1
|
Shi Y, Wang Q, Huang L, Li N, Ren X, Bi S. Effects of evidence-based nursing on surgical site wound infections in patients undergoing surgery for liver cancer: A meta-analysis. Int Wound J 2024; 21:e14545. [PMID: 38272814 PMCID: PMC10791573 DOI: 10.1111/iwj.14545] [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: 11/14/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 01/27/2024] Open
Abstract
This study aimed to systematically evaluate the impact of evidence-based nursing (EBN) on perioperative wound infections and postoperative complications in patients undergoing surgery for liver hepatocellular carcinoma (LIHC). Randomised controlled trials (RCTs) on the application of EBN on patients receiving LIHC surgery were searched in PubMed, Web of Science, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure from the inception of each database to September 2023. Studies were screened and evaluated by two investigators based on inclusion and exclusion criteria, and data were extracted from the final included literature. RevMan 4.0 was used for data analysis. Overall, 15 RCTs involving 1374 patients with LIHC were included, with 687 in the EBN group and 687 in the conventional care group. The analysis revealed that the incidence of wound infections (odds ratio [OR] = 0.32, 95% confidence interval [CI]: 0.18-0.56, p < 0.001) and postoperative complications (OR = 0.22, 95% CI: 0.15-0.31, p < 0.001) was significantly lower in the EBN group than in the conventional care group. The available evidence suggests that nursing strategies for EBN applied in the perioperative period in patients with LIHC receiving surgery can effectively reduce the incidence of wound infections and postoperative complications and promote postoperative recovery.
Collapse
Affiliation(s)
- Yong‐Hong Shi
- Department of Infectious DiseasePeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Qing‐Ju Wang
- Department of General MedicinePeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Li‐Zhen Huang
- Department of Infectious DiseasePeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Na Li
- Department of Infectious DiseasePeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Xin‐Ting Ren
- Department of Infectious DiseasePeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| | - Shu‐Min Bi
- Department of Gastrointestinal surgeryPeople's Hospital Affiliated to Shandong First Medical UniversityJinanChina
| |
Collapse
|
2
|
Fas -670 A/G polymorphism predicts prognosis of hepatocellular carcinoma after curative resection in Chinese Han population. Hepatobiliary Pancreat Dis Int 2022; 21:33-40. [PMID: 34366198 DOI: 10.1016/j.hbpd.2021.07.001] [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: 09/15/2020] [Accepted: 07/14/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Apoptosis, also called programmed cell death, is a genetically controlled process against hyperproliferation and malignancy. The Fas-Fas ligand (FasL) system is considered a major pathway for apoptosis in cells and tissues. Thus, this study aimed to investigate whether single nucleotide polymorphisms (SNPs) in Fas and FasL gene may have effects on the recurrence and survival of patients with hepatocellular carcinoma (HCC) after curative hepatectomy. METHODS We investigated the relationship between Fas rs1800682, rs2234767 and FasL rs763110 polymorphisms and recurrence-free survival (RFS) as well as overall survival (OS) in 117 Chinese Han patients with HCC who underwent hepatectomy. RESULTS In Kaplan-Meier survival analysis, only Fas rs1800682 (-670 A/G) was associated with RFS and OS. Compared with AA genotype, the AG/GG genotype was significantly associated with better RFS (P = 0.008) and OS (P = 0.020). Moreover, multivariate Cox regression analysis showed that Fas rs1800682 remained as a significant independent predictor of RFS for HCC patients with hepatectomy [AG/GG vs. AA: adjusted hazard ratio = 0.464, 95% confidence interval: 0.275-0.782, P = 0.004], but was not an independent predictor of OS (P = 0.395). CONCLUSIONS This study demonstrated that Fas -670 G allele may play a protective role in the recurrence and survival of HCC patients with hepatectomy. Furthermore, Fas rs1800682 polymorphism might be a promising biomarker for HCC patients after hepatectomy.
Collapse
|
3
|
Deng Y, Zhu S, Yan W, Qi L, Chen Z, Ma L. Influence of clear cell carcinoma on the post-hepatectomy prognosis of patients with hepatocellular carcinoma. Future Oncol 2021; 18:543-552. [PMID: 34878322 DOI: 10.2217/fon-2021-0381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: The authors aimed to identify factors that independently influence the survival of patients with primary clear cell carcinoma of the liver (PCCCL). Methods: A total of 470 patients with hepatocellular carcinoma were retrospectively analyzed. Multivariate Cox analysis was used to identify potential factors associated with prognosis of PCCCL. Results: Patients with PCCCL showed significantly higher disease-free survival (DFS) and overall survival (OS) compared with patients with non-clear cell hepatocellular carcinoma. Multivariate analysis revealed that AFP level, tumor size, liver cirrhosis and portal vein tumor thrombosis were risk factors for DFS. Tumor size, capsule formation and Ki-67 were risk factors for OS. Satellite nodules acted as a protective factor for DFS and OS. Conclusion: PCCCL is associated with better prognosis in hepatocellular carcinoma. Tumor size and satellite nodules may be independent predictors of OS and DFS.
Collapse
Affiliation(s)
- Yongheng Deng
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Shaoliang Zhu
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Wen Yan
- Clinical School of Medicine, Jiamusi University, China
| | - Lunan Qi
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Zushun Chen
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| | - Liang Ma
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, China
| |
Collapse
|
4
|
Jeong H, Kim KH, Jo S, Song S. Impact of prognostic nutritional index on the recurrence of hepatocellular carcinoma after a curative resection. Ann Hepatobiliary Pancreat Surg 2021; 25:456-461. [PMID: 34845116 PMCID: PMC8639306 DOI: 10.14701/ahbps.2021.25.4.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/02/2022] Open
Abstract
Backgrounds/Aims The purpose of this retrospective study was to determine the association between prognostic nutritional index (PNI) and recurrence of hepatocellular carcinoma after a curative resection. Methods Between 2007 to 2019, 130 patients who underwent curative hepatectomy for hepatocellular carcinoma were enrolled. PNI was calculated. Its cutoff value was identified through receiver operating characteristic curve analysis. According to PNI, patients were divided into two groups. Univariate and multivariate analyses were performed to identify independent risk factors for recurrence. Results The cutoff value of PNI was 52. In univariate analysis, alcoholic liver cirrhosis (p = 0.041), protein induced by vitamin K antagonist- II ≥ 200 (p = 0.012), indocyanine green retention test (ICG R15) >10% (p = 0.001), estimated blood loss ≥ 800 mL (p = 0.037), tumor size (p = 0.001), microvascular invasion (p = 0.023), T-stage (p = 0.001), and PNI < 52 (p = 0.001) were significant factors affecting the recurrence. In multivariate analysis, alcoholic liver cirrhosis (p = 0.046), ICG R15 >10% (p = 0.025), T-stage (p = 0.003), and PNI < 52 (p = 0.046) were independent prognostic factors for disease-free survival. Conclusions PNI, a nutritional and immunologic factor, is an independent prognostic factor that can predict the recurrence of hepatocellular carcinoma in patients undergoing a curative resection.
Collapse
Affiliation(s)
- Ho Jeong
- Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Kil Hwan Kim
- Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Sungho Jo
- Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| | - Sanghyun Song
- Department of Surgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea
| |
Collapse
|
5
|
Jeon SK, Lee DH, Park J, Suh KS, Yi NJ, Hong SK, Han JK. Tumor volume measured using MR volumetry as a predictor of prognosis after surgical resection of single hepatocellular carcinoma. Eur J Radiol 2021; 144:109962. [PMID: 34562746 DOI: 10.1016/j.ejrad.2021.109962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 01/27/2023]
Abstract
PURPOSE To evaluate the clinical value of tumor volume-measurement using magnetic resonance (MR) volumetry for predicting prognosis after surgical resection of single small-to-medium-sized hepatocellular carcinoma (HCC) (≤5cm). METHOD This retrospective study included 162 consecutive patients who underwent preoperative gadoxetic acid-enhanced MRI and subsequent surgical resection for single HCC (≤5cm). Tumor volume was measured at hepatobiliary phase of MR images using semi-automated three-dimensional volumetric software program. Recurrence-free survival (RFS) and overall survival (OS) were estimated using Kaplan-Meier method. The Cox-proportional-hazard-model was used to evaluate clinical, pathologic, and radiologic prognostic factors. A minimal p-value approach based on log-rank test statistics was used to obtain the optimal-cutoff tumor volume for predicting RFS and OS. Inter-examiner reproducibility of MR volumetric measurements was assessed using intraclass correlation coefficient (ICC) and coefficient of variance (CV). RESULTS After a median follow-up of 84.4 months (range, 2.8-126.5), HCC recurrence occurred in 69 (42.6%) patients and twenty-four (14.8%) patients died with estimated 5-year OS of 90.8%. Larger tumor volume was significantly associated with poor RFS(P = 0.018) and poor OS(P = 0.005) in multivariate analysis. For predicting RFS and OS after surgery, the optimal-cutoff of tumor volume was set at 4.0 mL and 4.0 mL, respectively, with larger volume ≥4.0 mL was significantly associated with poor RFS (hazard ratio[HR], 1.84, P = 0.023) and poor OS (HR, 2.66, P = 0.033). Inter-examiner reproducibility of tumor volume-measurement using MR-volumetry showed ICC of 0.980 and CV of 3.9%. CONCLUSIONS Tumor volume-measurement using MR-volumetry is clinically feasible and reproducible, and can help predict RFS and OS after resection of single small-to-medium-sized HCC.
Collapse
Affiliation(s)
- Sun Kyung Jeon
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Dong Ho Lee
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, South Korea.
| | - Juil Park
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Kyung-Suk Suh
- Department of Surgery, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Nam-Joon Yi
- Department of Surgery, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Suk Kyun Hong
- Department of Surgery, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| | - Joon Koo Han
- Department of Radiology, Seoul National University Hospital and Seoul National University College of Medicine, South Korea
| |
Collapse
|
6
|
Zakaria HM, Mohamed A, Omar H, Gaballa NK. Alpha-fetoprotein level to total tumor volume as a predictor of hepatocellular carcinoma recurrence after resection. A retrospective cohort study. Ann Med Surg (Lond) 2020; 54:109-113. [PMID: 32426129 PMCID: PMC7225379 DOI: 10.1016/j.amsu.2020.04.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/08/2020] [Accepted: 04/13/2020] [Indexed: 02/08/2023] Open
Abstract
Background Total tumor volume (TTV) and serum alfa fetoprotein (AFP) level are important risk factors linked with the high possibility of hepatocellular carcinoma (HCC) recurrence. The aim of the study was to evaluate the role of AFP/TTV ratio, as a prognostic marker, in the prediction of HCC recurrence after resection. Methods Patients who underwent liver resection for HCC between 2010 and 2018 were retrospectively analyzed. Patients were divided into 2 groups; a group with AFP/TTV ≤2 and another group with AFP/TTV >2. Risk factors for HCC recurrence were recorded. Results A total of 286 HCC patients underwent liver resection (184 patients with AFP/TTV ≤ 2, and 102 patients with AFP/TTV > 2). There was a significant difference between the 2 groups in the preoperative total bilirubin level, serum AFP level, mean tumor diameter, TTV, operative blood loss, microvascular invasion and hospital stay (all P values < 0.05). The 1-, 3-, and 5-year tumor recurrence rates were 24.1%, 43%, and 57.6% respectively. The independent risk factors for tumor recurrence were AFP/TTV >2 (HR = 1.62, 95% CI = 1.29–1.98, P = 0.042), Macrovascular invasion (HR = 2.03, 95% CI = 2.17–2.38, P = 0.021, and microvascular invasion (HR = 1.36, 95% CI = 1.08–1.77, P = 0.019). Conclusion AFP/TTV ratio is a feasible prognostic marker for prediction of HCC recurrence after resection so, it can help in providing an intensive postoperative surveillance program to high risk patients for early detection and management of any recurrence. AFP/TTV ratio is a feasible surrogate for prediction of HCC recurrence. It can help in providing an intensive postoperative surveillance program to high risk patients. By knowing the high risk patients for HCC recurrence, we can provide appropriate preventive measures. The appropriate preventive measures like loco-regional or new-adjuvant therapy, still need another study to clarify.
Collapse
Affiliation(s)
- Hazem M Zakaria
- Department of Hepatopancreatobiliary and Liver Transplant Surgery, National Liver Institute, Menoufia University, Egypt
| | - Anwar Mohamed
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Egypt
| | - Hazem Omar
- Department of Diagnostic and Intervention Radiology, National Liver Institute, Menoufia University, Egypt
| | - Nahla K Gaballa
- Department of Anesthesiology and Intensive Care, National Liver Institute, Menoufia University, Egypt
| |
Collapse
|
7
|
Xiang Y, Zhang Q, Wei S, Huang C, Li Z, Gao Y. Paeoniflorin: a monoterpene glycoside from plants of Paeoniaceae family with diverse anticancer activities. ACTA ACUST UNITED AC 2019; 72:483-495. [PMID: 31858611 DOI: 10.1111/jphp.13204] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/26/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Paeoniflorin, a representative pinane monoterpene glycoside in plants of Paeoniaceae family, possesses promising anticancer activities on diverse tumours. This paper summarized the advance of Paeoniflorin on cancers in vivo and in vitro, discussed the related molecular mechanisms, as well as suggested some perspectives of the future investigations. KEY FINDINGS Anticancer activities of paeoniflorin have been comprehensively investigated, including liver cancer, gastric cancer, breast cancer, lung cancer, pancreatic cancer, colorectal cancer, glioma, bladder cancer and leukaemia. Furthermore, the potential molecular mechanisms corresponding to the antitumour effects of Paeoniflorin might be related to the following aspects: inhibition of tumour cell proliferation and neovascularization, induction apoptosis, and inhibition of tumour invasion and metastasis. SUMMARY Paeoniflorin has wide spectrum antitumour activities; however, in vivo and clinical investigations on antitumour effect of Paeoniflorin are lacking which should be focused on further studies. Our present review on antitumour effects of Paeoniflorin would be beneficial for the further molecular mechanisms study, candidate antitumour drug development and clinical research of Paeoniflorin in the future.
Collapse
Affiliation(s)
- Yongjing Xiang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qing Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shujun Wei
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Cong Huang
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengsheng Li
- Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Yongxiang Gao
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| |
Collapse
|
8
|
Xiachuan Q, Xiang Z, Xuebing L, Yan L. Predictive Value of Contrast-enhanced Ultrasound for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection. ULTRASONIC IMAGING 2019; 41:49-58. [PMID: 30803409 DOI: 10.1177/0161734618815231] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This retrospective study aimed to use preoperative and contrast-enhanced ultrasound (CEUS) factors to assess and reveal risk factors of early recurrence (ER) in patients with hepatocellular carcinoma (HCC). We enrolled 141 patients with primary HCC who had undergone surgical resection. The assessment of the CEUS scan includes (a) the maximum diameter of the lesion, (b) the tumor echogenicity of gray-scale ultrasound (US), (c) the morphology of the tumor, (d) the margin of the tumor, (e) the peripheral hypoechoic halo, (f) tumor necrosis, (g) nutritional arteries shown by tumors, (h) ultrasonography for diagnosis of cirrhosis, and (i) the timer on the US screen displayed the time elapsed from the saline flush and was used to determine time to washout. According to the degree of the phase, the washout rate is divided into four grades, namely, levels 1 to 4. ER is defined as the time between resection and recurrence within 12 months after surgery. Risk factors for ER HCC were analyzed. Predictors of ER on a univariate logistic regression analysis in CEUS are size, washout rate, morphology, center necrosis, and feeding artery appearing in the tumor. Multivariate analysis results indicated that feeding artery, microvascular invasion (MVI), and washout rate were independent risk factors for ER. The relative high risk of ER for washout rate 1, 2, 3, and 4 were 29.3%, 43.2%, 53.1%, and 71.4%, respectively. The appropriateness of hepatectomy in the treatment of single lesion HCC should be carefully considered when the washout rate was 4.
Collapse
Affiliation(s)
- Qin Xiachuan
- 1 Department of Ultrasound, Nanchong Central Hospital, Nanchong, China
| | - Zhou Xiang
- 2 Department of Ultrasound, Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Liu Xuebing
- 1 Department of Ultrasound, Nanchong Central Hospital, Nanchong, China
| | - Luo Yan
- 3 Department of Ultrasound, West China Hospital, Chengdu, China
| |
Collapse
|
9
|
Serum alpha-fetoprotein level per total tumor volume as a predictor of recurrence of hepatocellular carcinoma after resection. Surgery 2017; 163:1002-1007. [PMID: 29284589 DOI: 10.1016/j.surg.2017.10.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/18/2017] [Accepted: 10/24/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND Alpha-fetoprotein has been used as a predictor of recurrence for hepatocellular carcinoma and disease-free survival post-resection. Studies in East Asia have shown that serum alpha-fetoprotein per total tumor volume ratio is a better prognostic indicator than alpha-fetoprotein alone. Similar studies in the United States evaluating serum alpha-fetoprotein to total tumor volume ratio have not been conducted. Its relevance is incompletely understood. METHODS Consecutive patients undergoing resection for hepatocellular carcinoma at a single tertiary center between 2000 and 2013 were identified for inclusion in this retrospective cohort study. Patient demographics, associated liver disease, Child-Pugh and Model for End-Stage Liver Disease scores, preoperative imaging, surgical pathology, alpha-fetoprotein at diagnosis, last alpha-fetoprotein before surgery, and peak alpha-fetoprotein levels were recorded. Actual tumor volume by imaging volumetrics was used when available (n = 70). For the remaining cases, total tumor volume was calculated using the sum of the volumes of all the tumors ((4/3)πr3) where "r" is the mean radius of each lesion. Peak serum alpha-fetoprotein was used to calculate the alpha-fetoprotein to total tumor volume ratio. RESULTS A total of 124 patients resected for hepatocellular carcinoma between 2000 and 2013 were identified. Overall 1-, 3-, and 5-year survival post resection was 76%, 53%, and 35%, respectively. On multivariate analysis, peak alpha-fetoprotein to total tumor volume ratio > 20 (P < .001, HR = 3.72, 95% CI [1.82-7.58]) and lymphovascular space invasion (P = .002, HR = 3.30, 95% CI [1.57-6.94]) were found to affect hepatocellular carcinoma recurrence-free survival. CONCLUSION A variety of prognostic values predict the recurrence of hepatocellular carcinoma postresection. Peak preoperative alpha-fetoprotein to total tumor volume > 20 and lymphovascular space invasion has been shown to predict recurrence of hepatocellular carcinoma. Our study confirms findings from East Asian studies. But larger series are needed to establish this correlation in patients with hepatocellular carcinoma not treated by resection.
Collapse
|
10
|
Zhang L, Xiang ZL, Zeng ZC, Fan J, Tang ZY, Zhao XM. A microRNA-based prediction model for lymph node metastasis in hepatocellular carcinoma. Oncotarget 2016; 7:3587-98. [PMID: 26657296 PMCID: PMC4823129 DOI: 10.18632/oncotarget.6534] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 11/22/2015] [Indexed: 12/17/2022] Open
Abstract
We developed an efficient microRNA (miRNA) model that could predict the risk of lymph node metastasis (LNM) in hepatocellular carcinoma (HCC). We first evaluated a training cohort of 192 HCC patients after hepatectomy and found five LNM associated predictive factors: vascular invasion, Barcelona Clinic Liver Cancer stage, miR-145, miR-31, and miR-92a. The five statistically independent factors were used to develop a predictive model. The predictive value of the miRNA-based model was confirmed in a validation cohort of 209 consecutive HCC patients. The prediction model was scored for LNM risk from 0 to 8. The cutoff value 4 was used to distinguish high-risk and low-risk groups. The model sensitivity and specificity was 69.6 and 80.2 %, respectively, during 5 years in the validation cohort. And the area under the curve (AUC) for the miRNA-based prognostic model was 0.860. The 5-year positive and negative predictive values of the model in the validation cohort were 30.3 and 95.5 %, respectively. Cox regression analysis revealed that the LNM hazard ratio of the high-risk versus low-risk groups was 11.751 (95 % CI, 5.110–27.021; P < 0.001) in the validation cohort. In conclusion, the miRNA-based model is reliable and accurate for the early prediction of LNM in patients with HCC.
Collapse
Affiliation(s)
- Li Zhang
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zuo-Lin Xiang
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhao-Chong Zeng
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jia Fan
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Zhao-You Tang
- Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Xiao-Mei Zhao
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| |
Collapse
|
11
|
Lequoy M, Desbois-Mouthon C, Wendum D, Gupta V, Blachon JL, Scatton O, Dumont S, Bonnemaire M, Schmidlin F, Rosmorduc O, Fartoux L. Somatostatin receptors in resected hepatocellular carcinoma: status and correlation with markers of poor prognosis. Histopathology 2016; 70:492-498. [DOI: 10.1111/his.13034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 07/06/2016] [Indexed: 12/16/2022]
Affiliation(s)
- Marie Lequoy
- Department of Hepatology; AP-HP; Saint-Antoine Hospital; Paris France
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
| | | | - Dominique Wendum
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
- Department of Pathology; AP-HP; Saint-Antoine Hospital; Paris France
| | - Vandana Gupta
- Oncology and Biomarkers; Ipsen Biosci. Inc.; Cambridge MA USA
| | | | - Olivier Scatton
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
- Department of Hepatobiliary Surgery; AP-HP; Pitié Salpêtrière Hospital; Paris France
| | - Sylvie Dumont
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
- Department of Pathology; AP-HP; Saint-Antoine Hospital; Paris France
| | | | | | - Olivier Rosmorduc
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
- Department of Hepatology; AP-HP; Pitié Salpêtrière Hospital; Paris France
| | - Laetitia Fartoux
- Saint-Antoine Research Centre; Sorbonne Universités; UPMC Univ. Paris 06, UMR_S 938; Paris France
- Department of Hepatology; AP-HP; Pitié Salpêtrière Hospital; Paris France
| |
Collapse
|
12
|
Xia J, Song P, Sun Z, Sawakami T, Jia M, Wang Z. Advances of diagnostic and mechanistic studies of γ-glutamyl transpeptidase in hepatocellular carcinoma. Drug Discov Ther 2016; 10:181-7. [PMID: 27534452 DOI: 10.5582/ddt.2016.01052] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second major cause of cancerous deaths in the world, accounting for 80-90% of all cases of liver cancer with an assessed global incidence of 782,000 new cases and approximate 746,000 deaths in 2012. Preoperative laboratory data (des-γ carboxyprothrombin (DCP), α-fetoprotein (AFP), Indocyanine green retention 15 min (ICG-R15), and γ-glutamyl transferase (GGT)) should be completely assessed before deciding a treatment and predicting prognosis in order to improve the prognosis for patients with HCC. A few recent studies have suggested GGT as an independent prognostic indicator in cases with HCC. And the data of our and other research teams revealed that combination of GGT and ICG-R15 or other factors may improve the efficiency of GGT as a prognostic predictor. In addition of clinical studies, a few mechanistic studies had been performed and GGT was suggested to promote tumor progression and poor prognosis through inducing DNA damage and genome instability, releasing reactive oxygen species to activating invasion-related signaling pathway, blocking chemotherapy, regulating microRNAs, and managing CpG island methylation. Although there were a few mechanistic studies, further and accurate researches were still in need.
Collapse
Affiliation(s)
- Jufeng Xia
- Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo
| | | | | | | | | | | |
Collapse
|
13
|
Hyun SH, Eo JS, Lee JW, Choi JY, Lee KH, Na SJ, Hong IK, Oh JK, Chung YA, Song BI, Kim TS, Kim KS, Moon DH, Yun M. Prognostic value of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with Barcelona Clinic Liver Cancer stages 0 and A hepatocellular carcinomas: a multicenter retrospective cohort study. Eur J Nucl Med Mol Imaging 2016; 43:1638-45. [PMID: 26936852 DOI: 10.1007/s00259-016-3348-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 02/16/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE We evaluated the prognostic value of pretreatment (18)F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) in patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 or A hepatocellular carcinoma (HCC) who had received curative treatment or transarterial chemoembolization (TACE). METHODS Between 2009 and 2010, 317 patients diagnosed with HCC at seven hospitals were enrolled. Among these, 195 patients underwent curative treatments including resection, liver transplantation, and radiofrequency ablation. TACE was performed in 122 patients. The tumor-to-normal liver standardized uptake value ratio (TLR) of the primary tumor was measured using pretreatment FDG PET/CT. The prognostic significance of TLR and other clinical variables was assessed using Cox regression models. Differences in the overall survival (OS) associated with TLR or other significant clinical factors were examined using the Kaplan-Meier method. RESULTS Over a median follow-up period of 46 months, 77 patients died from cancer. In the curative cohort, higher TLR (≥2) was significantly associated with death (hazard ratio [HR] = 2.68; 95 % CI, 1.16-6.15; P = 0.020) in multivariable analysis. Patients with a higher TLR had significantly worse OS than patients with a lower TLR (5-year overall survival, 61 % vs. 79.4 %; P = 0.006). In the TACE cohort, the Model for End-Stage Liver Disease (MELD) score (≥8) was a significant independent prognostic factor for OS (HR = 3.34; 95 % CI, 1.49-7.48; P = 0.003), whereas TLR was not associated with OS. The Kaplan-Meier curves showed significantly poorer OS in patients with higher MELD scores (≥8) than in those with lower MELD scores (5-year survival rate, 33.1 % vs. 79.6 %; P < 0.001). CONCLUSIONS Pretreatment TLR measured using FDG PET/CT was an independent prognostic factor for OS in patients with BCLC stage 0 or A HCC undergoing curative treatment. In contrast, underlying liver function appeared to be important in predicting the prognosis of patients undergoing TACE.
Collapse
Affiliation(s)
- Seung Hyup Hyun
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jeong Won Lee
- Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
| | - Joon Young Choi
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyung-Han Lee
- Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sae Jung Na
- Department of Nuclear Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Il Ki Hong
- Department of Nuclear Medicine, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jin Kyoung Oh
- Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Yong An Chung
- Department of Nuclear Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Bong-Il Song
- Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Tae-Sung Kim
- Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Kyung Sik Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dae Hyuk Moon
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Republic of Korea.
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
| |
Collapse
|
14
|
Teixeira UF, Izaguirre AGC, Machry MC, Cerski CT, Brandão ABDM, Fontes PRO. ASSOCIATION BETWEEN MURINE DOUBLE MINUTE 2 - T309G polymorphism and recurrence of hepatocellular carcinoma after surgical treatment. ARQUIVOS DE GASTROENTEROLOGIA 2016; 52:325-30. [PMID: 26840476 DOI: 10.1590/s0004-28032015000400014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/04/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Discovery and incorporation of biomarker panels to cancer studies enabled the understanding of genetic variation and its interference in carcinogenesis at molecular level. The potential association between single nucleotide polymorphism (SNP) 309 and increased development of tumors, such as hepatocellular carcinoma, has been subject to several studies. This is the first study on this association conducted in Brazil. METHODS 62 cases of cirrhotic patients with hepatocellular carcinoma surgically treated by partial hepatectomy (HPT) or by liver transplantation (LTX) from 2000 to 2009 at Santa Casa Hospital Complex, in the city of Porto Alegre, were retrospectively analyzed. Tumor samples from surgical specimen were collected and prepared for study in paraffin blocks. RESULTS Overall survival was 26.7 months in the HPT group and 62.4 months in the LTX group (P <0.01). Overall tumor recurrence was 66.7% in the HPT group (10/15) and 17% in the LTX group (8/47) (X²=13.602, P <0.01). Alpha-fetoprotein levels >200ng/mL, microvascular invasion and histological grade were associated with tumor recurrence (P <0.01). Recurrence rates in each surgical group and analysis of factors associated with tumor recurrence, when stratified for each genotypic pattern, were both not statistically significant. CONCLUSION G/G genotype was not associated with tumor recurrence after surgical treatment and it did not show any correlation with other prognostic factors.
Collapse
Affiliation(s)
| | | | | | - Carlos Thadeu Cerski
- Departamento de Patologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | | | | |
Collapse
|
15
|
An HJ, Shin WY, Lee KY, Ahn SI. A comparison of the risk factors of intrahepatic recurrence, early recurrencen, and multiple recurrences after resection for single nodular hepatocellular carcinoma. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2015; 19:89-97. [PMID: 26379729 PMCID: PMC4568596 DOI: 10.14701/kjhbps.2015.19.3.89] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 08/10/2015] [Accepted: 08/15/2015] [Indexed: 12/12/2022]
Abstract
Backgrounds/Aims Intrahepatic recurrence is one of the most important causes of compromised prognosis after surgical resection of hepatocellular carcinoma (HCC). This retrospective study was designed to identify and compare the risks of recurrence, early recurrence and multiple recurrences in a single patient population. Methods A series of 92 consecutive patients, who received resection for single nodular HCC at our institute from January 2007 to December 2013, were enrolled in this study. The patients were divided into recurrent and non-recurrent groups; the recurrent group was further divided into subgroups by applying two criteria: early and late recurrence (with a cutoff of 18 months), and single and multiple (≥2) recurrence. The potential risk factors were compared using univariate and multivariate analyses. The subgroup analysis was performed to determine the effects of different cut-off values on the analysis. Results 41 recurrences (44.6%) occurred during a mean follow-up of 42.4 months. The Child-Pugh score, and the portal vein invasion were found to be independent risk factors of recurrence, but differentiation was the only independent risk factor of early recurrence. The serum alpha-fetoprotein, tumor size, tumor necrosis, and hemorrhage were found to be the risk factors of multiple recurrences according to the univariate analysis, but lacked significance according to the multivariate analysis. When the cutoffs for early and multiple recurrences were changed to ≤10 months and >3 nodules, respectively, different risk factors were identified. Conclusions Our results implicated that different factors can predict the recurrence, timing, and multiplicity of an HCC recurrence. Further studies should be conducted to prove the complex relationships between tumor burden, invasiveness, and underlying liver cirrhosis for initial tumors, and the timing and multiplicity of recurrent HCC.
Collapse
Affiliation(s)
- Hyun Joon An
- Department of Surgery, Inha University School of Medicine, Incheon, Korea
| | - Woo Young Shin
- Department of Surgery, Inha University School of Medicine, Incheon, Korea
| | - Keon-Young Lee
- Department of Surgery, Inha University School of Medicine, Incheon, Korea
| | - Seung-Ik Ahn
- Department of Surgery, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
16
|
Malfertheiner P, Verslype C, Kolligs FT, Schütte K, Vandecaveye V, Paprottka PM, Ricke J. The effectiveness of selective internal radiation therapy in challenging cases of liver-predominant unresectable hepatocellular carcinoma. Future Oncol 2015; 10:17-27. [PMID: 25478762 DOI: 10.2217/fon.14.218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Peter Malfertheiner
- Department of Gastroenterology, Hepatology & Infectious Diseases, Otto-von-Guericke University Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany
| | | | | | | | | | | | | |
Collapse
|
17
|
Huang S, Huang GQ, Zhu GQ, Liu WY, You J, Shi KQ, Wang XB, Che HY, Chen GL, Fang JF, Zhou Y, Zhou MT, Chen YP, Braddock M, Zheng MH. Establishment and Validation of SSCLIP Scoring System to Estimate Survival in Hepatocellular Carcinoma Patients Who Received Curative Liver Resection. PLoS One 2015; 10:e0129000. [PMID: 26057656 PMCID: PMC4461285 DOI: 10.1371/journal.pone.0129000] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 05/04/2015] [Indexed: 12/21/2022] Open
Abstract
Background and Aims There is no prognostic model that is reliable and practical for patients who have received curative liver resection (CLR) for hepatocellular carcinoma (HCC). This study aimed to establish and validate a Surgery-Specific Cancer of the Liver Italian Program (SSCLIP) scoring system for those patients. Methods 668 eligible patients who underwent CLR for HCC from five separate tertiary hospitals were selected. The SSCLIP was constructed from a training cohort by adding independent predictors that were identified by Cox proportional hazards regression analyses to the original Cancer of the Liver Italian Program (CLIP). The prognostic performance of the SSCLIP at 12 and 36-months was compared with data from existing models. The patient survival distributions at different risk levels of the SSCLIP were also assessed. Results Four independent predictors were added to construct the SSCLIP, including age (HR = 1.075, 95%CI: 1.019–1.135, P = 0.009), albumin (HR = 0.804, 95%CI: 0.681–0.950, P = 0.011), prothrombin time activity (HR = 0.856, 95%CI: 0.751–0.975, P = 0.020) and microvascular invasion (HR = 19.852, 95%CI: 2.203–178.917, P = 0.008). In both training and validation cohorts, 12-month and 36-month prognostic performance of the SSCLIP were significantly better than those of the original CLIP, model of end-stage liver disease-based CLIP, Okuda and Child-Turcotte-Pugh score (all P < 0.05). The stratification of risk levels of the SSCLIP showed an enhanced ability to differentiate patients with different outcomes. Conclusions A novel SSCLIP to predict survival of HCC patients who received CLR based on objective parameters may provide a refined, useful prognosis algorithm.
Collapse
Affiliation(s)
- Sha Huang
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China
| | - Gui-Qian Huang
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Renji School of Wenzhou Medical University, Wenzhou 325000, China
| | - Gui-Qi Zhu
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China
| | - Wen-Yue Liu
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Jie You
- Department of Oncological Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Ke-Qing Shi
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Xiao-Bo Wang
- Intensive Care Unit, Wenzhou Central Hospital, Wenzhou 325000, China
| | - Han-Yang Che
- Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Guo-Liang Chen
- Department of General Surgery, Jinhua People’s Hospital, Jinhua 321000, China
| | - Jian-Feng Fang
- Department of Hepatobiliary Surgery, Shaoxing People’s Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing 312000, China
| | - Yi Zhou
- School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou 325000, China
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Meng-Tao Zhou
- Department of Hepatobiliary Surgery, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yong-Ping Chen
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
| | - Martin Braddock
- Global Medicines Development, AstraZeneca R&D, Alderley Park, Macclesfield, United Kingdom
| | - Ming-Hua Zheng
- Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, China
- * E-mail:
| |
Collapse
|
18
|
Song P, Inagaki Y, Wang Z, Hasegawa K, Sakamoto Y, Arita J, Tang W, Kokudo N. High Levels of Gamma-Glutamyl Transferase and Indocyanine Green Retention Rate at 15 min as Preoperative Predictors of Tumor Recurrence in Patients With Hepatocellular Carcinoma. Medicine (Baltimore) 2015; 94:e810. [PMID: 26020384 PMCID: PMC4616400 DOI: 10.1097/md.0000000000000810] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/02/2015] [Indexed: 02/06/2023] Open
Abstract
This study investigated the preoperative independent risk factors associated with survival and recurrence for patients with hepatocellular carcinoma (HCC) who underwent hepatic resection. In total, 384 consecutive patients who underwent curative hepatic resection for single primary HCC were studied. Predictive factors associated with 1-, 3-, and 5-year survival and recurrence-free survival (RFS) were assessed using a univariate log-rank test and multivariate Cox proportional hazards regression model. Gamma-glutamyl transferase (GGT) > 100 U/L was identified as a preoperative independent risk factor affecting 1-, 3-, and 5-year survival whereas GGT > 50 U/L and indocyanine green retention 15 min (ICG-R15) > 10% were identified as preoperative independent risk factors affecting 1-, 3-, and 5-year RFS. The 384 patients studied had a 1-, 3-, and 5-year RFS rate of 72.8%, 43.3%, and 27%, respectively. Patients with GGT > 50 U/L had a 1-, 3-, and 5-year RFS rate of 64.5%, 36.0%, and 21.7%. These patients had lower survival rates than did patients with GGT ≤ 50 U/L (P < 0.05). Patients with GGT > 50 U/L and ICG-R15 > 10% had a 1-, 3-, and 5-year RFS rate of 62.4%, 29.5%, and 14.1%, respectively. These patients had lower survival rates than did patients in the other 2 groups with different levels of GGT and ICG (P < 0.05, respectively). The same was also true for patients with a tumor < 5 cm in size. Combined information in the form of high levels of GGT and ICG-R15 is a preoperative predictor that warrants full attention when evaluating tumor recurrence postoperatively.
Collapse
Affiliation(s)
- Peipei Song
- From the Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Wang Z, Song P, Xia J, Inagaki Y, Tang W, Kokudo N. Can gamma-glutamyl transferase levels contribute to a better prognosis for patients with hepatocellular carcinoma? Drug Discov Ther 2015; 8:134-8. [PMID: 25031046 DOI: 10.5582/ddt.2014.01025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hepatocellular carcinoma (HCC) is the most common type of liver cancer. Hepatic resection has long been considered a main treatment option for HCC, but the high rate of recurrence after hepatic resection remains a problem that impacts the prognosis and survival of patients with HCC. Thus, clarifying the factors for survival and risk factors for tumor recurrence after hepatic resection is crucial. Imaging studies are currently emphasized before selecting a treatment and predicting the prognosis for patients with HCC. Recently, laboratory testing of des-gamma-carboxyprothrombin (DCP), alpha-fetoprotein (AFP), indocyanine green 15 min after administration (ICG-R15), and γ-glutamyl transpeptidase (γ-GTP) has garnered attention as a way to select treatment and predict the prognosis of patients with HCC. γ-GTP in particular has critical clinical significance as an indicator of prognosis. This indicator helps to predict prognosis and it helps with the selection of further treatment, as was revealed by studies based on different subgroups of patients published in the past 5 years. The reason for the association between γ-GTP and early recurrence and poor survival is being investigated. Preoperative laboratory results (DCP, AFP, ICG-R15, and γ-GTP) may warrant attention and need to be fully evaluated before selecting a treatment and predicting prognosis in order to improve the prognosis for patients with HCC.
Collapse
Affiliation(s)
- Zhigang Wang
- Hepato-Biliary-Pancreatic Surgery Division, The Second Affiliated Hospital of Jilin University
| | | | | | | | | | | |
Collapse
|
20
|
Niu ZS, Niu XJ, Wang M. Management of hepatocellular carcinoma: Predictive value of immunohistochemical markers for postoperative survival. World J Hepatol 2015; 7:7-27. [PMID: 25624992 PMCID: PMC4295195 DOI: 10.4254/wjh.v7.i1.7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/02/2014] [Accepted: 11/10/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatocellular carcinoma (HCC) accounts for over 90% of all primary liver cancers. With an ever increasing incidence trend year by year, it has become the third most common cause of death from cancer worldwide. Hepatic resection is generally considered to be one of the most effective therapies for HCC patients, however, there is a high risk of recurrence in postoperative HCC. In clinical practice, there exists an urgent need for valid prognostic markers to identify patients with prognosis, hence the importance of studies on prognostic markers in improving the prediction of HCC prognosis. This review focuses on the most promising immunohistochemical prognostic markers in predicting the postoperative survival of HCC patients.
Collapse
|
21
|
Abstract
Cirrhosis is the main risk factor for the development of hepatocellular carcinoma (HCC). The major causative factors of cirrhosis in the United States and Europe are chronic hepatitis C infection and excessive alcohol consumption with nonalcoholic steatohepatitis emerging as another important risk factor. Magnetic resonance imaging is the most sensitive imaging technique for the diagnosis of HCC, and the sensitivity can be further improved with the use of diffusion-weighted imaging and hepatocyte-specific contrast agents. The combination of arterial phase hyperenhancement, venous or delayed phase hypointensity "washout feature," and capsular enhancement are features highly specific for HCC with reported specificities of 96% and higher. When these features are present in a mass in the cirrhotic liver, confirmatory biopsy to establish the diagnosis of HCC is not necessary. Other tumors, such as cholangiocarcinoma, sometimes occur in the cirrhotic at a much lower rate than HCC and can mimic HCC, as do other benign lesions such as perfusion abnormalities. In this article, we discuss the imaging features of cirrhosis and HCC, the role of magnetic resonance imaging in the diagnosis of HCC and other benign and malignant lesions that occur in the cirrhotic liver, and the issue of nonspecific arterially hyperenhancing nodules often seen in cirrhosis.
Collapse
Affiliation(s)
- Daniel C Barr
- From the Department of Radiology/MRI, University of Michigan Health System, Ann Arbor, MI
| | | |
Collapse
|
22
|
Wang Y, Luo Q, Li Y, Deng S, Wei S, Li X. Radiofrequency ablation versus hepatic resection for small hepatocellular carcinomas: a meta-analysis of randomized and nonrandomized controlled trials. PLoS One 2014; 9:e84484. [PMID: 24404166 PMCID: PMC3880302 DOI: 10.1371/journal.pone.0084484] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 11/14/2013] [Indexed: 02/05/2023] Open
Abstract
Objectives To evaluate the efficacy and safety of radiofrequency ablation (RFA) versus hepatic resection (HR) for early hepatocellular carcinoma (HCC) meeting the Milan criteria. Methods A meta-analysis was conducted, and PubMed, Web of Science, the Cochrane Library, CBM, CNKI and VIP databases were systematically searched through November 2012 for randomized and nonrandomized controlled trials (RCTs and NRCTs). The Cochrane Collaboration's tool and modified MINORS score were applied to assess the quality of RCTs and NRCTs, respectively. The GRADE approach was employed to evaluate the strength of evidence. Results Three RCTs and twenty-five NRCTs were included. Among 11,873 patients involved, 6,094 patients were treated with RFA, and 5,779 with HR. The pooled results of RCTs demonstrated no significant difference between groups for 1- and 3-year overall survival (OS), recurrence-free survival (RFS) and disease-free survival (DFS) (p>0.05). The 5-year OS (Relative Risk, RR 0.72, 95% CI 0.60 to 0.88) and RFS (RR 0.56, 95% CI 0.40 to 0.78) were lower with RFA than with HR. The 3- and 5-year recurrences with RFA were higher than with HR (RR 1.48, 95% CI 1.14 to 1.94, and RR 1.52, 95% CI 1.18 to 1.97, respectively), but 1-year recurrence and in-hospital mortality showed no significant differences between groups (p>0.05). The complication rate (RR 0.18, 95% CI 0.06 to 0.53) was lower and hospital stays (Mean difference -8.77, 95% CI −10.36 to −7.18) were shorter with RFA than with HR. The pooled results of NRCTs showed that the RFA group had lower 1-, 3- and 5-year OS, RFS and DFS, and higher recurrence than the HR group (p<0.05). But for patients with very early stage HCC, RFA was comparable to HR for OS and recurrence. Conclusion The effectiveness of RFA is comparable to HR, with fewer complications but higher recurrence, especially for very early HCC patients.
Collapse
Affiliation(s)
- Yingqiang Wang
- The Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China
- Department of Medical Administration, 363 Hospital, Chengdu, China
| | - Qianqian Luo
- National Chengdu Center for Safety Evaluation of Drugs, West China Hospital, Chengdu, China
| | - Youping Li
- The Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China
- * E-mail:
| | - Shaolin Deng
- West China Medical School, West China Hospital, Sichuan University, Chengdu, China
| | - Shiyou Wei
- West China Medical School, West China Hospital, Sichuan University, Chengdu, China
| | - Xianglian Li
- The Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|