Advanced Strategies in the Care of Hepatocellular Carcinoma Patients

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 7136

Special Issue Editors


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Guest Editor
Department of Surgery, University Maggiore Hospital, Corso Mazzini 18, 28100 Novara, Italy
Interests: cholangiocarcinoma; Klatskin tumor; colorectal liver metastases; neuroendocrine tumors; hepatocellular carcinoma; hepatic resection; hepatectomy; liver resection; liver surgery; parenchymal-sparing liver surgery; intraoperative ultrasound; liver-specific magnetic resonance imaging; trans-arterial therapy; liver function; FibroScan; pancreatic tumor; pancreatic resection; laparoscopic surgery; robotic surgery
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Guest Editor
Director of Department of Surgery, Division of Hepatobiliary Surgery & General Surgery, Humanitas Research Hospital, 20089 Rozzano, Italy
Interests: liver; laparoscopic surgery; intraoperative US of liver
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are honored to be the Guest Editors of this Special Issue of Cancers that summarizes current research in the diagnosis and treatment of hepatocellular carcinoma (HCC). HCC is the most common primary liver cancer, with geographical variations among its prevalence. With HCC still being the leading cause of death in patients with cirrhosis, and considering the worldwide increasing incidence in patients with underlying metabolic associated liver disease, working on HCC should be one of the research priorities. In this Special Issue, we welcome papers that enhance our knowledge of innovative diagnostic and prognostic methods and discuss the results of therapeutic experimentation, including those focused on translational research.

We look forward to receiving your contributions.

Prof. Dr. Matteo Donadon
Prof. Dr. Guido Torzilli 
Guest Editors

Manuscript Submission Information

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Keywords

  • hepatocellular carcinoma
  • hepatic resection
  • hepatectomy
  • liver resection
  • liver surgery
  • parenchymal-sparing liver surgery
  • intraoperative ultrasound
  • liver-specific magnetic resonance imaging
  • trans-arterial therapy
  • liver function
  • FibroScan

Published Papers (4 papers)

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Research

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10 pages, 642 KiB  
Article
Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer
by Łukasz Masior, Maciej Krasnodębski, Mikołaj Kuncewicz, Kacper Karaban, Igor Jaszczyszyn, Emilia Kruk, Milena Małecka-Giełdowska, Krzysztof Korzeniowski, Wojciech Figiel, Marek Krawczyk, Tadeusz Wróblewski and Michał Grąt
Cancers 2023, 15(15), 3962; https://doi.org/10.3390/cancers15153962 - 04 Aug 2023
Viewed by 1218
Abstract
Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change [...] Read more.
Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (p = 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (p = 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821, p = 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE. Full article
(This article belongs to the Special Issue Advanced Strategies in the Care of Hepatocellular Carcinoma Patients)
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11 pages, 591 KiB  
Article
Impact of Oocyte Extract Supplement on Quality of Life after Hepatectomy for Liver Tumours: A Prospective, Multicentre, Double-Blind Randomized Clinical Trial
by Matteo Donadon, Angela Palmisano, Mariano Bizzarri, Roberto Ceriani, Luigi Veneroni, Gabriele Donati, Davide Tassinari, Massimo Giuseppe Viola, Emiliano Tamburini and Guido Torzilli
Cancers 2023, 15(10), 2809; https://doi.org/10.3390/cancers15102809 - 18 May 2023
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Abstract
Background: Previous studies on oocyte extract supplementation showed benefits in patients with liver tumours. In this trial, we hypothesized that the oocyte extract supplement impacted the QoL after hepatectomy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: This was a multicentre, double-blind, randomized clinical [...] Read more.
Background: Previous studies on oocyte extract supplementation showed benefits in patients with liver tumours. In this trial, we hypothesized that the oocyte extract supplement impacted the QoL after hepatectomy for hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: This was a multicentre, double-blind, randomized clinical trial designed to assess the QoL of patients receiving a supplement of oocyte extract or placebo postoperatively. QoL was assessed using the Short Form-36 questionnaire in participants randomly assigned to treatment (Synchrolevels) or placebo. All study personnel and participants were masked to treatment assignment. The endpoint was the change in the QoL score. Results: Between June 2018 and September 2022, 66 of 128 expected patients were considered as per interim analysis, of which 33 were assigned to the treatment and 33 to the placebo group. Baseline and clinicopathological characteristics were similar between the two groups. In the treatment group, the health, mental and psychological status improved for many of the items considered, reaching statistical significance, while in the placebo group, those items either did not change or were impaired in comparison with the corresponding baseline. Conclusions: Supplementation with oocyte extract modifies QoL after liver surgery by enhancing functional recovery. Further in-depth studies are required to confirm this evidence. Full article
(This article belongs to the Special Issue Advanced Strategies in the Care of Hepatocellular Carcinoma Patients)
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Review

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32 pages, 3336 KiB  
Review
Incidental Findings in Pediatric Patients: How to Manage Liver Incidentaloma in Pediatric Patients
by Andrius Cekuolis, Dagmar Schreiber-Dietrich, Rasa Augustinienė, Heike Taut, Judy Squires, Edda L. Chaves, Yi Dong and Christoph F. Dietrich
Cancers 2023, 15(8), 2360; https://doi.org/10.3390/cancers15082360 - 18 Apr 2023
Cited by 2 | Viewed by 1772
Abstract
The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled “Incidental imaging findings—the role of ultrasound”. IFs in the liver of newborns and children are rare and much less [...] Read more.
The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled “Incidental imaging findings—the role of ultrasound”. IFs in the liver of newborns and children are rare and much less commonly encountered than in adults; as a result, they are relatively much more frequently malignant and life-threatening, even when they are of benign histology. Conventional B-mode ultrasound is the well-established first line imaging modality for the assessment of liver pathology in pediatric patients. US technological advances, resulting in image quality improvement, contrast-enhanced ultrasound (CEUS), liver elastography and quantification tools for steatosis have expanded the use of ultrasound technology in daily practice. The following overview is intended to illustrate incidentally detected liver pathology covering all pediatric ages. It aims to aid the examiner in establishing the final diagnosis. Management of incidentally detected focal liver lesions (FLL) needs to take into account the diagnostic accuracy of each imaging modality, the patient’s safety issues (including ionizing radiation and nephrotoxic contrast agents), the delay in diagnosis, the psychological burden on the patient and the cost for the healthcare system. Moreover, this paper should help the pediatric clinician and ultrasound practitioner to decide which pathologies need no further investigation, which ones require interval imaging and which cases require further and immediate diagnostic procedures. Full article
(This article belongs to the Special Issue Advanced Strategies in the Care of Hepatocellular Carcinoma Patients)
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16 pages, 990 KiB  
Review
Surgical Strategies for Recurrent Hepatocellular Carcinoma after Resection: A Review of Current Evidence
by Flavio Milana, Michela Anna Polidoro, Simone Famularo, Ana Lleo, Renzo Boldorini, Matteo Donadon and Guido Torzilli
Cancers 2023, 15(2), 508; https://doi.org/10.3390/cancers15020508 - 13 Jan 2023
Cited by 4 | Viewed by 1896
Abstract
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, and both liver resection and liver transplantation are considered potentially curative options. However, high recurrence rates affect the prognosis depending both on the primary HCC pathology characteristics or on the type and time [...] Read more.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer, and both liver resection and liver transplantation are considered potentially curative options. However, high recurrence rates affect the prognosis depending both on the primary HCC pathology characteristics or on the type and time of the relapse. While great attention has been usually posted on treatment algorithms for the first HCC, treatment algorithms for recurrent HCC (rHCC) are lacking. In these cases, surgery still represents a curative option with both redo hepatectomy and/or salvage liver transplantation, which are considered valid treatments in selected patients. In the current era of personalised medicine with promises of new systemic-targeted immuno-chemotherapies, we wished to perform a narrative review of the literature on the role of surgical strategies for rHCC. Full article
(This article belongs to the Special Issue Advanced Strategies in the Care of Hepatocellular Carcinoma Patients)
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