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Renzulli M, Peta G, Vasuri F, Marasco G, Caretti D, Bartalena L, Spinelli D, Giampalma E, D'Errico A, Golfieri R. Standardization of conventional chemoembolization for hepatocellular carcinoma. Ann Hepatol 2021; 22:100278. [PMID: 33129978 DOI: 10.1016/j.aohep.2020.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 10/19/2020] [Indexed: 02/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES Conventional transarterial chemoembolization (cTACE) has several limitations due to the lack of standardization. The aim of this study was to evaluate the chemical and physical characteristics and behaviors over time of emulsions for cTACE and to assess intra- and inter-operator variabilities in the preparation processes. MATERIALS AND METHODS This in vitro study involved evaluation of emulsions for cTACE prepared using two methods: water-in-oil (WiO) and chemotherapeutic-in-oil (CiO). Three emulsions were prepared with each method and obtained after 20, 50, and 100 pumping exchanges. A drop from each final mixture was analyzed via light microscopy (time 1) and after 5, 10, 15, and 20min since the end of preparation. After 20min, all preparations were re-mixed and new drops were re-evaluated. The intra- and inter-operator variabilities were analyzed. RESULTS The mean droplet diameter decreased non-significantly when the number of pumping exchanges increased and increased significantly over time for both WiO and CiO. The droplets returned to their initial diameters after re-mixing. There were no significant differences in the intra- and inter-operator variabilities (P>0.01). CONCLUSIONS Any interventional radiologist, regardless of their experience, may prepare these emulsions. These data may represent a set of instructions to standardize cTACE.
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Affiliation(s)
- Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy.
| | - Giuliano Peta
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Francesco Vasuri
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Giovanni Marasco
- Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Daniele Caretti
- "Toso Montanari" Industrial Chemistry Department, University of Bologna, Bologna, Italy
| | - Laura Bartalena
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Daniele Spinelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | | | - Antonietta D'Errico
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, Bologna, Italy
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Nakasumi K, Yamamoto N, Takami T, Itoh H, Itamoto K, Horikirizono H, Iseri T, Nakaichi M, Nemoto Y, Sunahara H, Tani K. Effect of drug-eluting bead transarterial chemoembolization loaded with cisplatin on normal dogs. J Vet Med Sci 2021; 84:114-120. [PMID: 34866073 PMCID: PMC8810336 DOI: 10.1292/jvms.21-0396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Transcatheter arterial embolization (TAE) and transcatheter arterial chemoembolization (TACE) are standard treatments for advanced hepatocellular carcinoma (HCC) and particularly for unresectable tumors or liver metastases in humans. However, reports on TACE used in veterinary medicine are few. This study aimed to evaluate the feasibility and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE). We performed DEB-TACE in four clinically normal dogs and pharmacokinetically compared the results against hepatic arterial infusion (HAI) of cisplatin in two dogs. Drug-eluting beads (DEB) loaded with cisplatin were injected through a microcatheter for selective embolization of the left hepatic artery. After embolization, computed tomography (CT) images and histological examination findings were obtained during a 4-week observation period. Serum platinum concentrations were measured to evaluate cisplatin after each procedure. Biochemical analysis was performed during a 12-week observation period. Embolization was successful in all dogs, and there were no clinically apparent abnormalities. Embolization was confirmed up to 4 weeks after DEB-TACE in two of the four dogs and up to 1 week in the other two dogs using postoperative CT images. Cisplatin was not detected in peripheral veins in all dogs after DEB-TACE, but it was detected in trace amounts after HAI. DEB-TACE using cisplatin was safe and well tolerated by normal dogs. DEB-TACE may be useful in terms of determining systemic toxicity and drug concentration within tumors.
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Affiliation(s)
- Ko Nakasumi
- Departments of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Naoki Yamamoto
- Department of Gastroenterology & Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi University
| | - Taro Takami
- Department of Gastroenterology & Hepatology, Yamaguchi University Graduate School of Medicine, Yamaguchi University
| | - Harumichi Itoh
- Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Kazuhito Itamoto
- Small Animal Clinical Science, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Hiro Horikirizono
- Department of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Toshie Iseri
- Department of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Munekazu Nakaichi
- Department of Veterinary Radiology, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Yuki Nemoto
- Departments of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Hiroshi Sunahara
- Departments of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Kenji Tani
- Departments of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University
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3
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Granito A, Facciorusso A, Sacco R, Bartalena L, Mosconi C, Cea UV, Cappelli A, Antonino M, Modestino F, Brandi N, Tovoli F, Piscaglia F, Golfieri R, Renzulli M. TRANS-TACE: Prognostic Role of the Transient Hypertransaminasemia after Conventional Chemoembolization for Hepatocellular Carcinoma. J Pers Med 2021; 11:jpm11101041. [PMID: 34683182 PMCID: PMC8539564 DOI: 10.3390/jpm11101041] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of the present study was to correlate laboratory data and postprocedural parameters after conventional transarterial chemoembolization (cTACE) for hepatocellular carcinoma (HCC) with the radiological response. The study consisted of a retrospective analysis of prospectively collected data from 70 consecutive patients who underwent cTACE. Laboratory parameters were assessed daily after cTACE and compared to pretreatment values. Post-treatment radiological response was assessed using mRECIST at one month from cTACE, and factors associated with treatment response (complete and objective response) were assessed by logistic regression analysis. The optimal cutoff points in predicting the complete response of target lesions were a 52% ALT and a 46% AST increase after cTACE compared to the pre-treatment values. Using multivariate analyses, >46% AST and >52% ALT increases with respect to the pre-treatment value were significantly correlated with the objective response (p = 0.03 and p = 0.04, respectively) and the complete response (p = 0.02 and p = 0.02, respectively). No patients experienced liver function deterioration after cTACE, and no specific treatment was required. This study showed that post-treatment transient transaminase elevation was predictive of objective response to superselective cTACE in clinical practice, representing a simple tool to guide treatment strategy of HCC patients in a tailored approach.
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Affiliation(s)
- Alessandro Granito
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40137 Bologna, Italy; (A.G.); (F.T.); (F.P.)
| | - Antonio Facciorusso
- Gastroenterology and Digestive Endoscopy, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (A.F.); (R.S.); (U.V.C.); (M.A.)
| | - Rodolfo Sacco
- Gastroenterology and Digestive Endoscopy, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (A.F.); (R.S.); (U.V.C.); (M.A.)
| | - Laura Bartalena
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Cristina Mosconi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Ugo Vittorio Cea
- Gastroenterology and Digestive Endoscopy, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (A.F.); (R.S.); (U.V.C.); (M.A.)
| | - Alberta Cappelli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Matteo Antonino
- Gastroenterology and Digestive Endoscopy, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy; (A.F.); (R.S.); (U.V.C.); (M.A.)
| | - Francesco Modestino
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Nicolò Brandi
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Francesco Tovoli
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40137 Bologna, Italy; (A.G.); (F.T.); (F.P.)
| | - Fabio Piscaglia
- Division of Internal Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40137 Bologna, Italy; (A.G.); (F.T.); (F.P.)
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
| | - Matteo Renzulli
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40137 Bologna, Italy; (L.B.); (C.M.); (A.C.); (F.M.); (N.B.); (R.G.)
- Correspondence:
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4
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Oishi Y, Tani K, Taura Y. Transcatheter arterial embolisation in four dogs with hepatocellular carcinoma. J Small Anim Pract 2018; 60:761-766. [PMID: 30298574 DOI: 10.1111/jsap.12944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 01/07/2018] [Accepted: 06/26/2018] [Indexed: 01/02/2023]
Abstract
Four dogs with hepatocellular carcinoma were treated by transcatheter arterial embolisation. In all dogs, the tumour-supplying arteries were selectively embolised with gelatine sponge particles. Post-embolisation tumour volumes decreased relative to pre-embolisation volumes in all dogs. No adverse reactions were observed in three dogs after treatment but one dog showed pancreatitis. These results suggest that transcatheter arterial embolisation is a feasible treatment for dogs with hepatocellular carcinoma.
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Affiliation(s)
- Y Oishi
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, 753-8511, Japan
| | - K Tani
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, 753-8511, Japan
| | - Y Taura
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine, Yamaguchi University, Yamaguchi, 753-8511, Japan
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5
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Díaz-González Á, Forner A, Rodríguez de Lope C, Varela M. New challenges in clinical research on hepatocellular carcinoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2017; 108:485-93. [PMID: 26653993 DOI: 10.17235/reed.2015.4012/2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This is an updated review of screening, early diagnosis and treatment of hepatocellular carcinoma, focusing on the advancements occurred in the last years and highlighting the challenges in clinical research. Hepatocellular carcinoma (HCC) is nowadays the sixth most frequent cancer worldwide with up to 740,000 new cases diagnosed each year, and it is the third most prevalent cause of cancer-related-death worldwide (1). This neoplasm usually appears linked to an underlying liver disease, being one of the most relevant causes of death in patients diagnosed of liver cirrhosis (2,3). In the last years, important advancements in terms of diagnosis, staging and treatment of HCC, improving the management and outcome of the disease, have been made (4-7). Despite the fact that these improvements have absolutely changed natural history of HCC, there are several areas that still need further advancements. The aim of this document is to discuss some controversial aspects, which in our opinion constitute real challenges in clinical research of HCC.
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Affiliation(s)
- Álvaro Díaz-González
- Servicio de Hepatología. Hospital Clínic Barcelona, Unidad de Oncología Hepática (BCLC)
| | - Alejandro Forner
- Hospital Clínic Barcelona. Ciberehd, Unidad de Oncología Hepática (BCLC)
| | | | - María Varela
- Digestivo. Sección de Hepatología, Hospital Universitario Central de Asturias, España
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6
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Oishi Y, Tani K, Ozono K, Itamoto K, Haraguchi T, Taura Y. Transcatheter arterial embolization in normal canine liver. Vet Surg 2017; 46:797-802. [DOI: 10.1111/vsu.12663] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/20/2016] [Accepted: 12/16/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Yasuhisa Oishi
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Kenji Tani
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Koushiro Ozono
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Kazuhito Itamoto
- Animal Medical Center, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Tomoya Haraguchi
- Animal Medical Center, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
| | - Yasuho Taura
- Department of Veterinary Surgery, Joint Faculty of Veterinary Medicine; Yamaguchi University; Yamaguchi Japan
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7
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Si ZM, Wang GZ, Qian S, Qu XD, Yan ZP, Liu R, Wang JH. Combination Therapies in the Management of Large (≥ 5 cm) Hepatocellular Carcinoma: Microwave Ablation Immediately Followed by Transarterial Chemoembolization. J Vasc Interv Radiol 2016; 27:1577-83. [PMID: 27103146 DOI: 10.1016/j.jvir.2016.02.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 02/10/2016] [Accepted: 02/12/2016] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To evaluate the safety and efficacy of microwave (MW) ablation combined with transarterial chemoembolization in a single stage for the treatment of large (≥ 5 cm) hepatocellular carcinoma (HCC). MATERIALS AND METHODS From March 2013 to January 2015, 66 patients (54 men and 12 women; mean age, 54 y; range, 29-83 y) with 72 large HCC lesions were included in this study. Eighteen (27.3%) had Barcelona Clinic Liver Cancer class B disease, and 48 (72.7%) had class C disease. Seventy-nine percent of patients (n = 52) had hepatitis B virus infection. The average tumor size was 9.0 cm ± 3.9, ranging from 5 to 19 cm. MW ablation was performed under ultrasound guidance, immediately followed by chemoembolization. Local tumor response, progression-free survival (PFS), and overall survival (OS) were assessed. RESULTS The technique was successfully performed in all patients. Complete response (CR) was achieved in 28 cases (42.4%), and partial response (PR) was achieved in 34 cases (51.5%) at 1 month after the procedure. The objective response rate (ie, CR plus PR) was 93.9%. Median PFS and OS times were 9 months and 21 months, respectively. The 6-, 12-, and 18-month OS rates were 93.9%, 85.3%, and 66.6%, respectively. Hemorrhage was detected in three patients and arteriovenous fistula in two patients after MW ablation; all were promptly treated with embolization. There were no liver abscesses, bile-duct injuries, or other major procedure-related complications. CONCLUSIONS MW ablation immediately followed by chemoembolization is safe and effective in the treatment of large HCC lesions.
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MESH Headings
- Ablation Techniques/adverse effects
- Ablation Techniques/mortality
- Adult
- Aged
- Aged, 80 and over
- Angiography
- Carcinoma, Hepatocellular/diagnostic imaging
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/therapy
- Chemoembolization, Therapeutic/adverse effects
- Chemoembolization, Therapeutic/methods
- Chemoembolization, Therapeutic/mortality
- Chemotherapy, Adjuvant
- China
- Disease-Free Survival
- Female
- Humans
- Kaplan-Meier Estimate
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/mortality
- Liver Neoplasms/pathology
- Liver Neoplasms/therapy
- Male
- Microwaves/adverse effects
- Microwaves/therapeutic use
- Middle Aged
- Retrospective Studies
- Risk Factors
- Time Factors
- Tomography, X-Ray Computed
- Treatment Outcome
- Tumor Burden
- Ultrasonography, Interventional
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Affiliation(s)
- Zeng-Mei Si
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guang-Zhi Wang
- Department of Intervention Radiology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Sheng Qian
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xu-Dong Qu
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Zhi-Ping Yan
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rong Liu
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian-Hua Wang
- Shanghai Institute of Medical Imaging and Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
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8
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Forner A, Reig M, Varela M, Burrel M, Feliu J, Briceño J, Sastre J, Martí-Bonmati L, Llovet JM, Bilbao JI, Sangro B, Pardo F, Ayuso C, Bru C, Tabernero J, Bruix J. [Diagnosis and treatment of hepatocellular carcinoma. Update consensus document from the AEEH, SEOM, SERAM, SERVEI and SETH]. Med Clin (Barc) 2016; 146:511.e1-511.e22. [PMID: 26971984 DOI: 10.1016/j.medcli.2016.01.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 01/22/2016] [Accepted: 01/28/2016] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma is the most common primary malignancy of the liver and one of the most frequent causes of death in patients with liver cirrhosis. Simultaneously with the recognition of the clinical relevance of this neoplasm, in recent years there have been important developments in the diagnosis, staging and treatment of HCC. Consequently, the Asociación Española para el Estudio del Hígado has driven the need to update clinical practice guidelines, continuing to invite all the societies involved in the diagnosis and treatment of this disease to participate in the drafting and approval of the document (Sociedad Española de Trasplante Hepático, Sociedad Española de Radiología Médica, Sociedad Española de Radiología Vascular e Intervencionista y Sociedad Española de Oncología Médica). The clinical practice guidelines published in 2009 accepted as Clinical Practice Guidelines of the National Health System has been taken as reference document, incorporating the most important advances that have been made in recent years. The scientific evidence for the treatment of HCC has been evaluated according to the recommendations of the National Cancer Institute (www.cancer.gov) and the strength of recommendation is based on the GRADE system.
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Affiliation(s)
- Alejandro Forner
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España
| | - María Reig
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España
| | - María Varela
- Sección de Hepatología, Servicio de Aparato Digestivo, Hospital Universitario Central de Asturias (HUCA), Universidad de Oviedo, Oviedo, España
| | - Marta Burrel
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Jaime Feliu
- Servicio de Oncología Médica, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Sociedad Española de Oncología Médica, Madrid, España
| | - Javier Briceño
- Unidad de Trasplante Hepático, Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Reina Sofía, Córdoba, España
| | - Javier Sastre
- Servicio de Oncología Médica, Hospital Clínico San Carlos, Madrid, España
| | - Luis Martí-Bonmati
- Departamento de Radiología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Josep María Llovet
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España; Mount Sinai Liver Cancer Program, Division of Liver Diseases, Department of Medicine, Mount Sinai School of Medicine, New York, Estados Unidos
| | - José Ignacio Bilbao
- Unidad de Radiología Vascular e Intervencionista, Departamento de Radiodiagnóstico, Clínica Universidad de Navarra, Pamplona, España
| | - Bruno Sangro
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España; Unidad de Hepatología, Departamento de Medicina Interna, Clínica Universidad de Navarra, Pamplona, España
| | - Fernando Pardo
- Servicio de Cirugía Hepatobliopancreática y Trasplante, Clínica Universidad de Navarra, Pamplona, España
| | - Carmen Ayuso
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Concepció Bru
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Radiodiagnóstico, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España
| | - Josep Tabernero
- Servicio de Oncología Médica, Hospital Universitario Vall d'Hebrón, Barcelona, Universidad Autónoma de Barcelona, Barcelona, España
| | - Jordi Bruix
- Unidad de Oncología Hepática (Barcelona Clinic Liver Cancer), Servicio de Hepatología, Hospital Clínic, Barcelona, IDIBAPS, Universidad de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), España.
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9
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Wang J, Shao M, Liu M, Peng P, Li L, Wu W, Wang L, Duan F, Zhang M, Song S, Jia D, Ruan Y, Gu J. PKCα promotes generation of reactive oxygen species via DUOX2 in hepatocellular carcinoma. Biochem Biophys Res Commun 2015; 463:839-45. [PMID: 26056003 DOI: 10.1016/j.bbrc.2015.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 06/03/2015] [Indexed: 10/23/2022]
Abstract
Hepatocellular carcinoma (HCC) remains the second leading cause of cancer-related death worldwide, and elevated rates of reactive oxygen species (ROS) have long been considered as a hallmark of almost all types of cancer including HCC. Protein kinase C alpha (PKCα), a serine/threonine kinase among conventional PKC family, is recognized as a major player in signal transduction and tumor progression. Overexpression of PKCα is commonly observed in human HCC and associated with its poor prognosis. However, how PKCα is involved in hepatocellular carcinogenesis remains not fully understood. In this study, we found that among the members of conventional PKC family, PKCα, but not PKCβI or βII, promoted ROS production in HCC cells. PKCα stimulated generation of ROS by up-regulating DUOX2 at post-transcriptional level. Depletion of DUOX2 abrogated PKCα-induced activation of AKT/MAPK pathways as well as cell proliferation, migration and invasion in HCC cells. Moreover, the expression of DUOX2 and PKCα was well positively correlated in both HCC cell lines and patient samples. Collectively, our findings demonstrate that PKCα plays a critical role in HCC development by inducing DUOX2 expression and ROS generation, and propose a strategy to target PKCα/DUOX2 as a potential adjuvant therapy for HCC treatment.
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Affiliation(s)
- Jiajun Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Miaomiao Shao
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Min Liu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Peike Peng
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Lili Li
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Weicheng Wu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Lan Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Fangfang Duan
- Institute of Biomedical Science, Fudan University, Shanghai, PR China
| | - Mingming Zhang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Shushu Song
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China
| | - Dongwei Jia
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China.
| | - Yuanyuan Ruan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China.
| | - Jianxin Gu
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University, 200032 Shanghai, PR China; Institute of Biomedical Science, Fudan University, Shanghai, PR China
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Ruan Y, Sun L, Hao Y, Wang L, Xu J, Zhang W, Xie J, Guo L, Zhou L, Yun X, Zhu H, Shen A, Gu J. Ribosomal RACK1 promotes chemoresistance and growth in human hepatocellular carcinoma. J Clin Invest 2012; 122:2554-66. [PMID: 22653060 DOI: 10.1172/jci58488] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 04/24/2012] [Indexed: 01/14/2023] Open
Abstract
Coordinated translation initiation is coupled with cell cycle progression and cell growth, whereas excessive ribosome biogenesis and translation initiation often lead to tumor transformation and survival. Hepatocellular carcinoma (HCC) is among the most common and aggressive cancers worldwide and generally displays inherently high resistance to chemotherapeutic drugs. We found that RACK1, the receptor for activated C-kinase 1, was highly expressed in normal liver and frequently upregulated in HCC. Aberrant expression of RACK1 contributed to in vitro chemoresistance as well as in vivo tumor growth of HCC. These effects depended on ribosome localization of RACK1. Ribosomal RACK1 coupled with PKCβII to promote the phosphorylation of eukaryotic initiation factor 4E (eIF4E), which led to preferential translation of the potent factors involved in growth and survival. Inhibition of PKCβII or depletion of eIF4E abolished RACK1-mediated chemotherapy resistance of HCC in vitro. Our results imply that RACK1 may function as an internal factor involved in the growth and survival of HCC and suggest that targeting RACK1 may be an efficacious strategy for HCC treatment.
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Affiliation(s)
- Yuanyuan Ruan
- Key Laboratory of Glycoconjugate Research, Ministry of Public Health, Shanghai Medical College of Fudan University, Shanghai, People’s Republic of China
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11
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Pitton MB, Kloeckner R, Herber S, Otto G, Kreitner KF, Dueber C. MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma. World J Gastroenterol 2009; 15:6044-51. [PMID: 20027676 PMCID: PMC2797660 DOI: 10.3748/wjg.15.6044] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the diagnostic capability of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC) tumour nodules and their effect on patient management.
METHODS: A total of 28 patients (25 male, 3 female, mean age 67 ± 10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT (slice 3 mm native, arterial and portal-venous phase, 120 mL Iomeprol, 4 mL/s, delay by bolus trigger) and MRI (T1fs fl2d TE/TR 2.72/129 ms, T2tse TE/TR 102/4000 ms, 5-phase dynamic contrast-enhanced T1fs fl3d TE/TR 1.56/4.6, Gadolinium-DTPA, slice 4 mm). Consensus reading of both modalities was used as reference. Tumour nodules were analyzed with respect to number, size, and location.
RESULTS: In total, 162 tumour nodules were detected by consensus reading. MRI detected significantly more tumour nodules (159 vs 123, P < 0.001) compared to MDCT, with the best sensitivity for early arterial phase MRI. False-negative CT findings included nodules ≤ 5 mm ( n = 5), ≤ 10 mm ( n = 17), ≤ 15 mm ( n = 12 ), ≤ 20 mm ( n = 4 ), and 1 nodule > 20 mm. MRI missed 2 nodules ≤ 10 mm and 1 nodule ≤ 15 mm. On MRI, nodule diameters were greater than on CT (29.2 ± 25.1 mm, range 5-140 mm vs 24.1 ± 22.7 mm, range 4-129 mm, P < 0.005). In 2 patients, MDCT showed only unilobar tumour spread, whereas MRI revealed additional nodules in the contralateral lobe. Detection of these nodules could have changed the therapeutic strategy.
CONCLUSION: Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules. Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.
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Finn RS, Zhu AX. Targeting angiogenesis in hepatocellular carcinoma: focus on VEGF and bevacizumab. Expert Rev Anticancer Ther 2009; 9:503-9. [PMID: 19374603 DOI: 10.1586/era.09.6] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and one of the few malignancies with an increasing incidence in the USA. While the relationship between HCC and its inciting risk factors (e.g., hepatitis B, hepatitis C and alcohol liver disease) is well defined, driving genetic alterations are still yet to be identified. Clinically, HCC tends to be hypervascular and, for that reason, transarterial chemoembolization has proven to be effective in managing many patients with localized disease. More recently, angiogenesis has been targeted effectively with pharmacologic strategies, including monoclonal antibodies against VEGF and the VEGF receptor, as well as small-molecule kinase inhibitors of the VEGF receptor. Targeting angiogenesis with these approaches has been validated in several different solid tumors since the initial approval of bevacizumab for advanced colon cancer in 2004. In HCC, only sorafenib has been shown to extend survival in patients with advanced HCC and has opened the door for other anti-angiogenic strategies. Here, we will review the data supporting the targeting of the VEGF axis in HCC and the preclinical and early clinical development of bevacizumab.
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Affiliation(s)
- Richard S Finn
- Department of Medicine, Division of Hematology/Oncology, Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 11-934 Factor building, Los Angeles, CA 90095, USA.
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13
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Kudo M. Review of 4th Single Topic Conference on HCC. Hepatocellular carcinoma: International consensus and controversies. Hepatol Res 2007; 37 Suppl 2:S83-7. [PMID: 17877501 DOI: 10.1111/j.1872-034x.2007.00167.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Masatoshi Kudo
- Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan
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