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Liver, liver transplantation, hepatocellular carcinoma, hepatectomy, cholangiocarcinoma

Sonia T Orcutt, Daniel A Anaya
Primary liver cancer-including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC)-incidence is increasing and is an important source of cancer-related mortality worldwide. Management of these cancers, even when localized, is challenging due to the association with underlying liver disease and the complex anatomy of the liver. Although for ICC, surgical resection provides the only potential cure, for HCC, the risks and benefits of the multiple curative intent options must be considered to individualize treatment based upon tumor factors, baseline liver function, and the functional status of the patient...
January 2018: Cancer Control: Journal of the Moffitt Cancer Center
Aaron R Huber, Raul S Gonzalez, Mark S Orloff, Christopher T Barry, Christa L Whitney-Miller
CONTEXT: Liver cancers (including hepatocellular carcinoma [HCC] and cholangiocarcinoma) are the fifth most common cause of cancer death. The most powerful independent histologic predictor of overall survival after transplantation for HCC is the presence of microscopic vascular invasion (VI). AIMS: Given that VI is known to have somewhat high interobserver variability in both HCC and other tumors, we hypothesized that pathologists with special interest and training in liver pathology would be more likely to identify and report VI in HCC than would general surgical pathologists...
October 2017: Indian Journal of Pathology & Microbiology
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
Paolo Magistri, Giuseppe Tarantino, Valentina Serra, Cristiano Guidetti, Roberto Ballarin, Fabrizio Di Benedetto
INTRODUCTION: Combined hepatocellular-cholangiocarcinoma (CHC or cHCC-CC) is a rare primary liver tumor displaying histological features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). Most patients are not suitable for surgery because of the advanced stage of the disease at the moment of diagnosis. We decided to review the literature in order to identify the outcomes after liver transplantation for CHC and to clarify which is the most appropriate treatment. MATERIAL AND METHODS: A systematic literature search was performed...
May 2017: Digestive and Liver Disease
Fernando Rotellar, Fernando Pardo, Pablo Martí-Cruchaga, Gabriel Zozaya, Victor Valentí, Manuel Bellver, Luis Lopez-Olaondo, Francisco Hidalgo
PURPOSE: The purpose of this study is to describe a technical modification that facilitates right liver mobilization in laparoscopic right hepatectomy (LRH). METHODS: In the supine position, an inflatable device is placed under the patient's right chest. For right hemiliver mobilization, the table is placed in 30° anti-Trendelenburg and full-left tilt. Balloon inflation offers an additional 30° left inclination that places the patient in an almost left lateral position...
February 2017: Langenbeck's Archives of Surgery
C-H Wu, C-C Yong, E-H Liew, L L-C Tsang, M Lazo, H-W Hsu, H-Y Ou, C-Y Yu, T-Y Chen, T-L Huang, A M Concejero, C-L Chen, Y-F Cheng
BACKGROUND: Primary liver malignancy is the leading cause of cancer death worldwide, with hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) representing the majority. Combined HCC-CC, in contrast, accounts for less than 5% of these liver cancers and has not been clearly characterized by imaging, making diagnosis and management difficult. MATERIALS AND METHODS: This retrospective study investigated 32 patients with early-stage combined HCC-CC tumor who underwent hepatectomy (n = 24) or liver transplantation (n = 8)...
May 2016: Transplantation Proceedings
Hao Li, Xi-tao Wang, Ai-qun Zhang, Xiang-fei Meng, Qiang Yu, Wen-ping Lü, Wei-dong Duan, Jia-hong Dong
OBJECTIVE: To compare the predictive values of eight staging systems for primary liver cancer in the prognosis of combined hepatocellular-cholangiocellular carcinoma (cHCC-CC) patients after surgery. METHODS: The clinical data of 54 cHCC-CC patients who underwent hepatectomy or liver transplantation from May 2005 to Augest 2013 in Chinese PLA General Hospital were collected. We evaluated the prognostic value of the Okuda staging system, Cancer of the Liver Italian Program (CLIP) score, French staging system, Barcelona Clinic Liver Cancer (BCLC) staging system, 7th edition of tumour-node-metastasis (TNM) staging system for hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC), Japan Integrated Staging (JIS) score, and Chinese University Prognostic Index...
April 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
S Truant, O Scatton, S Dokmak, J-M Regimbeau, V Lucidi, A Laurent, R Gauzolino, C Castro Benitez, A Pequignot, V Donckier, C Lim, M-L Blanleuil, R Brustia, Y-P Le Treut, O Soubrane, D Azoulay, O Farges, R Adam, F-R Pruvot
BACKGROUND: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was recently developed to induce rapid hypertrophy and reduce post-hepatectomy liver failure in patients with insufficient remnant liver volume (RLV). However, mortality rates >12% have been reported. This study aimed to analyze the perioperative course of ALPPS and to identify factors associated with morbi-mortality. METHODS: Between April 2011 and September 2013, 62 patients operated in 9 Franco-Belgian hepatobiliary centres underwent ALPPS for colorectal metastases (N = 50) or primary tumors, following chemotherapy (N = 50) and/or portal vein embolization (PVE; N = 9)...
May 2015: European Journal of Surgical Oncology
Perla Oliveira Schulz, Fabio Gonçalves Ferreira, Maria de Fátima Araújo Nascimento, Andrea Vieira, Mauricio Alves Ribeiro, André Ibrahim David, Luiz Arnaldo Szutan
AIM: To investigate the association between nonalcoholic fatty liver disease (NAFLD) and liver cancer, and NAFLD prevalence in different liver tumors. METHODS: This is a retrospective study of the clinical, laboratory and histological data of 120 patients diagnosed with primary or secondary hepatic neoplasms and treated at a tertiary center where they underwent hepatic resection and/or liver transplantation, with subsequent evaluation of the explant or liver biopsy...
January 21, 2015: World Journal of Gastroenterology: WJG
David S Shin, Christopher R Ingraham, Manjiri K Dighe, Carolyn Wang, Sandeep Vaidya, Mariam Moshiri, Chandana Lall, James O Park, Puneet Bhargava
OBJECTIVE: Hepatic malignancy is a common and lethal disease, whether due to a primary tumor or metastasis. There are numerous treatment options available depending on the stage of the disease and medical condition of the patient, including systemic chemotherapy, transcatheter embolization, thermal ablation, and surgical resection. In a subset of patients with liver malignancy, surgical resection can offer the best chance of long-term survival and potentially even cure. This article reviews the major indications and contraindications for resection, basic surgical techniques and terminology, key clinical and imaging preoperative workup, and pertinent interventional oncology procedures in the management of hepatic malignancy...
July 2014: AJR. American Journal of Roentgenology
Mattia Garancini, Paolo Goffredo, Fabio Pagni, Fabrizio Romano, Sanziana Roman, Julie Ann Sosa, Vittorio Giardini
Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare primary liver cancer. Our aims were to analyze the demographic, clinical, and pathological characteristics of cHCC-CC at a population level and to investigate the effects of these features as well as different management strategies on the prognosis. The Surveillance, Epidemiology, and End Results (SEER) database was analyzed for 1988-2009. Data analyses were performed with chi-square tests, analyses of variance, Kaplan-Meier curves, and Cox proportional hazards regression...
August 2014: Liver Transplantation
Cemal Yazici, David J Niemeyer, David A Iannitti, Mark W Russo
Hepatocellular carcinoma (HCC) is the third most common cause of cancer worldwide and is rising in incidence. Ultrasound is the preferred modality for screening high-risk patients for HCC because it detects clinically significant nodules, widespread availability and lower cost. HCC does not require a biopsy for diagnosis if specific imaging criteria are fulfilled. Transarterial chemoembolization (TACE) is the most common modality used to treat HCC followed by ablation. Cholangiocarcinoma (CCA) is increasing in incidence and the second most common primary malignancy of the liver...
January 2014: Expert Review of Gastroenterology & Hepatology
S Song, H H Moon, S Lee, T-S Kim, M Shin, J M Kim, J B Park, C H D Kwon, S J Kim, S-K Lee, J-W Joh
OBJECTIVE: The treatment of choice for combined hepatocellular and cholangiocarcinoma (cHCC-CC) is surgical resection. However, the efficacy of liver transplantation is not clear. We compared the surgical outcome of hepatic resection and liver transplantation for cHCC-CC. PATIENTS AND METHODS: From 1995 to 2012, 89 patients were diagnosed with cHCC-CC after hepatic resection and 8 patients diagnosed with cHCC-CC after liver transplantation. We excluded 21 patients who were American Joint Committee on Cancer Staging Stage III or IV and lost to follow-up...
October 2013: Transplantation Proceedings
Ser Yee Lee, Daniel Cherqui
Cholangiocarcinomas (CCAs) are rare malignancies that originate from the epithelial cells of the bile ducts. It is the second most-common primary liver cancer after hepatocellular carcinoma. Recent epidemiologic studies have shown that the overall incidence and mortality rates of CCAs are increasing. Diagnosis is often challenging due to the difficulty in getting tissue/cytology for confirmation, and it comprises a combination of cross-imaging, tumor markers, histology, and cholangiography. Surgery involving major resections of liver, bile duct, pancreas, and at times adjacent vessels is the only chance for cure...
August 2013: Seminars in Liver Disease
M Guba, J Andrassy, M Angele, C Bruns
Tumor treatment and transplantation-associated with unavoidable mandatory immunosuppression-appear to be unreconcilable opposites. The clinical reality shows, however, that transplantation in many early stage primary tumors is the most effective treatment. The essential immunosuppression after transplantation can however promote tumor recurrence. Immunosuppression also leads to a significant increased rate of de novo tumors-in all organ transplant recipients. However, not all immunosuppressant drugs have the same effect on tumors...
August 2013: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Michael Vouche, Robert J Lewandowski, Rohi Atassi, Khairuddin Memon, Vanessa L Gates, Robert K Ryu, Ron C Gaba, Mary F Mulcahy, Talia Baker, Kent Sato, Ryan Hickey, Daniel Ganger, Ahsun Riaz, Jonathan Fryer, Juan Carlos Caicedo, Michael Abecassis, Laura Kulik, Riad Salem
BACKGROUND & AIMS: Portal vein embolization (PVE) is a standard technique for patients not amenable to liver resection due to small future liver remnant ratio (FLR). Radiation lobectomy (RL) with (90)Y-loaded microspheres (Y90) is hypothesized to induce comparable volumetric changes in liver lobes, while potentially controlling the liver tumor and limiting tumor progression in the untreated lobe. We aimed at testing this concept by performing a comprehensive time-dependent analysis of liver volumes following radioembolization...
November 2013: Journal of Hepatology
Tiffany C L Wong, Ronnie T P Poon
With the higher incidences of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) in the East compared with the West, Asian centers have made significant contributions to the management of these malignancies. The major risk factor for HCC is hepatitis B infection in Asia in contrast to hepatitis C in Western populations. Barcelona Clinic for Liver Cancer (BCLC) staging that guides the treatment of patients with HCC in the West is considered too conservative by many Asian centers. In Asia, liver resection is widely offered to patients with multifocal, bilobar tumor or tumor invasion to the portal vein...
2013: Digestive Diseases
Fumitoshi Hirokawa, Michihiro Hayashi, Yoshiharu Miyamoto, Mitsuhiro Asakuma, Tetsunosuke Shimizu, Koji Komeda, Yoshihiro Inoue, Kazuhisa Uchiyama, Yasuichiro Nishimura
BACKGROUND: Antibiotic prophylaxis is frequently administered after liver resection to prevent postoperative infections. However, very few studies have examined the usefulness of antibiotic prophylaxis after liver resection. A randomized controlled trial was conducted to evaluate the postoperative antibiotic prophylaxis in patients after liver resection. METHODS: A total of 241 patients scheduled to undergo liver resection were randomly assigned to the non-postoperative antibiotic group (n = 95) or the antibiotic group (n = 95)...
July 2013: American Journal of Surgery
Ryan T Groeschl, Kiran K Turaga, T Clark Gamblin
BACKGROUND AND OBJECTIVES: Although transplantation has demonstrated survival benefit for patients with hepatocellular carcinoma (HCC), there is limited data to support or refute transplantation for combined hepatocellular-cholangiocarcinoma (cHCC-CC). We hypothesized that cHCC-CC patients had poorer overall survival (OS) than HCC patients after liver transplantation. METHODS: Patients with localized HCC and cHCC-CC treated with surgical resection or transplant were identified using the Surveillance, Epidemiology, and End Results (SEER) Database (1973-2007)...
May 2013: Journal of Surgical Oncology
U Settmacher, H Scheuerlein, Y Dittmar, F Rauchfuss
Liver transplantation is nowadays an established treatment option for end-stage liver disease and the associated complications. In this article, we summarise the actual aspects of allocation, indication for transplantation as well as approaches for donor pool expansion in the field of liver transplantation in Germany. Beside the maintenance of long-term survival and quality of life, the actual donor organ shortage is the most important issue worldwide. While trying to control this shortage, there is a lot of discussion about the transplantation for malignant liver disease...
December 2013: Zentralblatt Für Chirurgie
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