free-treatment-of-hepatitis-c-virus-associated-cirrhosis-and-liver-graft-infection
#8
REVIEW
Nina Weiler, Stefan Zeuzem, Martin-Walter Welker
Chronic hepatitis C is a major reason for development of cirrhosis and hepatocellular carcinoma and a leading cause for liver transplantation. The development of direct-acting antiviral agents lead to (pegylated) interferon-alfa free antiviral therapy regimens with a remarkable increase in sustained virologic response (SVR) rates and opened therapeutic options for patients with advanced cirrhosis and liver graft recipients. This concise review gives an overview about most current prospective trials and cohort analyses for treatment of patients with liver cirrhosis and liver graft recipients...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27890896/interventional-treatment-of-severe-portal-vein-thrombosis-after-living-donor-liver-transplantation
#9
Youichi Kawano, Satoru Murata, Nobuhiko Taniai, Masato Yoshioka, Atsushi Hirakata, Yoshiaki Mizuguchi, Tetsuya Shimizu, Tomohiro Kanda, Junji Ueda, Hideyuki Takada, Hiroshi Yoshida, Koho Akimaru, Shiro Onozawa, Shinichirou Kumita, Eiji Uchida
Portal vein thrombosis (PVT) is a rare complication of liver transplantation which can lead to graft failure and patient death. Treatment can be difficult, especially in cases of PVT from the intrahepatic portal vein to the proximal jejunal veins. A 55-year-old woman had undergone living-donor liver transplantation with splenectomy for end-stage liver cirrhosis due to hepatitis C with hepatocellular carcinoma. Ten months after transplantation, massive ascites and slight abdominal pain developed, and computed tomography revealed a PVT between the intrahepatic portal vein and the superior mesenteric vein...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27882776/benefits-of-long-term-therapy-with-nucleos-t-ide-analogues-in-treatment-na%C3%A3-ve-patients-with-chronic-hepatitis-b
#10
Lai Wei, Jia-Horng Kao
OBJECTIVE: To assess the benefits of long-term nucleos(t)ide analogue (NA) therapy in reducing the severity and progression of liver disease in treatment-naïve patients with chronic hepatitis B (CHB). SCOPE: As complications of CHB, such as hepatic decompensation and hepatocellular carcinoma (HCC), take a long time to develop in patients with less advanced disease, the long-term benefits of NA therapy in such patients are more difficult to prove than short- or medium-term benefits...
November 24, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27878821/liver-transplantation-for-fibrolamellar-hepatocellular-carcinoma-a-national-perspective
#11
Leonardo Garcia Atienza, Jonathan Berger, Xiaonan Mei, Malay B Shah, Michael F Daily, Alla Grigorian, Roberto Gedaly
BACKGROUND: Fibrolamellar Hepatocellular Carcinoma (FL-HCC) is a rare primary liver tumor that usually presents in younger patients without underlying liver disease. METHODS: We queried the United Network of Organ Sharing (UNOS) database between October 1988 and January 2013 to evaluate outcomes in patients with FL-HCC undergoing liver transplantation in the United States compared to patients with conventional Hepatocellular Carcinoma (HCC). RESULTS: Sixty-three patients were identified (57% female, mean age 30 years)...
November 23, 2016: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27878478/liver-resection-after-selective-internal-radiation-therapy-with-yttrium-90-is-safe-and-feasible-a-bi-institutional-analysis
#12
G Paul Wright, J Wallis Marsh, Manish K Varma, Michael G Doherty, David L Bartlett, Mathew H Chung
BACKGROUND: Treatment with yttrium-90 (Y90) microspheres has emerged as a viable liver-directed therapy for patients with unresectable tumors and those outside transplantation criteria. A select number of patients demonstrate a favorable response and become candidates for surgical resection. METHODS: Patients who underwent selective internal radiation therapy (SIRT) with Y90 microspheres at two institutions were reviewed. Patients who underwent liver resection were included in the study...
November 22, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27872682/prophylactic-liver-transplantation-for-high-risk-recurrent-hepatocellular-carcinoma
#13
REVIEW
Po-Chih Yang, Cheng-Maw Ho, Rey-Heng Hu, Ming-Chih Ho, Yao-Ming Wu, Po-Huang Lee
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. Radical treatment of HCC in early stages results in a long disease-free period and improved overall survival. The choice of optimal management strategy for HCC mainly depends on the severity of the underlying liver disease. For patients with decompensated liver cirrhosis and HCC within Milan criteria (MC), liver transplant (LT) is the choice of treatment. However, for patients with good residual liver reserve and HCC within MC, selection of other curative treatments such as liver resection (LR) or radiofrequency ablation may be a reasonable alternative...
November 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27867681/local-ablative-treatments-for-hepatocellular-carcinoma-an-updated-review
#14
REVIEW
Antonio Facciorusso, Gaetano Serviddio, Nicola Muscatiello
Ablative treatments currently represent the first-line option for the treatment of early stage unresectable hepatocellular carcinoma (HCC). Furthermore, they are effective as bridging/downstaging therapies before orthotopic liver transplantation. Contraindications based on size, number, and location of nodules are quite variable in literature and strictly dependent on local expertise. Among ablative therapies, radiofrequency ablation (RFA) has gained a pivotal role due to its efficacy, with a reported 5-year survival rate of 40%-70%, and safety...
November 6, 2016: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/27865034/prevention-of-hepatitis-c-recurrence-by-bridging-sofosbuvir-ribavirin-from-pre-to-post-liver-transplant-a-real-life-strategy
#15
Maria Francesca Donato, Cristina Morelli, Renato Romagnoli, Federica Invernizzi, Chiara Mazzarelli, Rosa Maria Iemmolo, Marzia Montalbano, Ilaria Lenci, Sherrie Bhoori, Giulia Pieri, Sonia Berardi, Paolo Caraceni, Silvia Martini
BACKGROUND AND AIMS: Hepatitis C virus (HCV) reinfection following liver transplant (LT) is associated with reduced graft and patients survival. Before transplant, Sofosbuvir/Ribavirin (SOF/R) treatment prevents recurrent HCV in 96% of those patients achieving viral suppression for at least 4 weeks before transplant. We evaluated whether a bridging SOF-regimen from pre to post-transplant is safe and effective to prevent HCV recurrence in those patients with less than 4 week HCV-RNA undetectability at the time of transplant...
November 19, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27864873/hereditary-haemorrhagic-telangiectasia-to-transplant-or-not-to-transplant-is-there-a-right-time-for-liver-transplantation
#16
Yannick D Muller, Roland Oppliger, Romain Breguet, Philippe Meyer, Laura Rubbia-Brandt, Pierre-Auguste Petignat, Thomas Harr, Eric Dayer, Jörg D Seebach
BACKGROUND & AIMS: Hereditary haemorrhagic telangiectasia is characterized by arterio-venous malformations (AVM). It frequently involves the liver without clinical symptoms, but may lead to biliary ischaemia, portal hypertension, or fatal high-output heart failure. The indication of liver transplantation is controversial. METHODS: Herein, we report the case of a 65-year-old female patient with a 'double Osler syndrome' consisting of hereditary haemorrhagic telangiectasia (HHT) and type I hereditary angioedema diagnosed at the age of 25 and 22 years respectively...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27864870/hereditary-hemorrhagic-telangiectasia-to-transplant-or-not-to-transplant
#17
Sophie Dupuis-Girod, Elisabetta Buscarini
This report comments the case reported by Muller et al. which describes a combination of at least two different indications for orthotopic liver transplant (OLT) in a same patient: hepatocarcinoma and HHT complicated with severe liver involvement and high output cardiac failure. This case report highlighted that the clear time for OLT in HHT can be difficult to determine. In HHT, if intensive medical approach is not efficient, OLT, has to be considered. In the case of Muller et al., the patient was correctly listed for OLT for a single hepatocellular carcinoma, however, he did not receive a sufficient priority so as to avoid worsening of liver vascular malformations complications...
December 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27863968/periocular-periorbital-and-orbital-pathology-in-liver-disease
#18
REVIEW
William J Carroll, Travis Peck, Thomas L Jenkins, Zeynel A Karcioglu
Though the connection is not often apparent, hepatic pathology may be associated with ophthalmic disease . We review the literature concerning the periocular, periorbital, and orbital manifestations of various hepatic disorders. This includes periocular/periorbital jaundice, the impact of hepatitis B and C, eyelid changes in cirrhosis, orbital mass lesions in hepatocellular carcinoma, and cutaneous vascular malformations as they are related to liver disease. The motility disorders associated with Wilson's disease, the ophthalmic manifestations of Alagille syndrome, and the effects of liver transplantation are also discussed...
November 15, 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/27861295/improving-national-results-in-liver-transplantation-using-grafts-from-donation-after-cardiac-death-donors
#19
Kristopher P Croome, David D Lee, Andrew P Keaveny, C Burcin Taner
BACKGROUND: Published reports describing the national experience with liver grafts from donation after cardiac death (DCD) donors have resulted in reservations with their widespread utilization. The present study aimed to investigate if temporal improvements in outcomes have been observed on a national level and to determine if donor and recipient selection have been modified in a fashion consistent with published data on DCD use in liver transplantation (LT). METHODS: Patients undergoing DCD LT between 2003 and 2014 were obtained from the United Network of Organ Sharing Standard Transplant Analysis and Research file and divided into 3 equal eras based on the date of DCD LT: era 1 (2003-2006), era 2 (2007-2010), and era 3 (2011-2014)...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27860456/independent-prognostic-factors-for-posttransplant-survival-in-hepatocellular-carcinoma-patients-undergoing-liver-transplantation
#20
Minzhi Xing, Hyun S Kim
The aim of this study was to investigate longitudinal trends in locoregional therapy (LRT) use in hepatocellular carcinoma (HCC) patients listed for transplant, and evaluate independent prognostic factors for overall survival (OS) in HCC patients undergoing orthotopic liver transplantation (OLT). The United Network for Organ Sharing (UNOS) database was used to identify HCC patients listed for liver transplantation from 1988 to 2014, and longitudinal rates of bridging LRT were calculated. OLT recipients listed from 2002 to 2013 and transplanted up to 2014, with ≥1 year of follow-up were further analyzed...
November 16, 2016: Cancer Medicine
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