Advances in minimally invasive surgery for hepatocellular carcinoma

Zhang, Cunzhen; Li, Nan

doi:10.20517/2394-5079.2020.74

Cited by 4 publications

(2 citation statements)

References 45 publications

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“…However, the most recent series include resection of multiple HCC in their population and show very encouraging results [ 99 ]. Indeed, robotic liver resection (RLR) can ideally overcome some limitations of LLR, such as the lack of flexibility of the operating instruments, due to the ability to articulate the instruments because of the 360° of freedom for the surgeon’s wrist and a magnified high-definition vision, as well as to considerable ergonomic advantages [ 100 , 101 ]. Recently, a meta-analysis including 487 RLR concluded for lower bleeding rates after RLR at the expense of a longer operation time [ 102 ].…”

Section: Minimally Invasive Approach For Multiple Hepatocellular Carc...mentioning

confidence: 99%

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Cassese

Han

Cho

et al. 2022

Cancers

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According to the Barcelona Clinic Liver Cancer (BCLC) staging system, the optimal strategy for patients with multiple HCC within the Milan Criteria is liver transplantation (LT). However, LT cannot be offered to all the patients due to organ shortages and long waiting lists, as well as because of the advanced disease carrying a high risk of poor outcomes. For early stages, liver resection (LR) or thermal ablation (TA) can be proposed, while trans-arterial chemoembolization (TACE) still remains the treatment of choice for intermediate stages (BCLC-B). Asian guidelines and the National Comprehensive Cancer Network suggest LR for resectable multinodular HCCs, even beyond Milan criteria. In this scenario, a growing body of evidence shows better outcomes after surgical resection when compared with TACE. Trans-arterial radioembolization (TARE) and stereotaxic body radiation therapy (SBRT) can also play an important role in this setting. Furthermore, the role of minimally invasive liver surgery (MILS) specifically for patients with multiple HCC is still not clear. This review aims to summarize current knowledge about the best therapeutical strategy for multiple HCC while focusing on the role of minimally invasive surgery and on the most attractive future perspectives.

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Section: Minimally Invasive Approach For Multiple Hepatocellular Carc...mentioning

confidence: 99%

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Cassese

Han

Cho

et al. 2022

Cancers

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“…HCC is one of the most difficult tumors to treat because of its insidious onset and ease of intrahepatic dissemination. The fact is that HCC is often in the progressive stage when diagnosed, with an extremely prognosis, and often dying within six months without treatment [ 3 , 4 ]. Therefore, exploring the specific mechanisms of HCC growth in vivo and mastering new treatment strategies have become the sticking point to ameliorate the prognosis of patients with hepatocellular carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Exosome-transmitted circ_002136 promotes hepatocellular carcinoma progression by miR-19a-3p/RAB1A pathway

et al. 2022

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Background Circular RNAs (circRNAs) are enriched in exosomes and are extremely stable. Exosome-mediated intercellular transfer of specific biologically active circRNA molecules can drive the transformation of the tumor microenvironment and accelerate or inhibit the local spread and multifocal growth of hepatocellular carcinoma (HCC). In this study, we explored in depth about the biological roles of HCC cell-derived exosomes and exosome-transported circRNAs on HCC in vivo and in vitro. Methods Exosomes extracted from HCC cells (Huh7 and HA22T) were characterized using transmission electron microscopy, nanoparticle size tracer analysis, and western blotting. Exosomes were observed for endocytosis using fluorescent labeling. The effects of HCC cell-derived exosomes and the circ_002136 they carried on cell growth, metastasis and apoptosis were determined by CCK-8 assay, transwell assay, flow cytometry analysis and TUNEL staining, respectively. The expressions of circ_002136, miR-19a-3p and RAB1A were detected by quantitative RT-PCR (qRT-PCR). Targeted binding between miR-19a-3p and circ_002136 or RAB1A was predicted and verified by bioinformatics analysis, dual-luciferase reporter and RNA pull-down experiments. The in vivo effect of circ_002136 was determined by constructing a xenograft tumor model. Results The findings revealed that Huh7 and HA22T exosomes conferred enhanced viability as well as invasive ability to recipient HCC cells. Circ_002136 was shown for the first time to be differentially upregulated in HCC tissues and cells and transferred by HCC cell-derived exosomes. More importantly, selective silencing of circ_002136 depleted the malignant biological behaviors of HCC exosome-activated Huh7 and HA22T cells. Depletion of circ_002136 in vivo effectively retarded the growth of HCC xenograft tumors. Furthermore, a well-established circ_002136 ceRNA regulatory network was constructed, namely circ_002136 blocked miR-19a-3p expression, elevated RAB1A expression activity and stimulated HCC development. Finally, high levels of circ_002136 or RAB1A, as well as low levels of miR-19a-3p, negatively affected HCC patient survival. Conclusion The study on circ_002136 provides good data to support our insight into the mechanism of to-be-silenced circRNA as a therapeutic agent in the progression of HCC.

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Feasibility and safety of minimally invasive R1 vascular surgery for hepatocellular carcinoma: a cohort study

Abdelhadi,

Sandra-Petrescu,

Vassilev

et al. 2024

Surg Endosc

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Background In recent studies addressing colorectal liver metastases and HCC, R1 vascular surgery has demonstrated safety and oncological adequacy. Recognizing that patient prognosis after liver surgery for HCC depends more on preserving an adequate future liver remnant than on the width of the surgical margin, this surgical approach has achieved rising interest. However, data for its feasibility and safety for minimally invasive approaches for HCC resections are limited. Therefore, the aim of our study was to determine the feasibility and safety of minimally invasive R1 vascular surgery for HCC. Methods Consecutive patients who underwent curative hepatectomies between April 2018 and May 2023 were identified from a prospectively collected institutional database. Intraoperative ultrasound was performed to guide the resection, confirm the preoperative finding regarding the tumor’s relation to the main vessels, and exclude any undetected vascular invasion or additional lesions. Postoperative complications were graded according to the Clavien-Dindo classification. Results Among 58 patients included, 22 (38%) underwent minimally invasive R1vasc surgery for HCC and 36 (62%) non-R1vasc surgery. In the MI-R1vasc surgery group, there were significantly more infiltrated liver segments (2 vs. 1, p = 0.04) and a shorter tumor distance to the main hepatic veins (5 mm vs. 21 mm, p < 0.001) and Glissonean pedicles (4 mm vs. 26 mm, p < 0.001) than in MI-non-R1vasc surgery group. The comparisons of the type of surgical resection revealed similar findings between the study groups, with non-anatomic resections and segmentectomies being the most frequently performed resections. The median blood loss (600 ml vs. 500 ml, p = 0.41), operative time (264 min vs. 231 min, p = 0.13), and R1par resection rate (5% vs. 3%, p = 0.72) were comparable in both groups. Other intra- and postoperative outcomes were also comparable between the two groups. Conclusion Minimally invasive R1 vascular surgery is safe and feasible for patients with Hepatocellular Carcinoma.

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Advances in minimally invasive surgery for hepatocellular carcinoma

Cited by 4 publications

References 45 publications

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Selecting the Best Approach for the Treatment of Multiple Non-Metastatic Hepatocellular Carcinoma

Exosome-transmitted circ_002136 promotes hepatocellular carcinoma progression by miR-19a-3p/RAB1A pathway

Feasibility and safety of minimally invasive R1 vascular surgery for hepatocellular carcinoma: a cohort study

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