Pub Date : 2024-07-24DOI: 10.20517/2394-5079.2024.22
M. Mendiratta-Lala, Shaan Batra, Kethan Lala, Miles Kohn, Dawn Owen
Treatment of hepatocellular carcinoma with both internal and external radiation therapy is becoming more common, with the recent incorporation of internal radiation therapy (transarterial radioembolization) into the Barcelona Clinic Liver guidelines. With the increasing use of radiation therapy for the treatment of liver cancer, it is essential to understand the expected imaging findings after therapy and establish a consensus on the management of these patients. Recent insights into the unique post-treatment imaging features of HCC treated with radiation have prompted updates to treatment response algorithms to improve inter-reader response assessment. One must understand the type of locoregional treatment, the time interval of post-treatment imaging and the sequence of the treatment strategy to provide an accurate treatment response assessment. Although imaging response systems attempt to predict treatment efficacy, many of these complex cases should be discussed in a multidisciplinary setting for management recommendations.
{"title":"Multidisciplinary assessment of tumor response after internal and external radiation therapy for hepatocellular carcinoma","authors":"M. Mendiratta-Lala, Shaan Batra, Kethan Lala, Miles Kohn, Dawn Owen","doi":"10.20517/2394-5079.2024.22","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.22","url":null,"abstract":"Treatment of hepatocellular carcinoma with both internal and external radiation therapy is becoming more common, with the recent incorporation of internal radiation therapy (transarterial radioembolization) into the Barcelona Clinic Liver guidelines. With the increasing use of radiation therapy for the treatment of liver cancer, it is essential to understand the expected imaging findings after therapy and establish a consensus on the management of these patients. Recent insights into the unique post-treatment imaging features of HCC treated with radiation have prompted updates to treatment response algorithms to improve inter-reader response assessment. One must understand the type of locoregional treatment, the time interval of post-treatment imaging and the sequence of the treatment strategy to provide an accurate treatment response assessment. Although imaging response systems attempt to predict treatment efficacy, many of these complex cases should be discussed in a multidisciplinary setting for management recommendations.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"28 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141807422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-17DOI: 10.20517/2394-5079.2024.70
Hao Su, Yongguang Wei, Xiwen Liao, Guangzhi Zhu, Minhao Peng, Fang Fan, Tao Peng
Additional randomized controlled studies and high-level evidence for the diagnosis and management of liver cancer patients have been published since the release of Diagnosis and Treatment of Primary Liver Cancer Guidelines (CNLC-2022 edition). The 2024 version algorithm was updated accordingly by the national expert committee for the standardization and homogenization of liver cancer diagnosis and treatment in China. In this review, with reference to the guidelines of the 2022 version, we interpreted the main update points of the 2024 version to facilitate the nationwide dissemination and implementation of the guidelines.
{"title":"Interpretation of the updates of the chinese guidelines for the diagnosis and treatment of primary liver cancer (CNLC-2024 Edition)","authors":"Hao Su, Yongguang Wei, Xiwen Liao, Guangzhi Zhu, Minhao Peng, Fang Fan, Tao Peng","doi":"10.20517/2394-5079.2024.70","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.70","url":null,"abstract":"Additional randomized controlled studies and high-level evidence for the diagnosis and management of liver cancer patients have been published since the release of Diagnosis and Treatment of Primary Liver Cancer Guidelines (CNLC-2022 edition). The 2024 version algorithm was updated accordingly by the national expert committee for the standardization and homogenization of liver cancer diagnosis and treatment in China. In this review, with reference to the guidelines of the 2022 version, we interpreted the main update points of the 2024 version to facilitate the nationwide dissemination and implementation of the guidelines.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-07DOI: 10.20517/2394-5079.2024.06
T. Stecca, Alessandra Greco, Pier Paolo Brollo, Marco Massani
Combined hepatic artery infusion (HAI) and systemic chemotherapy have demonstrated its clinical efficacy in prolonging overall survival in unresectable intrahepatic cholangiocarcinoma and as a conversion to treatment strategy in a small proportion of patients. The utilization of HAI chemotherapy is restricted by the scarcity of surgeons and oncologists who are well-experienced in its use. This represents a significant drawback of this treatment method. In recent years, a solid push to expand its use, mainly in the United States and recently also in Europe, has been made possible by the HAI Consortium Research Network. Results of ongoing Clinical Trials are eagerly awaited to give the basis for further expansion of this technique and oncological treatment outside of historically established centers. In this technical note review, we aim to give a brief historical description of the origins and evolution of intra-arterial chemotherapy for unresectable intrahepatic cholangiocarcinoma. We will, therefore, discuss the surgical technique by providing some tips and tricks without neglecting the difficulties that may be encountered.
肝动脉灌注（HAI）和全身化疗相结合的临床疗效已得到证实，可延长无法切除的肝内胆管癌患者的总生存期，并可作为小部分患者的转归治疗策略。由于缺乏有丰富经验的外科医生和肿瘤学家，HAI 化疗的使用受到了限制。这是这种治疗方法的一个重大缺陷。近年来，在 HAI 联合研究网络的推动下，HAI 化疗的使用范围不断扩大，主要集中在美国，最近也扩展到了欧洲。人们翘首以盼正在进行的临床试验结果，以便为在历史悠久的中心之外进一步推广这种技术和肿瘤治疗奠定基础。在这篇技术说明综述中，我们旨在简要介绍动脉内化疗治疗不可切除肝内胆管癌的起源和演变。因此，我们将通过提供一些技巧和窍门来讨论手术技术，同时也不会忽略可能遇到的困难。
{"title":"Hepatic arterial infusion chemotherapy: a review with technical notes","authors":"T. Stecca, Alessandra Greco, Pier Paolo Brollo, Marco Massani","doi":"10.20517/2394-5079.2024.06","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.06","url":null,"abstract":"Combined hepatic artery infusion (HAI) and systemic chemotherapy have demonstrated its clinical efficacy in prolonging overall survival in unresectable intrahepatic cholangiocarcinoma and as a conversion to treatment strategy in a small proportion of patients. The utilization of HAI chemotherapy is restricted by the scarcity of surgeons and oncologists who are well-experienced in its use. This represents a significant drawback of this treatment method. In recent years, a solid push to expand its use, mainly in the United States and recently also in Europe, has been made possible by the HAI Consortium Research Network. Results of ongoing Clinical Trials are eagerly awaited to give the basis for further expansion of this technique and oncological treatment outside of historically established centers. In this technical note review, we aim to give a brief historical description of the origins and evolution of intra-arterial chemotherapy for unresectable intrahepatic cholangiocarcinoma. We will, therefore, discuss the surgical technique by providing some tips and tricks without neglecting the difficulties that may be encountered.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.20517/2394-5079.2024.60
Fereshteh Yazdanpanah, Omar Al-Daoud, Moein Moradpour, Stephen Hunt
The evolving treatment landscape of hepatocellular carcinoma (HCC) includes curative treatments such as ablation, resection, and transplantation, along with palliative interventions such as locoregional and systemic therapies. Evaluating the response to therapy is critical to planning the next intervention or follow-up needed, as well as for comparing the outcomes across the treatment options. Response to therapy can be measured using serum markers, through pathology, using imaging surrogates, and clinical response. This review provides a brief overview of these measures of treatment response and their relevance to HCC management.
{"title":"Measures for response assessment in HCC treatment","authors":"Fereshteh Yazdanpanah, Omar Al-Daoud, Moein Moradpour, Stephen Hunt","doi":"10.20517/2394-5079.2024.60","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.60","url":null,"abstract":"The evolving treatment landscape of hepatocellular carcinoma (HCC) includes curative treatments such as ablation, resection, and transplantation, along with palliative interventions such as locoregional and systemic therapies. Evaluating the response to therapy is critical to planning the next intervention or follow-up needed, as well as for comparing the outcomes across the treatment options. Response to therapy can be measured using serum markers, through pathology, using imaging surrogates, and clinical response. This review provides a brief overview of these measures of treatment response and their relevance to HCC management.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.20517/2394-5079.2023.122
Giuseppe Guido Maria Scarlata, Claudia Cicino, R. Spagnuolo, N. Marascio, A. Quirino, G. Matera, D. L. Dumitrașcu, Francesco Luzza, L. Abenavoli
Hepatocellular carcinoma (HCC) is a primary liver cancer that occurs with a frequency of 85% in patients with liver cirrhosis. It is the sixth most common type of cancer globally. Asia is the continent with the highest incidence (72%), followed by Europe (8%) and Africa (5%). Men are four times more likely than women to develop this cancer, especially in the 70-80 age group. Risk factors include alcoholic liver disease, tobacco use, genetic predisposition, dysmetabolic comorbidities such as type 2 diabetes mellitus and obesity, hepatitis B virus and hepatitis C virus infections, and non-alcoholic fatty liver disease. Unhealthy dietary regimens and gut dysbiosis are additional risk factors that have been recently investigated. These two factors are closely related because the gut microbiota performs several biological functions, including nutrient metabolism, a process that promotes gut homeostasis, known as eubiosis. With regard to the correlation between diet, gut microbiota, and HCC development, there are several mechanisms that have not yet been fully elucidated. This narrative review aims to evaluate the impact of diet and gut microbiota changes in the development of HCC. Our analysis, performed on several clinical and pre-clinical studies, showed that a high-fat diet promotes gut dysbiosis and hepatic fat accumulation, leading to the progression from simple steatosis to HCC, while the Mediterranean diet, rich in fiber and monounsaturated fatty acids, had a protective role. For this reason, international employment of this dietary regimen for therapeutic purposes should be encouraged.
{"title":"Impact of diet and gut microbiota changes in the development of hepatocellular carcinoma","authors":"Giuseppe Guido Maria Scarlata, Claudia Cicino, R. Spagnuolo, N. Marascio, A. Quirino, G. Matera, D. L. Dumitrașcu, Francesco Luzza, L. Abenavoli","doi":"10.20517/2394-5079.2023.122","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.122","url":null,"abstract":"Hepatocellular carcinoma (HCC) is a primary liver cancer that occurs with a frequency of 85% in patients with liver cirrhosis. It is the sixth most common type of cancer globally. Asia is the continent with the highest incidence (72%), followed by Europe (8%) and Africa (5%). Men are four times more likely than women to develop this cancer, especially in the 70-80 age group. Risk factors include alcoholic liver disease, tobacco use, genetic predisposition, dysmetabolic comorbidities such as type 2 diabetes mellitus and obesity, hepatitis B virus and hepatitis C virus infections, and non-alcoholic fatty liver disease. Unhealthy dietary regimens and gut dysbiosis are additional risk factors that have been recently investigated. These two factors are closely related because the gut microbiota performs several biological functions, including nutrient metabolism, a process that promotes gut homeostasis, known as eubiosis. With regard to the correlation between diet, gut microbiota, and HCC development, there are several mechanisms that have not yet been fully elucidated. This narrative review aims to evaluate the impact of diet and gut microbiota changes in the development of HCC. Our analysis, performed on several clinical and pre-clinical studies, showed that a high-fat diet promotes gut dysbiosis and hepatic fat accumulation, leading to the progression from simple steatosis to HCC, while the Mediterranean diet, rich in fiber and monounsaturated fatty acids, had a protective role. For this reason, international employment of this dietary regimen for therapeutic purposes should be encouraged.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"91 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140659477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-24DOI: 10.20517/2394-5079.2024.23
M. G. Guerra Veloz, Sital Shah, J. Lok, Almuthana Mohamed, Mary Cannon, Paul J Ross, I. Carey, Kosh Agarwal
Aims: The optimal timing for DAA therapy initiation in patients with chronic hepatitis C (CHC) and HCC is still debated. The aim of our study was to provide real-world data on virological response and overall survival in patients with hepatitis C-related HCC. Methods: Retrospectively, we included patients with HCV-related HCC between 2015 and 2020. The primary outcome was to compare the SVR rate in the patients with active or historical HCC who were treated with DAA therapy. The secondary outcome was to measure the overall survival of those patients. Results: 98 patients were included, and the majority were cirrhotic with compensated liver disease. 71.4% received DAA therapy at the time of initial HCC diagnosis and 11.2% received HCV treatment at the time of HCC recurrence (Active HCC cohort). 17.3% had previously received HCC treatment, but there was no evidence of recurrence at the time of DAA (Historical HCC Cohort). The SVR rate was 81.6%, but decreased to 75.7% in patients with active HCC. The presence of active HCC and the number of HCC nodules were the only factors associated with not achieving SVR in the multivariate analysis. The median survival was higher in those who achieved SVR. Active HCC and failure to achieve SVR were the main factors associated with mortality. Conclusions: Treating hepatitis C in patients with HCC is feasible with significant rates of SVR, even if SVR rates decrease in patients with active HCC and these patients require more than one DAA therapy. Failure to achieve SVR is one of the main factors associated with mortality.
{"title":"Achieving SVR in patients with hepatitis C-related HCC is associated with an improvement in overall survival: real word data","authors":"M. G. Guerra Veloz, Sital Shah, J. Lok, Almuthana Mohamed, Mary Cannon, Paul J Ross, I. Carey, Kosh Agarwal","doi":"10.20517/2394-5079.2024.23","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.23","url":null,"abstract":"Aims: The optimal timing for DAA therapy initiation in patients with chronic hepatitis C (CHC) and HCC is still debated. The aim of our study was to provide real-world data on virological response and overall survival in patients with hepatitis C-related HCC.\u0000 Methods: Retrospectively, we included patients with HCV-related HCC between 2015 and 2020. The primary outcome was to compare the SVR rate in the patients with active or historical HCC who were treated with DAA therapy. The secondary outcome was to measure the overall survival of those patients.\u0000 Results: 98 patients were included, and the majority were cirrhotic with compensated liver disease. 71.4% received DAA therapy at the time of initial HCC diagnosis and 11.2% received HCV treatment at the time of HCC recurrence (Active HCC cohort). 17.3% had previously received HCC treatment, but there was no evidence of recurrence at the time of DAA (Historical HCC Cohort). The SVR rate was 81.6%, but decreased to 75.7% in patients with active HCC. The presence of active HCC and the number of HCC nodules were the only factors associated with not achieving SVR in the multivariate analysis. The median survival was higher in those who achieved SVR. Active HCC and failure to achieve SVR were the main factors associated with mortality.\u0000 Conclusions: Treating hepatitis C in patients with HCC is feasible with significant rates of SVR, even if SVR rates decrease in patients with active HCC and these patients require more than one DAA therapy. Failure to achieve SVR is one of the main factors associated with mortality.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"43 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-23DOI: 10.20517/2394-5079.2024.04
Masayuki Ohtsuka, T. Takayashiki, S. Takano, D. Suzuki, N. Sakai, I. Hosokawa, T. Mishima, T. Konishi, Kensuke Suzuki, H. Nishino, Shinichiro Nakada
Intrahepatic cholangiocarcinoma (ICC) is known to have a high frequency of lymph node metastasis. Lymph node dissection (LND) is recommended for accurate staging, but the survival benefit of LND remains unclear. Knowledge of the pathways and direction of lymphatic drainage to the regional lymph nodes is essential when considering LND to improve patient survival. The liver has three lymphatic drainage pathways: portal, sublobular, and subcapsular. Of these, the portal lymphatic pathway, which lies along with the portal tracts, is the primary pathway. The efferent portal lymphatic vessels from the left-sided liver, which continue from the portal lymphatic pathway of the liver, communicate with the lymphatic vessels and lymph nodes along the hepatic artery at the hepatoduodenal ligament. In addition, lymphatic flow may also present along the left embryonic (aberrant) hepatic artery in the lesser omentum, based on our experience. This pathway is the previously reported pathway from the left-sided ICC to the lesser curvature of the stomach. However, through this pathway, ICC cells reach lymph nodes along the root of the left gastric artery but not the perigastric lymph nodes along the lesser curvature because of the opposite direction of lymph flow. Although further analyses using a large number of cases are needed to confirm these observations, these two pathways, along the hepatic artery at the hepatoduodenal ligament and the left embryonic (aberrant) hepatic artery in the lesser omentum should be considered when performing LND in the case of ICC in the left-sided liver.
{"title":"Lymphatic spread from left-sided intrahepatic cholangiocarcinoma: reconsiderations based on the lymphatic drainage from the liver","authors":"Masayuki Ohtsuka, T. Takayashiki, S. Takano, D. Suzuki, N. Sakai, I. Hosokawa, T. Mishima, T. Konishi, Kensuke Suzuki, H. Nishino, Shinichiro Nakada","doi":"10.20517/2394-5079.2024.04","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.04","url":null,"abstract":"Intrahepatic cholangiocarcinoma (ICC) is known to have a high frequency of lymph node metastasis. Lymph node dissection (LND) is recommended for accurate staging, but the survival benefit of LND remains unclear. Knowledge of the pathways and direction of lymphatic drainage to the regional lymph nodes is essential when considering LND to improve patient survival. The liver has three lymphatic drainage pathways: portal, sublobular, and subcapsular. Of these, the portal lymphatic pathway, which lies along with the portal tracts, is the primary pathway. The efferent portal lymphatic vessels from the left-sided liver, which continue from the portal lymphatic pathway of the liver, communicate with the lymphatic vessels and lymph nodes along the hepatic artery at the hepatoduodenal ligament. In addition, lymphatic flow may also present along the left embryonic (aberrant) hepatic artery in the lesser omentum, based on our experience. This pathway is the previously reported pathway from the left-sided ICC to the lesser curvature of the stomach. However, through this pathway, ICC cells reach lymph nodes along the root of the left gastric artery but not the perigastric lymph nodes along the lesser curvature because of the opposite direction of lymph flow. Although further analyses using a large number of cases are needed to confirm these observations, these two pathways, along the hepatic artery at the hepatoduodenal ligament and the left embryonic (aberrant) hepatic artery in the lesser omentum should be considered when performing LND in the case of ICC in the left-sided liver.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"29 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.20517/2394-5079.2023.101
Edoardo Poli, Eleonora De Martin
Hepatocellular carcinoma (HCC) is the primary liver cancer type, often seen in individuals with chronic liver disease. Once the patient progresses to the cirrhotic stage, the annual incidence of HCC is approximately 2%-4%. As it exceeds the minimum threshold of 1.0%-1.5% per year, HCC screening every 6 months through abdominal ultrasound is indicated in the cirrhotic population. While the incidence of viral hepatitis-associated HCC is decreasing, there is a notable rise of HCC associated with metabolic dysfunction-related steatotic liver disease and alcohol-related liver disease, particularly in high-income countries. The most effective approach for oncological prevention remains addressing the cause of liver disease. The indications for HCC screening in patients without cirrhosis depend on the etiology of liver disease and the stage of fibrosis, assessed by liver biopsy or noninvasive tests such as FIB-4 or transient elastography. However, clear recommendations for HCC screening in patients without cirrhosis and for the different etiologies are currently unavailable. Research efforts should focus on identifying markers, or combinations thereof, to provide a more accurate estimate of HCC occurrence. Such advancements would enable the effective targeting of populations at the highest risk of HCC and the establishment of the correct timing to start the screening.
{"title":"Progression of liver disease and associated risk of hepatocellular carcinoma","authors":"Edoardo Poli, Eleonora De Martin","doi":"10.20517/2394-5079.2023.101","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.101","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the primary liver cancer type, often seen in individuals with chronic liver disease. Once the patient progresses to the cirrhotic stage, the annual incidence of HCC is approximately 2%-4%. As it exceeds the minimum threshold of 1.0%-1.5% per year, HCC screening every 6 months through abdominal ultrasound is indicated in the cirrhotic population. While the incidence of viral hepatitis-associated HCC is decreasing, there is a notable rise of HCC associated with metabolic dysfunction-related steatotic liver disease and alcohol-related liver disease, particularly in high-income countries. The most effective approach for oncological prevention remains addressing the cause of liver disease. The indications for HCC screening in patients without cirrhosis depend on the etiology of liver disease and the stage of fibrosis, assessed by liver biopsy or noninvasive tests such as FIB-4 or transient elastography. However, clear recommendations for HCC screening in patients without cirrhosis and for the different etiologies are currently unavailable. Research efforts should focus on identifying markers, or combinations thereof, to provide a more accurate estimate of HCC occurrence. Such advancements would enable the effective targeting of populations at the highest risk of HCC and the establishment of the correct timing to start the screening.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"23 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140372099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Introduction to 2023 Chinese expert consensus on the whole-course management of hepatocellular carcinoma","authors":"Jiexun Li, Zhuoran Qi, Jian Zhang, Sinuo Chen, Jinglin Xia","doi":"10.20517/2394-5079.2024.16","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.16","url":null,"abstract":"","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"20 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140225935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-20DOI: 10.20517/2394-5079.2024.14
Matteo Donadon, Marcello Di Martino, Paolo Baroffio, M. Polidoro
Hepatectomy is a curative procedure in selected patients affected by hepatocellular carcinoma (HCC). However, recurrence rates are as high as 70% five years after resection, and having a valid postoperative systemic regimen would represent a significant improvement in the care of HCC patients. While burgeoning evidence is emerging around the use of immunotherapy in the setting of resected HCC, little is yet known to allow the widespread use of immunotherapy after surgery. Here, we pointed out some reflections and perspectives on adjuvant strategies for patients with resected HCC and discussed potential benefits and drawbacks.
{"title":"Reflections and perspectives on adjuvant treatment in the setting of resected hepatocellular carcinoma","authors":"Matteo Donadon, Marcello Di Martino, Paolo Baroffio, M. Polidoro","doi":"10.20517/2394-5079.2024.14","DOIUrl":"https://doi.org/10.20517/2394-5079.2024.14","url":null,"abstract":"Hepatectomy is a curative procedure in selected patients affected by hepatocellular carcinoma (HCC). However, recurrence rates are as high as 70% five years after resection, and having a valid postoperative systemic regimen would represent a significant improvement in the care of HCC patients. While burgeoning evidence is emerging around the use of immunotherapy in the setting of resected HCC, little is yet known to allow the widespread use of immunotherapy after surgery. Here, we pointed out some reflections and perspectives on adjuvant strategies for patients with resected HCC and discussed potential benefits and drawbacks.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"25 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140227015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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