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Elsolh B, Bayat Z, Lyu D, Lin J, Wakeam E. Lung transplantation for lung cancer: A systematic review of the literature. J Heart Lung Transplant 2023; 42:1425-1436. [PMID: 37253398 DOI: 10.1016/j.healun.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 04/05/2023] [Accepted: 05/20/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Lung transplant (LTx) is an accepted treatment for end-stage pulmonary failure. A small proportion of explanted lungs harbor incidentally identified nonsmall cell lung cancers (NSCLC). We review the literature on studies assessing LTx patients found to have NSCLC lung cancer in their explanted lungs, and perform a pooled analysis of outcomes. METHODS MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched. We included studies assessing outcomes of patients with incidentally identified NSCLC following LTx, or following LTx for diffuse lepidic adenocarcinoma as a primary indication. RESULTS A total of 1404 articles were reviewed. 17 eligible studies were identified: 14 studies on incidental NSCLC (N = 169), 4 on diffuse lepidic adenocarcinoma (N = 70). Overall survival (OS) for patients with incidentally identified lung cancer at 1-year, 3-year, and 5-year was 60.8% (95%CI 43.7%-77.9%, I2 =81.8%), 25.5% (95%CI 1.6%-49.5%, I2 =93.6%), and 23.0% (95%CI 2.0%-44.0%, I2 =92.0%) respectively. When restricted to those with earlier stage disease, those with stage I or II NSCLC had better 1-year, 3-year, and 5-year OS at 72.7% (95%CI 57.2%-88.2%, I2 =67.3%), 41.6% (95%CI 14.0%-69.1%, I2 =89.1%), and 34.5% (95%CI 8.1%-61.0%, I2 =89.8%), respectively. A sensitivity analysis limited to stage I showed 1-year, 3-year, and 5-year survival of 73.0% (95%CI 56.3%-89.7%), 40.4% (95%CI 110.3%-70.6%), and 35.4% (95%CI 6.2%-64.5%), respectively. The 4 studies on diffuse lepidic adenocarcinoma were too heterogeneous for pooled analysis. CONCLUSIONS We present a review and pooled analysis examining survival following LTx with incidentally identified NSCLC. Patients with earlier stage incidentally explanted NSCLC had better survival outcomes. OS in the stage I population approximates that of LTx without incidental NSCLC.
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Affiliation(s)
- Basheer Elsolh
- Division of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Zubair Bayat
- Division of General Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Dennis Lyu
- Division of Pulmonary Medicine, University of Michigan, Ann Arbor, Michigan
| | - Jules Lin
- Section of Thoracic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Elliot Wakeam
- Division of Thoracic Surgery, Toronto General Hospital, Toronto, Ontario, Canada.
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Ince V, Sahin TT, Akbulut S, Yilmaz S. Liver transplantation for hepatocellular carcinoma: Historical evolution of transplantation criteria. World J Clin Cases 2022; 10:10413-10427. [PMID: 36312504 PMCID: PMC9602233 DOI: 10.12998/wjcc.v10.i29.10413] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/27/2022] [Accepted: 08/25/2022] [Indexed: 02/05/2023] Open
Abstract
Liver transplantation (LT) for hepatocellular carcinoma is still a hot topic, and the main factor that is associated with the success of treatment is to determine the patients who will benefit from LT. Milan criteria have been defined 25 years ago and still is being used for patient selection for LT. However, in living donor LT, the Milan criteria is being extended. Current criteria for patient selection do not only consider morphologic characteristics such as tumor size and number of tumor nodules but also biologic markers that show tumor aggressiveness is also being considered. In the present review article, we have summarized all the criteria and scoring systems regarding LT for hepatocellular carcinoma. All criteria have 5-year overall survival rates that were comparable to the Milan Criteria and ranged between 60%-85%. On the other hand, it was seen that the recurrence rates had increased as the Milan criteria were exceeded; the 5-year recurrence rates ranged between 4.9% to 39.9%. Treatment of hepatocellular carcinoma needs a multidisciplinary approach. Ideal selection criteria are yet to be discovered. The same is true for treatment modalities. The goal will be achieved by a harmonic interplay between basic science researchers and clinicians.
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Affiliation(s)
- Volkan Ince
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Tevfik Tolga Sahin
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Sami Akbulut
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
- Biostatistics and Medical Informatics, Inonu University Faculty of Medicine, Malatya 44280, Turkey
| | - Sezai Yilmaz
- Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey
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Qiu JJ, Wei GF, Du JL, Guo J. Advances in the application of different anesthetic methods and drugs in interventional therapy for hepatocellular carcinoma. Clin Res Hepatol Gastroenterol 2022; 46:101982. [PMID: 35732267 DOI: 10.1016/j.clinre.2022.101982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/09/2022] [Accepted: 06/18/2022] [Indexed: 02/04/2023]
Abstract
Currently, interventional therapy has been widely used in clinical practice as a treatment method for hepatocellular carcinoma (HCC). The limitations of interventional therapy lie mainly in the intolerable pain felt by the patients during the treatment process. Hence, the selection of the anesthetic methods and drugs, as well as the precise control of the dosages, are particularly crucial before the initiation of the treatment. Moreover, different anesthetic methods and drugs may also affect the patient's recovery differently. To better comprehend the current status of various anesthetic methods and drugs used in interventional therapy for HCC, this study reviewed the advantages and disadvantages of different anesthetic methods and drugs.
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Affiliation(s)
- Jun-Jie Qiu
- Department of Anesthesiology, The First People's Hospital of Tongxiang, Tongxiang, Zhejiang 314500, China
| | - Gui-Fen Wei
- Department of Hepatobiliary Pancreatic Surgery, The First People's Hospital of Tongxiang, Tongxiang, Zhejiang 314500, China
| | - Jian-Long Du
- Department of Anesthesiology, The First People's Hospital of Tongxiang, Tongxiang, Zhejiang 314500, China
| | - Jing Guo
- Department of Anesthesiology, The First People's Hospital of Tongxiang, Tongxiang, Zhejiang 314500, China.
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Artificial Intelligence Algorithm in Classification and Recognition of Primary Hepatic Carcinoma Images under Magnetic Resonance Imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8950600. [PMID: 35800234 PMCID: PMC9197610 DOI: 10.1155/2022/8950600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/27/2022]
Abstract
This study aimed to discuss the application value of the bias field correction algorithm in magnetic resonance imaging (MRI) images of patients with primary hepatic carcinoma (PHC). In total, 52 patients with PHC were selected as the experimental group and divided into three subgroups: mild (15 cases), moderate (19 cases), and severe (18 cases) according to pathological grading. Another 52 patients with hepatic nodules in the same period were included in the control group. All the patients underwent dynamic contrast-enhanced (DCE) MRI examination, and the image qualities of MRI before and after bias field correction were compared. The DCE-MRI perfusion parameters were measured, including the transport constant Ktrans, reverse rate constant Kep, extravascular extracellular volume fraction (Ve), plasma volume (Vp), microvascular density (MVD), hepatic artery perfusion index (HPI), mean transit time of contrast agent (MTT), time to peak (TTP), blood volume (BV), hepatic arterial perfusion (HAP), full perfusion (FP), and portal venous perfusion (PVP). It was found that the sensitivity (93.63%), specificity (71.62%), positive predictive value (95.63%), negative predictive value (71.62%), and accuracy (90.01%) of MRI examination processed by the bias field correction algorithm were all significantly greater than those before processing (P < 0.05). The Ktrans, Kep, Ve, Vp, and MVD of patients in the experimental group were significantly larger than those of the control group, and severe group> moderate group> mild group (P < 0.05). HPI, MTT, TTP, BV, and HAP of patients in the experimental group were also significantly greater than those of the control group, which was shown as severe group > moderate group > mild group (P < 0.05). FP and PVP of the experimental group were significantly lower than those of the control group, and severe group < moderate group < mild group (P < 0.05). It was suggested that in MRI images of patients with PHC, the bias field correction algorithm could significantly improve the diagnosis rate. Each perfusion parameter was related to the pathological grading, which could be used to evaluate the prognosis of patients.
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Abstract
Selective internal radiation therapy represents an endovascular treatment option for patients with primary liver malignancies, in different clinical stages. Potential applications of this treatment are in early-stage hepatocellular carcinoma, as a curative option, or in combination with systemic treatments in intermediate and advanced-stages. This review, based on existing literature and ongoing trials, will focus on the future of this treatment in patients with hepatocellular carcinoma, in combination with systemic treatments, or with the use of new devices and technological developments; it will also describe new potential future indications and structural and organizational perspectives.
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Hassan SA, Ali AAH, Sohn D, Flögel U, Jänicke RU, Korf H, von Gall C. Does timing matter in radiotherapy of hepatocellular carcinoma? An experimental study in mice. Cancer Med 2021; 10:7712-7725. [PMID: 34545699 PMCID: PMC8559477 DOI: 10.1002/cam4.4277] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 01/10/2023] Open
Abstract
This study investigates whether a chronotherapeutic treatment of hepatocellular carcinoma (HCC) may improve treatment efficacy and mitigate side effects on non-tumoral liver (NTL). HCC was induced in Per2::luc mice which were irradiated at four time points of the day. Proliferation and DNA-double strand breaks were analyzed in irradiated and nonirradiated animals by detection of Ki67 and γ-H2AX. Prior to whole animal experiments, organotypic slice cultures were investigated to determine the dosage to be used in whole animal experiments. Irradiation was most effective at the proliferation peaks in HCC at ZT02 (early inactivity phase) and ZT20 (late activity phase). Irradiation effects on NTL were minimal at ZT20. As compared with NTL, nonirradiated HCC revealed disruption in daily variation and downregulation of all investigated clock genes except Per1. Irradiation affected rhythmic clock gene expression in NTL and HCC at all ZTs except at ZT20 (late activity phase). Irradiation at ZT20 had no effect on total leukocyte numbers. Our results indicate ZT20 as the optimal time point for irradiation of HCC in mice at which the ratio between efficacy of tumor treatment and toxic side effects was maximal. Translational studies are now needed to evaluate whether the late activity phase is the optimal time point for irradiation of HCC in man.
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Affiliation(s)
- Soha A. Hassan
- Institute of Anatomy II, Medical FacultyHeinrich‐Heine‐UniversityDüsseldorfGermany
- Zoology DepartmentFaculty of ScienceSuez UniversitySuezEgypt
| | - Amira A. H. Ali
- Institute of Anatomy II, Medical FacultyHeinrich‐Heine‐UniversityDüsseldorfGermany
- Department of Anatomy and EmbryologyFaculty of MedicineMansoura UniversityMansouraEgypt
| | - Dennis Sohn
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and RadiooncologyMedical Faculty of Heinrich‐Heine‐UniversityDüsseldorfGermany
| | - Ulrich Flögel
- Department of Molecular CardiologyHeinrich‐Heine‐UniversityDüsseldorfGermany
| | - Reiner U. Jänicke
- Laboratory of Molecular Radiooncology, Clinic and Policlinic for Radiation Therapy and RadiooncologyMedical Faculty of Heinrich‐Heine‐UniversityDüsseldorfGermany
| | - Horst‐Werner Korf
- Institute of Anatomy IMedical FacultyHeinrich‐Heine‐UniversityDüsseldorfGermany
| | - Charlotte von Gall
- Institute of Anatomy II, Medical FacultyHeinrich‐Heine‐UniversityDüsseldorfGermany
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Zhu Y, Xu J, Hu W, Wang F, Zhou Y, Gong W, Xu W. Inhibiting USP8 overcomes hepatocellular carcinoma resistance via suppressing receptor tyrosine kinases. Aging (Albany NY) 2021; 13:14999-15012. [PMID: 34081623 PMCID: PMC8221339 DOI: 10.18632/aging.203061] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 04/29/2021] [Indexed: 01/05/2023]
Abstract
The ubiquitin-specific protease 8 (USP8) is a prototypic multidomain deubiquitinating enzyme with pleiotropic functions. We investigated the role of USP8 in hepatocellular carcinoma (HCC) by analyzing expression patterns of USP8 in HCC patients, and evaluating its functions and underlying signaling. Among 20 HCC patients investigated, we found that USP8 protein upregulation was a common phenomenon (17 out of 20) in HCC compared to normal liver tissue. Furthermore, the upregulation of USP8 was not associated with any clinicopathology. USP8 inhibition via genetic and pharmacological approaches resulted in growth inhibition and apoptosis induction in both sensitive and doxorubicin-resistant HCC cells. Of note, USP8 inhibition significantly enhanced doxorubicin or sorafenib's efficacy in HCC cells and mouse models. We further found that USP8 inhibition decreased levels of multiple receptor tyrosine kinases (RTKs) by ~90%, such as epidermal growth factor receptor (EGFR) and c-Met. Consistently, the downstream signaling regulated by RTKs was disrupted in HCC cells after USP8 inhibition, as shown by the decreased p-Akt, p-STAT3 and p-Raf. Our findings demonstrate that USP8 is a novel therapeutic target in HCC. Inhibiting USP8 has potential to overcome current drug resistance, particularly on HCC patients with high USP8 expression.
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Affiliation(s)
- Ying Zhu
- Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Jianguo Xu
- Department of Liver Disease Center, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Wei Hu
- Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Fang Wang
- Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Yan Zhou
- Information Management Section, Bethune International Peace Hospital, Shijiazhuang, Hebei Province, China
| | - Wei Gong
- Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
| | - Wen Xu
- Department of Gastroenterology, Shenzhen Hospital of Southern Medical University, Shenzhen, Guangdong, China
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Factors affecting the response to treatment and survival in hepatocellular carcinoma patients treated with transarterial radioembolisation: a single-centre experience. Eur J Gastroenterol Hepatol 2021; 33:926-931. [PMID: 33731592 DOI: 10.1097/meg.0000000000002117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVE Transarterial radioembolisation (TARE) is a promising technique for unresectable primary tumours of the liver. We present our clinical experience and the response to treatment and survival data of patients with hepatocellular carcinoma (HCC) who were treated with Y-90 radioembolisation in our hospital's angiography department. MATERIAL AND METHODS The data of all the patients with HCC referred to our department for Y-90 treatment were analysed retrospectively. The patients were selected according to the treatment protocol criteria, and lung shunt fraction was evaluated using macroaggregated albumin scintigraphy before radioembolisation. Patients with compatible blood tests and lung shunt fraction rates were chosen for treatment with Y-90 TARE. RESULTS Twenty-four patients were suitable for Y-90 treatment. The patients were treated with 137 ± 44.6 (80-245) Gy Y-90 glass microspheres. The treatment results were evaluated using modified RECIST criteria, and the partial response, complete response, stable disease and progression rates were found to be 54.2, 16.7, 20.8 and 8.3%, respectively. The median survival rate following treatment was 10 months. Higher alpha-fetoprotein (AFP) levels were related to decreased survival, and posttreatment AFP levels had a significant effect on mortality rates. Higher survival rates were detected in the patients who were treated more selectively than the group treated via a lobar approach. CONCLUSION Y-90 microsphere radioembolisation is a safe method and may be helpful in treating patients with unresectable hepatocellular tumours. More favourable results were obtained in the patients treated using the more selective approach. AFP levels before and after treatment could predict survival rates.
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