Advancements in the Diagnosis of Hepatocellular Carcinoma

Parra, Natalia Salinas; Ross, Heather M.; Khan, Adnan; Wu, Marisa; Goldberg, Risa; Shah, Lokesh; Mukhtar, Sarah; Beiriger, Jacob; Gerber, Alexis; Marzio, Dina Halegoua-De

doi:10.3390/ijtm3010005

Cited by 23 publications

(13 citation statements)

References 99 publications

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“…The current diagnostic tools for HCC include ultrasonography, CT, magnetic resonance imaging (MRI), and biopsy[ 39 ]. Biopsy confirmation is usually not required for a diagnosis[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Pahari,

Raj,

Sawant

et al. 2024

World J Transplant

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BACKGROUND Liver transplantation (LT) for hepatocellular carcinoma (HCC) has been widely researched and is well established worldwide. The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience. The variations among the criteria are staggering, and the short- and long-term outcomes are controversial. AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future. METHODS We conducted a survey of major centers in India that performed LT in December 2022. A total of 23 responses were received. The centers were classified as high- and low-volume, and the current trend of care for patients undergoing LT for HCC was noted. RESULTS Of the 23 centers, 35% were high volume center (> 500 Liver transplants) while 52% were high-volume centers that performed more than 50 transplants/year. Approximately 39% of centers had performed > 50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15% in approximately 73% of the patients. Barring a few, most centers were divided equally between University of California, San Francisco (UCSF) and center-specific criteria when choosing patients with HCC for LT, and most (65%) did not have separate transplant criteria for deceased donor LT and living donor LT (LDLT). Most centers (56%) preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion. Positron-emission tomography-computed tomography (CT) was the modality of choice for metastatic workup in the majority of centers (74%). Downstaging was the preferred option for over 90% of the centers and included transarterial chemoembolization, transarterial radioembolization, stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications. The alpha-fetoprotein (AFP) cut-off was used by 74% of centers to decide on transplantation as well as to downstage tumors, even if they met the criteria. The criteria for successful downstaging varied, but most centers conformed to the UCSF or their center-specific criteria for LT, along with the AFP cutoff values. The wait time for LT from downstaging was at least 4–6 wk in all centers. Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52% of the centers. Approximately 65% of the centers preferred to start everolimus between 1 and 3 months post-LT. CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%. The aim of transplantation is to achieve at least a 60% 5-year disease free survival rate, which will provide relief to the prediction of an HCC surge over the next 20 years. The current worldwide criteria (Milan/UCSF) may have a higher 5-year survival (> 70%); however, the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment, with much lower survival rates. To make predictions for 2040, we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome. With more advanced technology and better donor outcomes, LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.

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“…The current diagnostic tools for HCC include ultrasonography, CT, magnetic resonance imaging (MRI), and biopsy[ 39 ]. Biopsy confirmation is usually not required for a diagnosis[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Pahari,

Raj,

Sawant

et al. 2024

World J Transplant

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“…We discuss the evolution of key concepts in the field as well as the major technologies, the development pipelines of cancer biomarkers with a particular focus on pancreatic and liver cancer biomarkers. Pancreatic and liver cancers are known as some of the cancer types remarkably difficult to detect early, with particularly high morbidity and mortality, − so we put a special emphasis on examining the advancements on the early detection of these two types of malignancies. The objective of the paper is to provide a broad overview of the evolving landscape of current knowledge on cancer biomarkers, to outline challenges and evaluate growth opportunities, in order to further efforts to solve the problems that remain.…”

Section: Biomarker Research Growthmentioning

confidence: 99%

Biomarkers for Early Cancer Detection: A Landscape View of Recent Advancements, Spotlighting Pancreatic and Liver Cancers

Tenchov,

Sapra,

Sasso

et al. 2024

ACS Pharmacol. Transl. Sci.

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Cancer is one of the leading causes of death worldwide. Early cancer detection is critical because it can significantly improve treatment outcomes, thus saving lives, reducing suffering, and lessening psychological and economic burdens. Cancer biomarkers provide varied information about cancer, from early detection of malignancy to decisions on treatment and subsequent monitoring. A large variety of molecular, histologic, radiographic, or physiological entities or features are among the common types of cancer biomarkers. Sizeable recent methodological progress and insights have promoted significant developments in the field of early cancer detection biomarkers. Here we provide an overview of recent advances in the knowledge related to biomolecules and cellular entities used for early cancer detection. We examine data from the CAS Content Collection, the largest human-curated collection of published scientific information, as well as from the biomarker datasets at Excelra, and analyze the publication landscape of recent research. We also discuss the evolution of key concepts and cancer biomarkers development pipelines, with a particular focus on pancreatic and liver cancers, which are known to be remarkably difficult to detect early and to have particularly high morbidity and mortality. The objective of the paper is to provide a broad overview of the evolving landscape of current knowledge on cancer biomarkers and to outline challenges and evaluate growth opportunities, in order to further efforts in solving the problems that remain. The merit of this review stems from the extensive, wide-ranging coverage of the most up-to-date scientific information, allowing unique, unmatched breadth of landscape analysis and in-depth insights.

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“…Combining tumor markers with ultrasound may improve HCC detection accuracy. A combination of ultrasound and DCP had higher sensitivity and specificity than ultrasound alone for detecting early HCC, according to a systematic review and meta-analysis [24,25]. Other studies have found that using a panel of three different HCC markers (AFP, DCP, and OPN) together had a higher sensitivity rate than using each marker alone [26][27][28].…”

Section: Serum Markersmentioning

confidence: 99%

Advances in the Early Detection of Hepatobiliary Cancers

Yıldırım,

Kavgaci,

Chalabiyev

et al. 2023

Cancers

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Hepatocellular cancer (HCC) and biliary tract cancers (BTCs) have poor survival rates and a low likelihood of a cure, especially in advanced-stage disease. Early diagnosis is crucial and can significantly improve survival rates through curative treatment approaches. Current guidelines recommend abdominal ultrasonography (USG) and alpha-fetoprotein (AFP) monitoring for HCC screening in high-risk groups, and abdominal USG, magnetic resonance imaging (MRI), and magnetic resonance cholangiopancreatography (MRCP) monitoring for biliary tract cancer. However, despite this screening strategy, many high-risk individuals still develop advanced-stage HCC and BTC. Blood-based biomarkers are being developed for use in HCC or BTC high-risk groups. Studies on AFP, AFP-L3, des-gamma-carboxy prothrombin, glypican-3 (GPC3), osteopontin (OPN), midkine (MK), neopterin, squamous cell carcinoma antigen (SCCA), Mac-2-binding protein (M2BP), cyclic guanosine monophosphate (cGMP), and interleukin-6 biomarkers for HCC screening have shown promising results when evaluated individually or in combination. In the case of BTCs, the potential applications of circulating tumor DNA, circulating microRNA, and circulating tumor cells in diagnosis are also promising. These biomarkers have shown potential in detecting BTCs in early stages, which can significantly improve patient outcomes. Additionally, these biomarkers hold promise for monitoring disease progression and evaluating response to therapy in BTC patients. However, further research is necessary to fully understand the clinical utility of these biomarkers in the diagnosis and management of HCC and BTCs.

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Advancements in the Diagnosis of Hepatocellular Carcinoma

Cited by 23 publications

References 99 publications

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

Biomarkers for Early Cancer Detection: A Landscape View of Recent Advancements, Spotlighting Pancreatic and Liver Cancers

Advances in the Early Detection of Hepatobiliary Cancers

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