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Huang Q, Lin K, Lin Z, Ji H, Zhou X, Wang B, Chen Y, Sun C, Zheng S, Chen J, Wang Y, Zhou Y, Zhou W, Zeng Y. Prognosis value of microscopic bile duct invasion in hepatocellular carcinoma: A multicenter study. Cancer Med 2023; 12:20821-20829. [PMID: 37909228 PMCID: PMC10709741 DOI: 10.1002/cam4.6650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 09/28/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE To evaluate the prognostic significance of microscopic bile duct invasion (MiBDI) in hepatocellular carcinoma (HCC) following R0 resection. PATIENTS AND METHODS Patients who underwent R0 resection for HCC at nine medical centers were stratified into five groups: neither bile duct nor vascular invasion (MiBDI-MVI-), microscopic bile duct invasion alone (MiBDI+MVI-), both microscopic bile duct and vascular invasion (MiBDI+MVI+), microscopic vascular invasion alone (MiBDI-MVI+), and macroscopic bile duct invasion (MaBDI). Overall survival (OS) was assessed using Kaplan-Meier analysis, and independent risk factors of OS were determined using Cox proportional hazards models. RESULTS A total of 377 HCC cases were analyzed. The OS for MiBDI+MVI- was similar to that of MiBDI-MVI- (p > 0.05) but better than MiBDI+MVI+, MiBDI-MVI+, and MaBDI (all p < 0.05). Multivariate analysis indicated that MiBDI was not an independent risk factor for OS, while MVI and MaBDI were. CONCLUSIONS Overall survival (OS) in patients with MiBDI was superior to those with MVI and MaBDI. Isolated MiBDI did not influence OS in patients with HCC after R0 resection.
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Affiliation(s)
- Qizhen Huang
- Department of Radiation OncologyMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Kongying Lin
- Department of Hepatopancreatobiliary SurgeryMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Zhipeng Lin
- Department of Hepatopancreatobiliary SurgeryMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Hongbin Ji
- Department of Radiation OncologyMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Xiaoyu Zhou
- The School of Basic Medical SciencesFujian Medical UniversityFuzhouChina
| | - Bin Wang
- The School of Basic Medical SciencesFujian Medical UniversityFuzhouChina
- Department of PathologyMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
| | - Yufeng Chen
- Department of Hepatopancreatobiliary SurgeryZhangzhou Affiliated Hospital of Fujian Medical UniversityZhangzhouChina
| | - Chuandong Sun
- Department of Hepatobiliary and Pancreatic SurgeryAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Shuguo Zheng
- Institute of Hepatobiliary Surgery, Southwest HospitalThird Military Medical UniversityChongqingChina
| | - Jinhong Chen
- Department of General SurgeryHuashan Hospital, Fudan UniversityShanghaiChina
| | - Yifan Wang
- Department of General Surgery, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
| | - Yanming Zhou
- Department of Hepato‐Biliary‐Pancreato‐Vascular SurgeryFirst Affiliated Hospital of Xiamen UniversityXiamenChina
| | - Weiping Zhou
- The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghaiChina
| | - Yongyi Zeng
- Department of Hepatopancreatobiliary SurgeryMengchao Hepatobiliary Hospital of Fujian Medical UniversityFuzhouChina
- Department of Hepatopancreatobiliary SurgeryFirst Affiliated Hospital of Fujian Medical UniversityFuzhouChina
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Kim JH, Kim JH, Yoon HK, Ko GY, Shin JH, Gwon DI, Ko HK, Chu HH, Kim SH, Kim GH, Kim Y, Aljerdah S. Transarterial chemoembolization for advanced hepatocellular carcinoma without macrovascular invasion or extrahepatic metastasis: analysis of factors prognostic of clinical outcomes. Front Oncol 2023; 13:1072922. [PMID: 37346065 PMCID: PMC10281503 DOI: 10.3389/fonc.2023.1072922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Objectives To evaluate the safety and efficacy of TACE and factors predicting survival in patients with advanced hepatocellular carcinoma (HCC) without macrovascular invasion (MVI) or extrahepatic spread (EHS). Methods This single-center retrospective study included 236 treatment-naïve patients who underwent TACE as first-line treatment for advanced HCC without MVI or EHS between January 2007 and December 2021. Results Following TACE, the median overall survival (OS) was 24 months. Multivariate Cox regression analyses revealed that tumor number ≥4 (risk point: 3), maximal tumor size >10 cm (risk point: 2), Child-Pugh class B (risk point: 2), alpha-fetoprotein (AFP) concentration ≥400 ng/mL (risk point: 2), and presence of HCC rupture (risk point: 2) were risk factors significantly associated with OS. The expected median OS among patients with <2, 2-4, and 5-9 risk points were 72, 29, and 12 months respectively. The major complication rates were significantly lower in patients with maximal tumor size ≤10 cm than in those with maximal tumor size >10 cm (4% [5/138] vs 21% [21/98], p = 0.001). Conclusion TACE may be safe and effective in selected patients with advanced HCC without MVI or EHS, with a median OS of 24 months. Patients with limited tumor burden, compensated liver function, absence of HCC rupture, and favorable biologic markers may benefit the most from TACE. TACE is not recommended for patients with huge HCCs (>10 cm) because of its high rate of major complications (21%).
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Affiliation(s)
- Ji Hoon Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
- Ajou University Hospital, College of Medicine, Ajou University, Najran, Saudi Arabia
| | - Jin Hyoung Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Hyun-Ki Yoon
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Gi-Young Ko
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Ji Hoon Shin
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Dong Il Gwon
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Heung-Kyu Ko
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Hee Ho Chu
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Seong Ho Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Gun Ha Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Yonghun Kim
- Asan Medical Center, College of Medicine, University of Ulsan, Songpa-Gu, Republic of Korea
| | - Shakir Aljerdah
- College of Medicine, Najran University, Najran, Saudi Arabia
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Conticchio M, Maggialetti N, Rescigno M, Brunese MC, Vaschetti R, Inchingolo R, Calbi R, Ferraro V, Tedeschi M, Fantozzi MR, Avella P, Calabrese A, Memeo R, Scardapane A. Hepatocellular Carcinoma with Bile Duct Tumor Thrombus: A Case Report and Literature Review of 890 Patients Affected by Uncommon Primary Liver Tumor Presentation. J Clin Med 2023; 12:jcm12020423. [PMID: 36675352 PMCID: PMC9861411 DOI: 10.3390/jcm12020423] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/13/2022] [Accepted: 12/29/2022] [Indexed: 01/06/2023] Open
Abstract
Bile duct tumor thrombus (BDTT) is an uncommon finding in hepatocellular carcinoma (HCC), potentially mimicking cholangiocarcinoma (CCA). Recent studies have suggested that HCC with BDTT could represent a prognostic factor. We report the case of a 47-year-old male patient admitted to the University Hospital of Bari with abdominal pain. Blood tests revealed the presence of an untreated hepatitis B virus infection (HBV), with normal liver function and without jaundice. Abdominal ultrasonography revealed a cirrhotic liver with a segmental dilatation of the third bile duct segment, confirmed by a CT scan and liver MRI, which also identified a heterologous mass. No other focal hepatic lesions were identified. A percutaneous ultrasound-guided needle biopsy was then performed, detecting a moderately differentiated HCC. Finally, the patient underwent a third hepatic segmentectomy, and the histopathological analysis confirmed the endobiliary localization of HCC. Subsequently, the patient experienced a nodular recurrence in the fourth hepatic segment, which was treated with ultrasound-guided percutaneous radiofrequency ablation (RFA). This case shows that HCC with BDTT can mimic different types of tumors. It also indicates the value of an early multidisciplinary patient assessment to obtain an accurate diagnosis of HCC with BDTT, which may have prognostic value that has not been recognized until now.
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Affiliation(s)
- Maria Conticchio
- Unit of Hepatobiliary Surgery, Miulli Hospital, 70124 Acquaviva Delle Fonti, Italy
| | - Nicola Maggialetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Marco Rescigno
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Maria Chiara Brunese
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
- Correspondence:
| | - Roberto Vaschetti
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Roberto Calbi
- Radiology Unit, Miulli Hospital, 70124 Acquaviva Delle Fonti, Italy
| | - Valentina Ferraro
- Unit of Hepatobiliary Surgery, Miulli Hospital, 70124 Acquaviva Delle Fonti, Italy
| | - Michele Tedeschi
- Unit of Hepatobiliary Surgery, Miulli Hospital, 70124 Acquaviva Delle Fonti, Italy
| | | | - Pasquale Avella
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples, 80131 Naples, Italy
| | | | - Riccardo Memeo
- Unit of Hepatobiliary Surgery, Miulli Hospital, 70124 Acquaviva Delle Fonti, Italy
| | - Arnaldo Scardapane
- Interdisciplinary Department of Medicine, Section of Radiology and Radiation Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Zhu XR, Zhu JQ, Chen YF, Liu YY, Lu JJ, Sun J, Peng SQ, Chen MB, Du YP. Bioinformatics analysis and experimental verification of the prognostic and biological significance mediated by fatty acid metabolism related genes for hepatocellular carcinoma. Front Oncol 2022; 12:972744. [PMID: 35982956 PMCID: PMC9378871 DOI: 10.3389/fonc.2022.972744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
Background Liver cancer is among the leading causes of death related to cancer around the world. The most frequent type of human liver cancer is hepatocellular carcinoma (HCC). Fatty acid (FA) metabolism is an emerging hallmark that plays a promoting role in numerous malignancies. This study aimed to discover a FA metabolism-related risk signature and formulate a better model for HCC patients’ prognosis prediction. Methods We collected mRNA expression data and clinical parameters of patients with HCC using the TCGA databases, and the differential FA metabolism-related genes were explored. To create a risk prognostic model, we carried out the consensus clustering as well as univariate and multivariate Cox regression analyses. 16 genes were used to establish a prognostic model, which was then validated in the ICGC dataset. The accuracy of the model was performed using receiver operating characteristic (ROC) analyses, decision curve analysis (DCA) and nomogram. The immune cell infiltration level of risk genes was evaluated with single-sample GSEA (ssGSEA) algorithm. To reflect the response to immunotherapy, immunophenoscore (IPS) was obtained from TCGA-LIHC. Then, the expression of the candidate risk genes (p < 0.05) was validated by qRT-PCR, Western blotting and single-cell transcriptomics. Cellular function assays were performed to revealed the biological function of HAVCR1. Results According to the TCGA-LIHC cohort analysis, the majority of the FA metabolism-related genes were expressed differentially in the HCC and normal tissues. The prognosis of patients with high-risk scores was observed to be worse. Multivariate COX regression analysis confirmed that the model can be employed as an independent prognosis factor for HCC patients. Furthermore, ssGSEA analysis revealed a link between the model and the levels of immune cell infiltration. Our model scoring mechanism also provides a high predictive value in HCC patients receiving anti-PDL1 immunotherapy. One of the FA metabolism-related genes, HAVCR1, displays a significant differential expression between normal and HCC cell lines. Hepatocellular carcinoma cells (Huh7, and HepG2) proliferation, motility, and invasion were all remarkably inhibited by HAVCR1 siRNA. Conclusion Our study identified a novel FA metabolism-related prognostic model, revealing a better potential treatment and prevention strategy for HCC.
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Affiliation(s)
- Xiao-Ren Zhu
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
- Department of Medical Oncology, Affiliated Kunshan Hospital of Jiangsu University, Medical School of Jiangsu University, Kunshan, China
| | - Jia-Qi Zhu
- Department of Thoracic Surgery, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China
- Nantong Key Laboratory of Translational Medicine in Cardiothoracic Diseases and Research Institution of Translational Medicine in Cardiothoracic Diseases, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, China
| | - Yu-Fei Chen
- Department of Hepatology, Infectious Diseases Hospital Affiliated with Soochow University, Suzhou, China
| | - Yuan-Yuan Liu
- Clinical Research and Lab Center, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Jing-Jing Lu
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
| | - Jun Sun
- Department of Medical Oncology, Affiliated Kunshan Hospital of Jiangsu University, Medical School of Jiangsu University, Kunshan, China
| | - Shi-Qing Peng
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
- Department of Medical Oncology, Affiliated Kunshan Hospital of Jiangsu University, Medical School of Jiangsu University, Kunshan, China
| | - Min-Bin Chen
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
- *Correspondence: Min-Bin Chen, ; Yi-Ping Du,
| | - Yi-Ping Du
- Department of Radiotherapy and Oncology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China
- *Correspondence: Min-Bin Chen, ; Yi-Ping Du,
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