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hepatocellular carcinoma & liver transplantation

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https://www.readbyqxmd.com/read/28520210/biases-in-the-reporting-of-hcc-tumor-sizes-on-the-liver-transplant-waiting-list
#1
Mariya L Samoylova, Mark J Nigrini, Jennifer L Dodge, John P Roberts
We investigate the possibility that patients with hepatocellular carcinoma (HCC) listed for liver transplant with tumors just outside Stage T2 size criteria may be inaccurately reported as just meeting the tumor size criteria for transplant. The UNOS/STAR database identified 12,958 patients listed for liver transplants with HCC exception points from 2006-2013, 9,168 of whom were listed with one tumor. A logistic power peak function was fitted to the single-tumor size histogram, with the fitted values representing unbiased expected values...
May 18, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28509806/advances-in-management-of-hepatocellular-carcinoma
#2
Manon Allaire, Jean-Charles Nault
PURPOSE OF REVIEW: Hepatocellular carcinoma (HCC) is one of the leading causes of death by cancer worldwide due to a dismal prognosis. The aim of this review is to summarize the main advances in the pathophysiology and management of HCC. RECENT FINDINGS: Genomic analysis has recently delineated the key signaling pathways aberrantly deregulated in HCC (telomere maintenance, cell cycle gene, Wnt/β-catenin, epigenetic modifier, oxidative stress etc.). Major advances in the clinical care of patients with HCC are helping to refine the diagnosis algorithm and tumor staging...
May 15, 2017: Current Opinion in Oncology
https://www.readbyqxmd.com/read/28507924/improved-outcomes-following-hepatocellular-carcinoma-hcc-diagnosis-in-patients-screened-for-hcc-in-a-large-academic-liver-center-versus-patients-identified-in-the-community
#3
Nneoma Okoronkwo, Yucai Wang, Capecomorin Pitchumoni, Baburao Koneru, Nikolaos Pyrsopoulos
Background and Aims: Hepatocellular carcinoma (HCC) is the sixth most commonly occurring cancer worldwide. Knowledge and adherence to HCC surveillance guidelines has been associated with earlier detection. We sought to evaluate characteristics and outcomes following HCC diagnosis in patients screened for HCC in a large academic liver center versus patients diagnosed and referred from the community. Methods: We reviewed the records of patients diagnosed with HCC in the liver center of an academic institution from January 1999 till December 2013...
March 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28503555/surgical-options-for-intrahepatic-cholangiocarcinoma
#4
REVIEW
Kui Wang, Han Zhang, Yong Xia, Jian Liu, Feng Shen
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver cancer, accounting for 10-15% of primary hepatic malignancy. The incidence and cancer-related mortality of ICC continue to increase worldwide. At present, hepatectomy is still the most effective treatment for ICC patients to achieve long-term survival, although its overall efficacy may not be as good as that for patients with hepatocellular carcinoma (HCC) due to the unique pathogenesis and clinical-pathological profiles of ICC. Viral infection, lithiasis and metabolic factors may all be associated with the pathogenesis of ICC...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28498607/human-hepatocellular-carcinomas-with-a-periportal-phenotype-have-the-lowest-potential-for-early-recurrence-after-curative-resection
#5
Romain Désert, Florian Rohart, Frédéric Canal, Marie Sicard, Mireille Desille, Stéphanie Renaud, Bruno Turlin, Pascale Bellaud, Christine Perret, Bruno Clément, Kim-Anh Lê Cao, Orlando Musso
Hepatocellular carcinomas (HCCs) exhibit a diversity of molecular phenotypes, raising major challenges in clinical management. HCCs detected by surveillance programs at an early stage are candidates for potentially curative therapies (local ablation, resection or transplantation). In the long term, transplantation provides the lowest recurrence rates. Treatment allocation is based on tumor number, size, vascular invasion, performance status, functional liver reserve and on the prediction of early (< 2 years) recurrence, which reflects the intrinsic aggressiveness of the tumor...
May 12, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28497761/beyond-the-milan-criteria-for-liver-transplantation-in-children-with-hepatic-tumours
#6
Jean de Ville de Goyet, Rebecka L Meyers, Greg M Tiao, Bruce Morland
The Milan criteria were originally defined in the context of adult liver transplantation for patients with hepatocellular carcinoma and cirrhotic livers. The aim of the criteria was to select patients with small tumours and no disease spread who had a good chance of success, thus avoiding futile transplants. This objective was reached successfully. For the management of selected children with unresectable hepatoblastoma, an almost opposite strategy was proposed and has been implemented in the past two decades, in which transplantation is indicated on the basis of large tumour size and anatomy that precludes the possibility of safe and radical resection...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28497759/long-term-challenges-and-perspectives-of-pre-adolescent-liver-disease
#7
REVIEW
Nedim Hadžić, Ulrich Baumann, Pat McKiernan, Valerie McLin, Valerio Nobili
Chronic liver disease is a growing problem that has substantial effects on public health. Many paediatric liver conditions are precursors of adult chronic liver disease, cirrhosis, and hepatocellular carcinoma. Clinical management of Wilson's disease, autoimmune liver disease, and chronic biliary disorders, such as biliary atresia, which remains the most common paediatric chronic liver disease and indication for liver transplantation, is similar in children and adults. In the past 10 or so years, paediatric hepatology has expanded into neighbouring clinical areas, such as metabolic liver diseases and systemic conditions with liver involvement...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28494530/radioembolization-for-the-treatment-of-hepatocellular-carcinoma
#8
Hyo-Cheol Kim
Transarterial radioembolization (TARE) with yttrium 90 (90Y), an intra-arterial procedure performed by interventional radiologists, has begun being utilized in managing hepatocellular carcinoma (HCC) in Korea. There are two available TARE products: glass and resin microspheres with different physical characteristics. All patients undergoing TARE must be assessed with clinical examination and laboratory tests as well as a thorough angiographic evaluation. TARE is safe and effective in the treatment of unresectable HCC, as it has longer time-to-progression, greater ability to downsize tumors for liver transplantation, less post-embolization syndrome, and shorter hospitalization compared with chemoembolization...
May 10, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28493615/why-we-need-fairer-allocation-rules-for-patients-with-hepatocellular-carcinoma-awaiting-a-liver-transplant
#9
Herold J Metselaar, Aad van den Berg, Minneke J Coenraad
The incidence of both cirrhosis and hepatocellular carcinoma (HCC) is increasing worldwide, despite the current available effective therapy for HCV infection [1]. As liver transplantation is a potential curative option for many patients, the demand for liver transplantation is rising too. Unfortunately, the availability of cadaveric donor livers has remained stable over the years, leading to a widening of the gap between donor organ supply and demand and a higher waiting list mortality or removal rate. The current waiting list mortality and removal rate within Eurotransplant is respectively 18% and 4% [2]...
May 11, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28491877/nodular-regenerative-hyperplasia-a-case-of-rare-prognosis
#10
Mindy Lee, Manhal Izzy, Ashwin Akki, Kathryn Tanaka, Harmit Kalia
Introduction: Nodular regenerative hyperplasia (NRH) is a known etiology of noncirrhotic portal hypertension. Cases of biopsy-proven NRH in human immunodeficiency virus (HIV)-positive patients have been described. While these patients often have normal synthetic liver function, several reports described disease progression to liver failure. Case: We here present a 26-year-old woman with history of congenital HIV on antiretroviral therapy complicated by Pneumocystis carinii pneumonia at age 14. CD4 counts have been >300 with undetectable viral load...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28489174/the-impact-of-the-meld-score-on-liver-transplant-allocation-and-results-an-integrative-review
#11
Ana Claudia Oliveira de Moraes, Priscilla Caroliny de Oliveira, Olival Cirilo Lucena da Fonseca-Neto
Introduction: Liver transplantation is intended to increase the survival of patients with chronic liver disease in terminal phase, as well as improved quality of life. Since the first transplant until today many changes have occurred in the organ allocation system. Objective: To review the literature on the Model for End-stage Liver Disease (MELD) and analyze its correlation with survival after liver transplantation. Method: An integrative literature review in Lilacs, SciELO, and Pubmed in October 2015, was realized...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28487614/patients-with-non-viral-liver-disease-have-a-greater-tumor-burden-and-less-curative-treatment-options-when-diagnosed-with-hepatocellular-carcinoma
#12
Waled Mohsen, Marcia Rodov, Emilia Prakoso, Barbara Charlton, David G Bowen, David J Koorey, Nicholas A Shackel, Geoffrey W McCaughan, Simone I Strasser
AIM: To assess the impact of underlying liver disease etiology on the presenting features and outcomes in a large cohort of patients with hepatocellular carcinoma (HCC). METHODS: A prospective database of all patients with HCC was established from 1998 to March 2012. One thousand and seventy-eight patients were categorized into three groups, based on the etiology of their liver disease: hepatitis B virus (HBV), hepatitis C virus (HCV) and non-viral liver disease (NVLD)...
April 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28482674/management-of-hepatocellular-in-the-united-states
#13
Ali A Mokdad, Caitlin A Hester, Amit G Singal, Adam C Yopp
Hepatocellular carcinoma (HCC) is a major cause of cancer burden globally. In the United States, the incidence of HCC is forecast to continue to rise for the next 15 years. Patients with HCC vary markedly owing to heterogeneous tumor characteristics and concomitant liver dysfunction. In the United States and Europe, HCC is staged and managed according to the Barcelona Clinic Liver Cancer (BCLC) system. For very early and early stage HCC, or BCLC 0/A, liver transplant is the optimal treatment option. Liver resection and radiofrequency or microwave ablation are alternative treatment options...
April 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28482403/-recent-advances-in-the-treatment-of-hepatitis-c-in-2016
#14
B F Luo, L Wei
It has been rapidly developed in treatment of chronic hepatitis C from the past few years. Here we summarize the progress in chronic hepatitis C treatment in 2016. We introduce the pan-genotypic regimens with short-duration, the efficacy of DAA regimens in difficult-to-treat population, the influence on hepatocellular carcinoma, decompensation of liver cirrhosis, liver fibrosis and liver transplantation, the safety of DAA regimens in special population, information from real-world studies and data from China...
March 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/28480517/the-clinical-outcomes-of-patients-with-portal-vein-tumor-thrombi-after-living-donor-liver-transplantation
#15
Ho Joong Choi, Dong Goo Kim, Gun Hyung Na, Tae Ho Hong, Si Hyun Bae, Young Kyoung You, Jong Young Choi, Seung Kew Yoon
INTRODUCTION: The purpose of this study was to evaluate the feasibility of living-donor liver transplantation (LDLT) for treatment of patients with hepatocellular carcinoma (HCC) and segmental portal vein tumor thrombi (PVTT) below the second-order branch. PATIENTS AND METHODS: Between January 2005 and December 2015, we retrospectively analyzed 242 patients in a control group (n = 184), a microvascular invasion (MVI) group (n = 24), and a PVTT group (n = 34). To assess the risks associated with PVTT, we evaluated recurrence, the disease-free survival rate (DFS), the overall survival rate (OS), and various other factors based on the characteristics of patients and tumors...
May 8, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28480062/locoregional-and-systemic-therapy-for-hepatocellular-carcinoma
#16
REVIEW
Olumide B Gbolahan, Michael A Schacht, Eric W Beckley, Thomas P LaRoche, Bert H O'Neil, Maximilian Pyko
The management of hepatocellular carcinoma (HCC) remains challenging due to late presentation and the presence of accompanying liver dysfunction. As such, most patients are not eligible for curative resection and liver transplant. Management in this scenario depends on a number of factors including hepatic function, tumor burden, patency of hepatic vasculature and patients' functional status. Based on these, patients can be offered catheter based intra-arterial therapy for intermediate stage disease and in more advanced disease, sorafenib...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28476200/analysis-of-the-long-term-results-of-living-donor-liver-transplantation-in-adults
#17
Santiago Sánchez Cabús, Laia Estalella, Mihai Pavel, David Calatayud, Víctor Molina, Joana Ferrer, Constantino Fondevila, Josep Fuster, Juan Carlos García-Valdecasas
INTRODUCTION: Living donor liver transplantation (LDLT) is an alternative to conventional transplantation given its excellent results. The aim of this study is to evaluate long-term outcomes in LDLT recipients. METHODS: 100 consecutive THDV recipients from the Hospital Clínic of Barcelona from March 2000 to October 2015 were included. The main indication for transplantation was end-stage liver disease (58%) followed by hepatocellular carcinoma (41%). 95% of grafts consisted of the right liver of the donor and the 5% of the left liver...
May 2, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28473952/liver-allocation-policies-for-patients-affected-by-hcc-in-europe
#18
Luciano De Carlis, Stefano Di Sandro, Leonardo Centonze, Andrea Lauterio, Vincenzo Buscemi, Riccardo De Carlis, Fabio Ferla, Raffaella Sguinzi, Stefano Okolicsanyi, Luca Belli, Mario Strazzabosco
The main goal of organ allocation systems is to guarantee an equal access to the limited resource of liver grafts for every patients on the waiting list, balancing between the ethical principles of equity, utility, benefit, need, and fairness. The European heath care scenario is very complex, as it is essentially decentralized and each Nation and Regions inside the nation, operate on a significant degree of autonomy. Furthermore the epidemiology of liver diseases and HCC, which is different among European countries, clearly inpacts on indications and priorities...
December 2016: Current Transplantation Reports
https://www.readbyqxmd.com/read/28473688/long-term-outcome-of-liver-resection-versus-transplantation-for-hepatocellular-carcinoma-in-a-region-where-living-donation-is-a-main-source
#19
Pil Soo Sung, Hyun Yang, Gun Hyung Na, Seawon Hwang, Donghoon Kang, Jeong Won Jang, Si Hyun Bae, Jong Young Choi, Dong Goo Kim, Seung Kew Yoon, Young Kyoung You
BACKGROUND The aim of this study was to define the best curative strategy in patients with hepatocellular carcinoma (HCC) in a hepatitis B virus (HBV)-endemic region where living donation dominates the type of cadaveric donation for liver transplantation (LT). MATERIAL AND METHODS A retrospective cohort comprised those patients whose clinical course could potentially be traced for at least 10 years. We found 262 HCC patients who had undergone curative surgical treatment from March 1997 to August 2006. Among these patients, 156 were treated with liver resection (LR) (R group) and 106 patients underwent LT (T group, 100 patients with living donor)...
May 5, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/28473066/acr-appropriateness-criteria-%C3%A2-chronic-liver%C3%A2-disease
#20
Jeanne M Horowitz, Ihab R Kamel, Hina Arif-Tiwari, Sumeet K Asrani, Nicole M Hindman, Harmeet Kaur, Michelle M McNamara, Richard B Noto, Aliya Qayyum, Tasneem Lalani
Because liver fibrosis can be treated, it is important to diagnose liver fibrosis noninvasively and monitor response to treatment. Although ultrasound (grayscale and Doppler) can diagnose cirrhosis, it does so unreliably using morphologic and sonographic features and cannot diagnose the earlier, treatable stages of hepatic fibrosis. Transient elastography, ultrasound elastography with acoustic radiation force impulse, and MR elastography are modalities that can assess for hepatic fibrosis. Although all international organizations recommend ultrasound for screening for hepatocellular carcinoma, ultrasound is particularly limited for identifying hepatocellular carcinoma in patients with obesity, nonalcoholic fatty liver disease, and nodular cirrhotic livers...
May 2017: Journal of the American College of Radiology: JACR
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