Updates in Liver Malignancies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (1 June 2023) | Viewed by 7039

Special Issue Editors


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Guest Editor
1. Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
2. Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: liver malignancies; colorectal cancer; hepato-pancreato-biliary surgery; peritoneal malignancies

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Guest Editor
1. Second Department of Surgery, University Emergency Hospital Bucharest, 050098 Bucharest, Romania
2. Department of General Surgery, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: colorectal cancer; liver tumors; hepato-pancreato-biliary surgery
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Guest Editor
Department of Oncology, Fundeni Clinical Institute, 022328 Bucharest, Romania
Interests: clinical oncology; digestive oncology; cancer diagnostics and treatments; cancer biomarkers; clonal hematopoiesis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

More than 900,000 patients were diagnosed with primary liver cancers worldwide in 2020. Furthermore, at least 40% of patients with colorectal cancers will develop liver-only metastases, and various percentages of patients with other primary malignancies develop liver metastases. Although the treatment modalities for patients with primary or secondary hepatic malignancies evolved over the last three decades, death rates remain high. In 2020, more than 830,000 patients with primary liver cancer and 935,000 with colorectal cancer, of whom more than 70% had liver metastases, died worldwide in 2020.

Renewed efforts are made to detect liver malignancies in early stages, increase the number of patients who can underwent a curative treatment, develop new efficient therapeutic strategies, identify new therapeutic targets, and personalize therapy according to the molecular profile of the tumors.

We invite surgeons, gastroenterologists, oncologists, radiologists, pathologists, and researchers around the world to report their results in fields centered around diagnoses, treatment, and basic science research in relation to this topic.

Clinical series reporting on diagnostic and therapeutic methods, surgical strategies (e.g., methods for conversion to respectability of initially unresectable liver tumors, liver transplantation, etc.), the impact of antiviral medications on the incidence of liver cancers, results of the new oncologic therapies on the long-term outcome of these patients, as well as specific anesthesia and the ICU management of patients with liver tumors are welcomed for this collection. We also invite colleagues involved in the field of molecular, genetic, or epigenetic research related to liver malignancies and report their results in this Special Issue. Comprehensive reviews and meta-analyses on liver malignancies are also welcomed, as well as special case reports that could open the door toward new therapeutic approaches addressed to such patients.

Dr. Sorin Tiberiu Alexandrescu
Dr. Narcis Octavian Zarnescu
Dr. Adina Emilia Croitoru
Guest Editors

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Keywords

  • hepatocellular carcinoma
  • cholangiocarcinoma
  • liver cirrhosis
  • liver metastases
  • hepatic and extrahepatic metastases
  • molecular profile
  • liver surgery
  • liver transplantation
  • immunotherapy
  • ICU management

Published Papers (4 papers)

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Research

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12 pages, 1103 KiB  
Article
Bevacizumab Treatment for Metastatic Colorectal Cancer in Real-World Clinical Practice
by Ioana Mihaela Dinu, Mariana Mihăilă, Mircea Mihai Diculescu, Vlad Mihai Croitoru, Adina Turcu-Stiolica, Diana Bogdan, Monica Ionela Miron, Cristian Virgil Lungulescu, Sorin Tiberiu Alexandrescu, Traian Dumitrașcu, Florina Buică, Ioana Niculina Luca, Cristina Lungulescu, Madalina Cristina Negulescu, Iulia Magdalena Gramaticu, Irina Mihaela Cazacu and Adina Emilia Croitoru
Medicina 2023, 59(2), 350; https://doi.org/10.3390/medicina59020350 - 13 Feb 2023
Cited by 2 | Viewed by 2330
Abstract
Background and Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related mortality and morbidity worldwide. Bevacizumab was approved for the treatment of metastatic colorectal cancer (mCRC) based on favorable benefit-risk assessments from randomized controlled trials, but evidence on its use in the [...] Read more.
Background and Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related mortality and morbidity worldwide. Bevacizumab was approved for the treatment of metastatic colorectal cancer (mCRC) based on favorable benefit-risk assessments from randomized controlled trials, but evidence on its use in the real-world setting is limited. The aim of the current study is to evaluate the outcomes and safety profile of bevacizumab in mCRC in a real-world setting in Romania. Patients and Methods: This was an observational, retrospective, multicentric, cohort study conducted in Romania that included patients with mCRC treated with bevacizumab as part of routine clinical practice. Study endpoints were progression-free survival, overall survival, adverse events, and patterns of bevacizumab use. Results: A total of 554 patients were included in the study between January 2008 and December 2018. A total of 392 patients (71%) received bevacizumab in the first line and 162 patients (29%) in the second line. Bevacizumab was mostly combined with a capecitabine/oxaliplatin chemotherapy regimen (31.6%). The median PFS for patients treated with bevacizumab was 8.4 months (interquartile range [IQR], 4.7–15.1 months) in the first line and 6.6 months (IQR, 3.8–12.3 months) in the second line. The median OS was 17.7 months (IQR, 9.3–30.6 months) in the first line and 13.5 months (IQR, 6.7–25.2 months) in the second line. Primary tumor resection was associated with a longer PFS and OS. The safety profile of bevacizumab combined with chemotherapy was similar to other observational studies in mCRC. Conclusions: The safety profile of bevacizumab was generally as expected. Although the PFS was generally similar to that reported in other studies, the OS was shorter, probably due to the less frequent use of bevacizumab after disease progression and the baseline patient characteristics. Patients with mCRC treated with bevacizumab who underwent resection of the primary tumor had a higher OS compared to patients with an unresected primary tumor. Full article
(This article belongs to the Special Issue Updates in Liver Malignancies)
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11 pages, 720 KiB  
Article
Effect of Percutaneous Biliary Drainage on Enzyme Activity of Serum Matrix Metalloproteinase-9 in Patients with Malignant Hilar Obstructive Hyperbilirubinemia
by Aleksandar Filipović, Dragan Mašulović, Kristina Gopčević, Danijel Galun, Aleksa Igić, Dušan Bulatović, Miloš Zakošek and Tamara Filipović
Medicina 2023, 59(2), 336; https://doi.org/10.3390/medicina59020336 - 10 Feb 2023
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Abstract
Background and Objectives. Cholestasis activates complex mechanisms of liver injury and as a result has an increased production of matrix metalloproteinases (MMP). Depending on the stage of liver disease, different matrix metalloproteinases expressions have been detected and could serve as indirect biomarkers [...] Read more.
Background and Objectives. Cholestasis activates complex mechanisms of liver injury and as a result has an increased production of matrix metalloproteinases (MMP). Depending on the stage of liver disease, different matrix metalloproteinases expressions have been detected and could serve as indirect biomarkers as well as therapeutic targets. MMP-9 proteolytic activity has a proven role in both liver regeneration and neoplastic cell invasion in various malignancies. The purpose of this prospective cohort study was to evaluate the effect of external biliary drainage on enzyme activity of MMP-9 in the serum of patients with malignant hilar biliary obstruction. Materials and Methods. Between November 2020 and April 2021, 45 patients with malignant hilar biliary obstruction underwent percutaneous biliary drainage following determination of serum MMP-9 enzyme activity (before treatment and 4 weeks after the treatment) by gelatin zymography. Results. MMP-9 values decreased statistically significantly 4 weeks after percutaneous biliary drainage (p = 0.028) as well as the value of total bilirubin (p < 0.001), values of direct bilirubin (p < 0.001), aspartate aminotransferase (AST) (p < 0.001), alanine transaminase (ALT) (p < 0.001), and gamma-glutamyl transferase (GGT) (p < 0.001). Conclusions. In patients with malignant hilar biliary obstruction treated by external percutaneous biliary drainage for cholestasis resolution, a significant reduction in MMP-9 serum values was noted 4 weeks after the treatment. Full article
(This article belongs to the Special Issue Updates in Liver Malignancies)
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Review

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16 pages, 927 KiB  
Review
Extracellular Vesicles in Hepatocellular Carcinoma: Progress and Challenges in the Translation from the Laboratory to Clinic
by Rong Yan, Haiming Chen and Florin M. Selaru
Medicina 2023, 59(9), 1599; https://doi.org/10.3390/medicina59091599 - 05 Sep 2023
Cited by 1 | Viewed by 1245
Abstract
Extracellular vesicles (EVs) play critical roles in intercellular communication by transporting bioactive cargo to recipient cells. EVs have been implicated in a range of physiological and pathological processes, including tumor progression, metastasis, immune modulation, and drug resistance. The objective of this review is [...] Read more.
Extracellular vesicles (EVs) play critical roles in intercellular communication by transporting bioactive cargo to recipient cells. EVs have been implicated in a range of physiological and pathological processes, including tumor progression, metastasis, immune modulation, and drug resistance. The objective of this review is to present a thorough overview of recent studies focusing on EVs in hepatocellular carcinoma (HCC), with an emphasis on their potential utility as diagnostic biomarkers as well as therapeutic agents. Initially, we explore the utility of EVs as diagnostic biomarkers for HCC, followed by a discussion of their potential as carriers of therapeutic payloads. Additionally, we delve into the emerging field of therapeutic EVs for modulating tumor immune responses. Through this review, our ultimate aim is to provide a comprehensive understanding of the opportunities and challenges in the clinical translation of EV research in the domain of HCC. Full article
(This article belongs to the Special Issue Updates in Liver Malignancies)
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16 pages, 391 KiB  
Review
Updates and Expert Opinions on Liver Transplantation for Gastrointestinal Malignancies
by Alexander H. Shannon, Samantha M. Ruff, Austin D. Schenk, Kenneth Washburn and Timothy M. Pawlik
Medicina 2023, 59(7), 1290; https://doi.org/10.3390/medicina59071290 - 13 Jul 2023
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Abstract
Transplant oncology is a relatively new field in which transplantation is used to treat patients who would otherwise be unresectable. New anticancer treatment paradigms using tumor and transplant immunology and cancer immunogenomics are emerging. In turn, liver transplantation (LT) has become a potential [...] Read more.
Transplant oncology is a relatively new field in which transplantation is used to treat patients who would otherwise be unresectable. New anticancer treatment paradigms using tumor and transplant immunology and cancer immunogenomics are emerging. In turn, liver transplantation (LT) has become a potential therapy for certain patients with colorectal cancer (CRC) with liver metastasis, hepatocellular (HCC), cholangiocarcinoma (CCA), and metastatic neuroendocrine tumor (NET) of the liver. Although there are established criteria for LT in HCC, evidence regarding LT as a treatment modality for certain gastrointestinal malignancies is still debated. The aim of this review is to highlight updates in the role of LT for certain malignancies, including HCC, metastatic CRC, hilar CCA, and neuroendocrine tumor (NET), as well as contextualize LT use and discuss controversies in transplant oncology. Full article
(This article belongs to the Special Issue Updates in Liver Malignancies)
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