Liver Transplantation for Intermediate-Stage Hepatocellular Carcinoma

Kamo, Naoko; Kaido, Toshimi; Yagi, Shintaro; Okajima, Hideaki; Üemoto, Shinji

doi:10.1159/000487058

Cited by 15 publications

(12 citation statements)

References 26 publications

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“…The Japan Society of Hepatology (JSH) advocated their own JSH guideline in 2017 [18], and the Barcelona Clinic Liver Cancer (BCLC) groups proposed the BCLC guideline in 2018 [16]. Intermediate-stage (IM) hepatocellular carcinoma (HCC) contains various clinical conditions therein and represents a highly heterogeneous population; active discussion is currently ongoing regarding its treatment strategy [17][18][19][20][21][22][23][24][25][26][27][28]. Based on the aforementioned guidelines, TACE/liver resection/hepatic arterial chemoembolization is recommended for IM-HCC treatment, but local ablation, including RFA, is not recommended [16,18].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Intermediate-Stage Hepatocellular Carcinoma in Japan: Position of Curative Therapies

et al. 2019

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Background: Transcatheter arterial chemoembolization (TACE) is the standard therapy for intermediate-stage (IM) hepatocellular carcinoma (HCC). However, IM-HCC includes various clinical conditions, and various therapies were conducted in practice. In this study, we retrospectively analyzed the actually conducted treatments for IM-HCC and their efficacies to elucidate the treatment strategies suitable for IM-HCC. Methods: This study included 627 IM-HCC of 5,260 HCC from 9 hospitals. We examined the treatment strategies of these patients and analyzed the efficacy of each therapy with the Cox proportional hazard model and propensity score-matched analysis. Results: Liver resection, radiofrequency ablation (RFA), and TACE were performed in 165, 108, and 351 patients, respectively. Liver resection and RFA were preferably selected in cases of Barcelona Clinic Liver Cancer (BCLC)-B1/B2, and patient survival was significantly longer than in those treated with TACE (p < 0.0001). However, no beneficial effect of these active therapies was observed in cases of BCLC-B3/B4. analysis revealed that surgical resection (hazard ratio = 0.384) and RFA (hazard ratio = 0.597) were negative risk factors for survival. Propensity score-matching analysis revealed that survival of RFA-treated patients was longer than that of TACE-treated patients (p = 0.036). Conclusion: RFA and surgical resection were effective for IM-HCC, particularly in BCLC-B1/B2 cases.

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Section: Introductionmentioning

confidence: 99%

Treatment of Intermediate-Stage Hepatocellular Carcinoma in Japan: Position of Curative Therapies

et al. 2019

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“…Surprisingly, patients with HCC within the University of California San Francisco (UCSF) downstaging criteria have achieved 92.1% 4-year survival post-transplantation.62 Of note, Kamo et al conducted a study on 56 patients with intermediate stage HCC who underwent liver transplantation. They reported 1-, 3-, and 5-year overall survival and recurrence rates of liver transplantation for intermediate stage HCC of 88%/64%/58% and 22%/34%/44%, respectively.63…”

Section: Treatment Modalities Beyond Conventional Tace For Intermediamentioning

confidence: 99%

<p>Intermediate stage hepatocellular carcinoma: a summary review</p>

Elshaarawy¹,

Gomaa²,

Omar³

et al. 2019

JHC

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It is well known that intermediate stage hepatocellular carcinoma (HCC) encompasses the widest class of patients with this disease. The main characteristic of this special sub-group of patients is that it is extensively heterogenous. This substantial heterogeneity is due to the wide range of liver functions of such patients and variable tumor numbers and sizes. Real world clinical data show huge support for transarterial chemo-embolization (TACE) as a therapeutic modality for intermediate stage HCC, applied in 50%–60% of those class of patients. There are special considerations in various international guidelines regarding treatment allocation in intermediate stage HCC. There is an epidemiological difference in HCC in eastern and western cohorts, and various guidelines have been proposed. In patients with HCC, it has frequently been reported that there is poor correlation between the clinical benefit and real gain in patient condition and the conventional way of tumor response assessment after locoregional treatments. This is due to the evaluation criteria in addition to the scoring systems used for treatment allocation in those patients. It became clear that intermediate stage HCC patients receiving TACE need a proper prognostic score that offers valid clinical prediction and supports proper decision-making. Also, it is the proper time to study more treatment options beyond TACE, such as multimodal regimens for this class of patients. In this review, we tried to provide a summary of the challenges and future directions in managing patients with intermediate stage HCC.

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“…Hepatocellular carcinoma (HCC) accounts for approximately 90% of primary liver cancers and is one of the most lethal cancers worldwide [1]. Despite signi cant improvement in the treatment of HCC, patient prognosis remains poor [2]. Existing treatments are insu cient for patients with locally advanced or distant metastasis [3].…”

Section: Introductionmentioning

confidence: 99%

Development of a prognostic model based on immunogenomic landscape analysis of hepatocellular carcinoma

Liu

Hua

et al. 2021

Preprint

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Background Hepatocellular carcinoma (HCC) is the most common subtype of liver cancer, and the systematic exploration of its prognostic indicators is urgently needed. In this study, we obtained 12 IRGs for the construction of a risk score prediction model in HCC by bioinformatics analysis. Methods Differentially expressed genes were screened using the R software edgeR package. Functional enrichment analysis was performed through gene ontology analyses as well as the Kyoto Encyclopedia of Genes and Genomes pathway analysis. Single factor and multi-factor Cox analysis were employed for survival analysis. We used the Timer software to examine the correlation between risk score and tumor-infiltrating immune cells. Results We identified 3,215 up-regulated and 1,044 down-regulated genes in HCC tissues based on a cohort from The Cancer Genome Atlas (TCGA). Differentially expressed immune-related genes (IRGs) and survival-associated IRGs were further identified. We also integrated multivariate Cox regression analyses to obtain 12 IRGs for the construction of a risk score prediction model, whose performance was verified using the Kaplan-Meier survival and receiver operating characteristic curve analyses. Our findings suggest that the risk score was associated with clinical characteristics and the infiltration of immune cells in HCC patients. Conclusions We obtained a risk score prediction model of 12 IRGs in HCC by bioinformatics analysis and confirmed its performance.

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Liver Transplantation for Intermediate-Stage Hepatocellular Carcinoma

Cited by 15 publications

References 26 publications

Treatment of Intermediate-Stage Hepatocellular Carcinoma in Japan: Position of Curative Therapies

Treatment of Intermediate-Stage Hepatocellular Carcinoma in Japan: Position of Curative Therapies

<p>Intermediate stage hepatocellular carcinoma: a summary review</p>

Development of a prognostic model based on immunogenomic landscape analysis of hepatocellular carcinoma

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