Articles
  • Review

    Management of advanced hepatocellular carcinoma: review of current and potential therapies

    Asmaa Gomaa , Imam Waked
    Over the past few years, despite improvement in screening and diagnosis of hepatocellular carcinoma (HCC), advanced stage remains the most common presentation at diagnosis, with limited management options, especially options available to patients in limited resource countries. There is currently no effective systemic chemotherapy, targeted, or immunologic therapy for advanced stage HCC. Sorafenib is the only approved front-line molecular-targeted treatment,with slight survival benefit. Regorafenib has recently been approved as second line therapy for HCC after failure of sorafenib. Ongoing...
    Published on: 15 Jun 2017
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  • Review

    Roles of p53 in extrinsic factor-induced liver carcinogenesis

    Tim Link , Tomoo Iwakuma
    Liver cancer remains one of the most common human cancers with a high mortality rate. Therapies for hepatocellular carcinoma (HCC) remain ineffective, due to the heterogeneity of HCC with regard to both the etiology and mutation spectrum, as well as its chemotherapy resistant nature; thus surgical resection and liver transplantation remain the gold standard of patient care. The most common etiologies of HCC are extrinsic factors. Humans have multiple defense mechanisms against extrinsic factor-induced carcinogenesis, of which tumor suppressors play crucial roles in preventing normal cells...
    Published on: 6 Jun 2017
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  • Original Article

    Detection of urine DNA markers for monitoring recurrent hepatocellular carcinoma

    Hie-Won Hann , Surbhi Jain , Grace Park , Jamin D. Steffen , Wei Song , Ying-Hsiu Su
    Aim: This study aimed to explore the potential of detecting hepatocellular carcinoma (HCC)-associated DNA markers, TP53 249T mutations and aberrant methylation of RASSF1A and GSTP1 genes, for monitoring HCC recurrence. HCC remains a leading cause of death worldwide, with one of the fastest growing incidence rates in the US. While treatment options are available and new ones emerging, there remains a poor prognosis of this disease mostly due to its late diagnosis and high recurrence rate. Although there are no specific guidelines addressing how HCC recurrence should be monitored, recurrence...
    Published on: 6 Jun 2017
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  • Case Report

    First case report of inflammatory myofibroblastic tumor of peritoneal cavity in a living donor liver transplantation recipient

    Naganathan Selvakumar , Parul Saboti , Sumaid Kaul , Subash Gupta
    Post-transplantation malignancies are well known complications after liver transplantation. Certain malignancies are more common in pediatric recipients than adults. Inflammatory myofibroblastic tumors (IMTs) are reactive neoplasms with miniscule malignant potential. IMTs are more common after hematopoietic stem cell transplantation. However, there is 1 case reported in the literature after deceased donor liver transplantation. The authors describe a case of IMT after living donor liver transplantation. The patient was a 1-year-old girl who underwent living donor liver transplantation...
    Published on: 17 May 2017
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  • Editorial

    Liver transplantation in acute-on-chronic liver failure

    Roger Williams
    Published on: 17 May 2017
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  • Minireview

    Primary hepatic lymphoma: is it a disease entity?

    Fei Xiong , Yong-Song Guan
    It is now widely accepted that lymphoma is a cancer of the lymphatic cells in the immune system and a type of blood cancer that develops when T or B lymphocytes of the white blood cells display uncontrolled proliferation and cellular immortality. Currently, a number of authors have published case reports or case series in which these lesions are defined as primary hepatic lymphoma. This minireview discusses several aspects of the entity of primary hepatic lymphoma, especially the dilemmas in diagnosis.
    Published on: 9 May 2017
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  • Original Article

    MELD score and AST-to-platelet ratio index predict long-term survival in patients with a small hepatocellular carcinoma following non-transplant therapies: a pilot study

    Joy Sarkar , Thomas DeLeon , Linda L. Wong
    Aim: Liver transplantation (LT) is the most effective treatment for long-term survival from hepatocellular carcinoma (HCC); however, insufficient donors limit therapy. The authors sought to identify characteristics that predicted long-term survival after non-transplant therapies in patients with small HCC. Methods: In a database of 1,050 HCC patients, the authors identified those with single HCC ≤ 3.0 cm, who underwent hepatic resection (HR, n = 16), radiofrequency ablation (RFA, n = 55), or LT (n = 23) with 5-year follow-up. Overall survival (OS) and odds-ratios (OR) for survival after...
    Published on: 9 May 2017
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  • Minireview

    Updates on hepatorenal syndrome and strategies bridging to liver transplantation

    Chung Yeung Cheung , Kenneth S.H. Chok
    Hepatorenal syndrome is not an uncommon life-threatening complication arising from liver cirrhosis. The diagnostic criteria for this syndrome have been revised throughout the years, with recent revisions aimed at improving earlier diagnosis and treatment. Liver transplantation remains the only definitive treatment for hepatorenal syndrome. Due to the scarcity of liver grafts, many patients die waiting. This review focuses on the different strategies to bridge patients to liver transplantation and to improve the postoperative outcome.
    Published on: 12 Apr 2017
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  • Original Article

    Late recurrence of hepatocellular carcinoma after liver transplantation

    Julia A. Zhang , Sandi A. Kwee , Linda L. Wong
    Aim: Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide and liver transplant (LT) prolongs survival. However, 15-20% will experience recurrent HCC, most occurring within 2 years of LT. HCC patients with late recurrences (> 5 years after LT) may have distinctive clinical/biological characteristics. Methods: A retrospective review was conducted of 88 patients who underwent LT for HCC during 1993-2015, analyzing demographics, clinical factors, explant pathology, and outcome. Results: Median follow-up was 6.4 years. HCC recurred in 15 (17.0%) patients with...
    Published on: 10 Apr 2017
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  • Original Article

    Attenuation of liver stiffness in sorafenib-treated patients with advanced hepatocellular carcinoma

    Chien-Fu Hung , Dong Liu , Tsung-Han Wu , Chao-Wei Lee , Kuang-Tse Pan , Ching-Ting Wang , Hsiu-Ying Chai , Ming-Chin Yu , Yi-Cheng Chen
    Aim: Sorafenib is a multi-tyrosine kinase inhibitor and the standard therapy for advanced hepatocellular carcinoma (HCC). This retrospective study aimed to observe the anti-fibrotic effect of sorafenib in patients with advanced HCC. Methods: Seventeen patients with advanced HCC were recruited. Shear wave velocity (SWV) using acoustic radiation force impulse elastography and non-invasive serum markers for liver fibrosis, such as the aspartate aminotransferase (AST) to alanine aminotransferase ratio (AAR), the AST to platelet ratio index, the fibrosis-4 index and the Lok index, were recorded...
    Published on: 24 Mar 2017
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  • Topic: Novel Approaches for HCC

    Immunotherapy for hepatocellular carcinoma: the force awakens in HCC?

    Lynn G. Feun , Ying-Ying Li , Medhi Wangpaichitr , Chun-Jing Wu , Niramol Savaraj
    Systemic therapy for hepatocellular carcinoma (HCC) has been disappointing. The only drug approved by Food and Drug Administration recently has been sorafenib. Sorafenib has modest benefits with a low response rate and an improvement in time to progression of only 2-3 months. Multiple randomized trials, which compare the new agent to sorafenib as either first line or second line therapy, have been negative, showing no improved clinical benefit. Recently, in a large phase III randomized trial, regorafenib has shown superiority to placebo as a second line treatment for HCC. However, this drug...
    Published on: 22 Mar 2017
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  • Original Article

    Comparison of p53 and prohibitin expression in the spectrum of hepatitis, cirrhosis, and hepatocellular carcinoma

    Lívia Maria Della Porta , Fernando Silva Ramalho , Carlos Augusto Oliveira , Deisy Mara Silva , Marlei Josiele Augusto , Leandra Náira Zambelli Ramalho
    Aim: To investigate the correlation of p53 and prohibitin (PHB) expression in the spectrum of hepatitis, cirrhosis, and human hepatocellular carcinoma (HCC). Methods: Hepatic biopsies from patients with HCC (n = 60), cirrhosis (CIR, n = 30), hepatitis C virus (HCV, n = 30), and normal livers (NL, n = 20) were examined for immunohistochemical expression of RelA/p65, tumor necrosis factor receptor-1 (TNFR1), TNF-related apoptosis-inducing ligand (TRAIL), p53, and PHB. The samples were also analysed by nuclear factor kappa B (NFκB) Southwestern histochemistry and a transferase-mediated...
    Published on: 28 Feb 2017
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  • Original Article

    Antioxidant activity and free radical-scavenging of cape gooseberry (Physalis peruviana L.) in hepatocellular carcinoma rats model

    Hanaa A. Hassan , Nermin E. Ghareb , Ghassan F. Azhari
    Aim: Oxidative damage of cellular components by free radicals and other reactive oxygen molecules is believed to be associated with the development of degenerative diseases. The aim of the present study was to evaluate the antioxidant capacity and free radical scavenging activity of cape gooseberry juice (CGJ) in diethylnitrosamine-(DENA) and CCl4 (3 mL/kg b.w.)-induced hepatocellular carcinoma (HCC) rats model. Methods: The rats were divided into 4 groups (6 rats each group). Group 1 (control): the rats of this group did not receive any treatments; group 2 (CGJ): rats were daily...
    Published on: 28 Feb 2017
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  • Review

    Further understanding of mechanisms involved in liver cancer chemoresistance

    Oscar Briz , Maria J. Perez , Jose J. G. Marin
    An important limitation for the success of chemotherapy in the treatment of primary liver cancer (hepatocellular carcinoma, hepatoblastoma and cholangiocarcinoma) is the marked efficacy of mechanisms of chemoresistance (MOC). These have been previously classified into five groups depending on whether they result in: a reduced drug uptake or enhanced drug export (MOC-1); poor intracellular activation of prodrugs or higher inactivation of active drugs (MOC-2); changes in the molecular targets that impairs the action of the drug by increasing the activity of the metabolic route to be inhibited...
    Published on: 19 Jan 2017
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  • Case Report

    Sorafenib from palliative to neoadjuvant chemotherapy in hepatocellular carcinoma with major vascular invasion: experience of two cases

    Naganathan Selvakumar , Sandeep Vohra , Deep Sika Arora , Subash Gupta
    Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide and the incidence is higher in cirrhosis. Treatment options depend on tumor stage, status of liver function, and the general condition of the patient. Major vascular invasion is a contraindication for liver transplantation. Sorafenib has been found to be useful in association with transarterial chemoembolization as an effective chemotherapeutic agent to prolong survival in inoperable HCCs. Here we describe our experience where sorafenib was used as palliation but later turned out to be a neoadjuvant. Both cases had...
    Published on: 12 Jan 2017
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  • Review

    Radiological diagnosis of hepatocellular carcinoma in non-cirrhotic patients

    Alba Castán , Ylenia Navarro , Luis Sarría , Raquel Larrosa , Mario Serradilla , Alejandro Serrablo
    Hepatocellular carcinoma (HCC) arising in non-cirrhotic livers is relatively rare. Compared with HCC arising in cirrhotic livers they have some quirks. HCC in healthy livers are large tumors at diagnosis, and are detected due to the onset of abdominal symptoms, outside of any scheduled monitoring program. In non-cirrhotic patients, HCC has the same appearance as the classic image of cirrhotic HCC substrate. The presence of capsule, extensive intratumoral necrosis and typical behavior in the dynamic study after administration of intravenous contrast are present in most of the non-cirrhotic...
    Published on: 12 Jan 2017
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  • Review

    Novel predictive and prognostic strategies of hepatitis B virus related hepatocellular carcinoma

    Wen-Bin Liu , Fan Yang , Ding-Yi Shao , Guang-Wen Cao
    Hepatocellular carcinoma (HCC) is a common malignancy and an important cause of cancer death worldwide. Chronic hepatitis B virus (HBV) infection is the major cause of HCC. Recent studies of HBV-induced carcinogenesis not only discovered many new biomarkers but also developed a novel theory: Cancer Evolution-Development (Cancer Evo-Dev). Cancer Evo-Dev provides an evolutionary insight of developing more reasonable predictive and prognostic strategies. Characterizing chronic inflammatory microenvironment of cancer evolution, genetic polymorphisms of inflammatory factors, and HCC-related HBV...
    Published on: 23 Dec 2016
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  • Commentary

    Comments on “The severity of non-alcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota”

    Anna Egresi , Krisztina Hagymási , Gabriella Lengyel
    Published on: 13 Dec 2016
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  • Original Article

    Effect of obesity on perioperative outcomes after laparoscopic hepatectomy

    Seeyuen J. Lee , Adam Hauch , Erica Kane , Christoper DuCoin , Michael Darden , Geoffrey Parker , Emad Kandil , Joseph F. Buell
    Aim: Laparoscopic hepatectomy is increasing in utilization, however the procedure has not been adequately examined in the obese patient. This study aims to analyze the effect of obesity on perioperative outcomes after laparoscopic hepatectomy. Methods: Retrospective analysis of 396 laparoscopic hepatectomies in normal [body mass index (BMI) < 25], overweight (BMI ≥ 25), obese (BMI ≥ 30), and severely obese (BMI ≥ 35) patients using multivariate regression models to determine the risk factors for post-operative complications. Results: Normal BMI (n = 78; 20%), overweight (n = 209; 52%),...
    Published on: 13 Dec 2016
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  • Original Article

    Role of contrast-enhanced ultrasound in the evaluation of vascularization of hepatocellular carcinoma

    Francesco Loria , Giuseppe Loria , Salvatore Basile , Giuseppe Crea , Luciano Frosina , Francesca Frosina
    Aim: Early individualization of hepatocellular carcinoma is crucial to obtain good therapeutic results, thanks to several options such as percutaneous therapies, surgical resections and transplant. Aim of this study is to evaluate the vascularization of hepatocarcinoma using contrast enhanced ultrasound (CEUS) in comparison with multislice computed thomography (MSCT). Methods: Between January 2009 and May 2014, 67 patients affected by hepatocarcinoma, who presented an overall of 92 nodules, were examined and enrolled in the study. Results: There was a significant difference in the...
    Published on: 22 Nov 2016
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  • Original Article

    Evaluating normalization approaches for the better identification of aberrant microRNAs associated with hepatocellular carcinoma

    Jing Shen , Qiao Wang , Irina Gurvich , Helen Remotti , Regina M. Santella
    Aim: Dysregulated microRNAs (miRNAs) have been identified in hepatocellular carcinoma (HCC), but only a small proportion have been confirmed. An appropriate normalizer is crucial to determining the accuracy and reliability of data from miRNA studies. Methods: Different normalization strategies were used to validate genome-wide miRNA profiles in HCC tumor and non-tumor tissues, and to determine the consistency and discrepancy of data on dysregulated miRNAs. Results: Two sets of stable miRNAs (miR-30c/miR-30b and miR-30c/miR-126) were identified in HCC tissues by geNorm and NormFinder tools,...
    Published on: 18 Nov 2016
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  • Case Report

    Aggressive primary hepatic histiocytic sarcoma: case report and literature review

    Guang Yang , Jeremy Deisch , Haixia Qin , Craig Zuppan , Anwar S. Raza
    Histiocytic sarcoma is an uncommon non-Langerhans histiocyte disorder of mature tissue histiocytes. The authors presented an example of this rare tumor in a 14-year-old girl who presented with left upper quadrant pain, loss of appetite, and weight loss. A large 18 cm × 10 cm heterogeneous solid and cystic enhancing mass was found in the left lobe of the liver. Based on the histomorphology and positivity for histiocyte-specific markers in a needle biopsy, a diagnosis of histiocytic sarcoma was made. Chemotherapy was initiated, but the tumor did not respond well, and she died about 7 weeks...
    Published on: 7 Nov 2016
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  • Case Report

    An extra-adrenal pheochromocytoma mimicking a primary liver cancer

    Kenneth Siu Ho Chok , Florence Loong , Chung Mau Lo
    Despite doctors’ every effort to be vigilant when diagnosing, sometimes a preoperative diagnosis is disproved by postoperative pathological examination. A patient was diagnosed with hepatocellular carcinoma and received surgery as treatment. On operation, a solitary retroperitoneal mass rather than a liver lesion was seen. On histopathological examination, the retroperitoneal mass was found to be an extra-adrenal pheochromocytoma.
    Published on: 7 Nov 2016
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  • Case Report

    Hepatocarcinoma with metastasis to the anterior mediastinum

    Rogério Camargo Pinheiro Alves , Lorena Sagrilo Auer , Lisa Rodrigues da Cunha Saud , Raquel Coris Arrelaro , Aline Carboni Casado , Bruno Gustavo Ferreira , Denis Szjenfeld , Paula Bechara Poletti
    Liver malignancies are the sixth leading cause of cancer worldwide, whereas hepatocellular carcinoma (HCC) is the most frequent histological type of liver cancer. Extrahepatic metastasis, which rarely involves the mediastinum, is associated with poor prognosis. An 80-year-old male presenting with mild diffuse abdominal pain for 4 months, associated with hyporexia, increased abdominal volume, dry cough, and loss of 4 kg in 1 month, sought medical assistance due to hemoptysis and chest pain. Tomographic study revealed HCC with mediastinal metastasis, after which sorafenib therapy was started....
    Published on: 21 Oct 2016
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  • Original Article

    Is transarterial embolization a valuable treatment option for spontaneous rupture of hepatocellular carcinoma: experience from a tertiary care hospital of South-Asia

    Amna Subhan Butt , Saeed Hamid , Nazish Butt , Fatima Sharif , Tanveer Ul Haq , Wasim Jafri
    Aim: Transarterial embolization (TAE) has been found beneficial in treatment of ruptured Hepatocellular carcinoma (HCC) in earlier studies. So far no data is available from Pakistan. The aim of this study was to evaluate clinicopathological characteristics, outcomes of patients presented with spontaneously ruptured, unresectable HCC treated with or without TAE and to evaluate the factors associated with 30-day mortality. Methods: This was a cross sectional study. Patients ≥ 18 years old, presented with spontaneous rupture of unresectable HCC, were evaluated. The outcome measures were...
    Published on: 21 Oct 2016
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  • Case Report

    Epstein-Barr virus associated secondary hemophagocytic lymphohistiocytosis with an unusual presentation of abdominal compartment syndrome

    Li Lei , Camilla J. Cobb , Jeffrey Cao , Anwar S. Raza
    Hemophagocytic lymphohistiocytosis (HLH) is a cytokine storm syndrome caused by an overactive but ineffective immune reaction. Without prompt diagnosis and treatment, HLH is life-threatening. However, presenting symptoms are often nonspecific, with fatigue and fever being the most common. A high index of suspicion is therefore critical for early diagnosis and timely management. A previously healthy, 65-year-old female who initially presented with fever and abdominal pain developed abdominal compartment syndrome (ACS) requiring decompressive laparotomy on hospital day 6. Intraoperative...
    Published on: 21 Oct 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Liver resection for hepatocellular carcinoma within a fast-track management: a propensity-score matched analysis between open and laparoscopic approach

    Francesca Ratti , Federica Cipriani , Raffaella Reineke , Marco Catena , Michele Paganelli , Luigi Beretta , Luca Aldrighetti
    Aim: The study was designed to assess the implications of enhanced recovery after surgery (ERAS) approach in patients submitted to open liver resection for hepatocellular carcinoma (HCC) comparing their short term outcome with patients treated by laparoscopic approach, in a case-matched design. Methods: The open-group (n = 60) was matched in a ratio of 1:1 with patients undergoing laparoscopic liver resection for HCC (Lap-group, n = 60), with a matching achieved on a basis of propensity scores including 6 covariates representing patients characteristics and severity of the disease. Primary...
    Published on: 30 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Laparoscopic resection of hepatocellular carcinoma in patients with and without cirrhosis: the Brisbane experience

    Daniel J. Kilburn , Universe Leung , David J. Cavallucci , Cassandra Jeavons , Mehan Siriwardhane , Richard Bryant , Thomas R. O’Rourke , Shinn Yeung , Nicholas A. O’Rourke
    Aim: Laparoscopic liver resection for hepatocellular carcinoma (HCC) is increasingly common around the world. There may be significant advantages over open resections. However, due to technical difficulties, they are performed in few centers with expertise in liver and advanced laparoscopic surgery. In this study the authors summarize the experience to date. Methods: A retrospective analysis of consecutive patients undergoing laparoscopic liver resection for HCC in 2 tertiary academic hepatobiliary units in Brisbane, Australia, between 1999 and 2015 was performed. Operative characteristics,...
    Published on: 30 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Laparoscopic liver resection for hepatocellular carcinoma in patients with cirrhosis

    Jai Young Cho , Ho-Seong Han
    Hepatocellular carcinoma (HCC) is a common malignant tumor and many cases occur in patients with liver cirrhosis. Although liver transplantation is the most effective treatment option, hepatectomy is still the first curative treatment option because liver transplantation is limited by the donors and high cost. In recent years, laparoscopic liver resection (LLR) has increasingly been performed in patients with liver cirrhosis, and has several advantages over open liver resection. Besides less pain and shorter hospital stay, LLR in patients with liver cirrhosis is also associated with lower...
    Published on: 30 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

    Zenichi Morise , Masashi Isetani , Norihiko Kawabe Norihiko Kawabe , Hirokazu Tomishige , Hidetoshi Nagata , Satoshi Arakawa , Masahiro Ikeda , Kenshiro Kamio
    A 73-year-old woman with liver cirrhosis caused by hepatitis C virus (HCV) underwent treatment of three hepatocellular carcinomas (HCCs) in liver segment 4, following three previous laparoscopic liver resections (LLRs) over 73 months. Contrast-enhanced computed tomography showed three 0.5-1.2 cm HCCs deep within the portal territories of subsegments 4a and 4b. The patient underwent laparoscopic resection of 4a and 4b, with the preservation of the portal branch to 4c, after minimal adhesiolysis around segment 4. The operation lasted 284 min, there was 50 mL of intra-operative bleeding and...
    Published on: 19 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Laparoscopic liver resection in the cirrhotic patient

    Ben Robichaux , Jesse Sulzer , Joseph F. Buell
    Aim: The adoption of laparoscopic liver resection has been expansive in the last 2 decades with the exception of cirrhotic patients. The current study examines the outcomes of our cirrhotic resections to determine the potential limitations of this technique. Methods: Retrospective analysis of 114 cirrhotic patients. Seventy-five (65.8%) laparoscopic resections were compared to 39 open resections. Seventy-six (66.7%) resections in the series were minor resections (less than 3 segments). Surgical approach and extent of resection were analyzed using student’s t test and regression multivariate...
    Published on: 19 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Indications and technique for laparoscopic liver resection in patients with hepatocellular carcinoma and liver cirrhosis

    Yuichiro Otsuka , Masaru Tsichiya , Toshio Katagiri , Yoshihisa Kubota , Jun Ishii , Tetsuya Maeda , Hironori Kaneko
    Liver resection is the preferred initial treatment option for solitary or limited multifocal hepatocellular carcinoma (HCC). However, because of the characteristics of HCC, including its high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis, both curability and invasiveness must be considered when selecting a treatment for HCC. Laparoscopic liver resection (LLR) is minimally invasive and increasingly performed worldwide as a curative surgical option for treatment of liver tumors. The 2014 International Consensus Conference on LLR concluded that minor LLRs are now...
    Published on: 19 Sep 2016
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  • Topic: Advances in Minimally Invasive Cirrhotic Surgery

    Introduction of the special issue: “Advances in Minimally Invasive Cirrhotic Surgery”

    Giulio Belli
    Published on: 19 Sep 2016
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  • Original Article

    Detecting hepatic nodules and identifying feeding arteries of hepatocellular carcinoma: efficacy of cone-beam computed tomography in transcatheter arterial chemoembolization

    Yasuhiro Ushijima , Tsuyoshi Tajima , Akihiro Nishie , Yoshiki Asayama , Kousei Ishigami , Masakazu Hirakawa , Daisuke Kakihara , Daisuke Okamoto , Hiroshi Honda
    Aim: To evaluate the effectiveness of using cone-beam computed tomography (CBCT) in transcatheter arterial chemoembolization (TACE) to detect hapatocellular carcinoma (HCC) nodules and their feeding arteries. Methods: Twenty-four patients with HCCs who underwent TACE using CBCT in addition to conventional digital subtraction angiography (DSA) were enrolled. After both conventional DSA and CBCT through the hepatic artery were acquired, TACE were performed. The nodules were defined as an HCC when dense accumulation of iodized oil was found within the nodule on CT obtained 2 weeks after the...
    Published on: 25 Aug 2016
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  • Commentary

    Comment on “Preliminary outcome of microwave ablation of hepatocellular carcinoma: breaking the 3-cm barrier?”

    Paola Tombesi , Francesca Di Vece , Francesca Ermili , Sergio Sartori
    Published on: 25 Aug 2016
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  • Review

    Role of natural antioxidants in the therapeutic management of hepatocellular carcinoma

    Hanaa Ali Hassan , Nermin E. El-Gharib , Anmar F. Azhari
    Hepatocellular carcinoma (HCC) is a growing health problem in humans. HCC is considered the most common of internal malignancy which cause the death of human, but in the developed Western world, HCC is less common accompanied by increasing essentially in incidence, due to it occurs specially in chronic liver disease. HCC associated with various risk factors including hepatitis B virus infection; hepatitis C virus infection; prolonged aflatoxin exposure; and alcoholic cirrhosis. Overall, one-third of cirrhosis patients will develop HCC during their life time. Also, chemical carcinogens cause...
    Published on: 5 Aug 2016
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  • Letter to Editor

    Hepatocellular carcinoma and type 2 diabetes mellitus: cytokeratin 8/18 expression in hepatocellular carcinoma and glycogen-storing hepatocytes

    Kunio Takegoshi , Eikichi Okada , Qin Su
    Published on: 5 Aug 2016
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  • Review

    Diet and nutrition therapy in pre-liver transplant patients

    Neha Bakshi , Kalyani Singh
    Malnutrition is universally prevalent among pre-liver transplantation patients. Malnutrition among cirrhotic patients had been associated to increased morbidity and mortality rates. Also, severely malnourished patients before the transplant surgery have a higher rate of complications and a decreased overall survival rate after liver transplantation. In light of the high incidence of malnutrition and associated complications, it is essential to initiate treatment as early as it is assessed. This review addresses the aetiologies of malnutrition and appropriate treatment strategies to correct...
    Published on: 5 Aug 2016
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  • Original Article

    Efficacy of sorafenib therapy in patients with advanced hepatocellular carcinoma in Indian population

    Alit Abraham , Charumathi Purushothaman , Dhanya Damien , Jackson James , Prudence Attilade Rodrigues , Gursharan Singh
    Aim: Hepatocellular carcinoma (HCC) is the fourth most common type of cancer and the third leading cause of cancer-related mortality. Sorafenib is an oral multikinase inhibitor that is used for unresectable advanced HCC. It is only approved systemic therapy for advanced HCC. Methods: A retrospective prospective study conducted in a multispeciality hospital with 50 patients who received sorafenib. The primary outcome of the study was to find out the survival rate of patients treated with sorafenib. The secondary outcome of the study was to explore the efficacy and safety of sorafenib in a...
    Published on: 5 Aug 2016
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  • Review

    Percutaneous hepatic perfusion with melphalan for unresectable liver metastasis

    Humair S. Quadri , Eden C. Payabyab , David J. Chen , William Figg , Marybeth S. Hughes
    Percutaneous hepatic perfusion (PHP) is an investigative technique for treating patients with diffuse unresectable metastatic liver disease. The technique has been clinically evaluated and shows great treatment potential for regional therapy to the liver. The advantage of PHP lies in its minimally invasive approach and ability to be repeated when compared to isolated hepatic perfusion. In a literature search, 135 publications were screened and 16 of these publications, including clinical trials and reviews, contributed to this review of PHP with melphalan. Melphalan is an alkylating agent...
    Published on: 13 Jul 2016
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  • Brief Communication

    Hepatic disorder in Zika virus infection

    Viroj Wiwanitkit
    Zika virus infection is the present global problem. This arbovirus infection can cause acute illness and affect fetus in utero. However, there can be other additional clinical manifestation including to the hepatic disorder. In this short commentary article, the author briefly discusses on the liver problem due to Zika virus infection.
    Published on: 13 Jul 2016
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  • Commentary

    Comment on "A series of microRNA in the chromosome 14q32.2 maternally imprinted region related to progression of non-alcoholic fatty liver disease in a mouse model”

    Pietro Di Fazio , Thaddeus Till Wissniowski
    Published on: 13 Jul 2016
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  • Review

    Hepatitis B virus molecular biology and pathogenesis

    R. Jason Lamontagne , Sumedha Bagga , Michael J. Bouchard
    As obligate intracellular parasites, viruses need a host cell to provide a milieu favorable to viral replication. Consequently, viruses often adopt mechanisms to subvert host cellular signaling processes. While beneficial for the viral replication cycle, virus-induced deregulation of host cellular signaling processes can be detrimental to host cell physiology and can lead to virus-associated pathogenesis, including, for oncogenic viruses, cell transformation and cancer progression. Included among these oncogenic viruses is the hepatitis B virus (HBV). Despite the availability of an HBV...
    Published on: 1 Jul 2016
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  • Case Report

    Hemorrhagic cardiac tamponade after percutaneous laser ablation of a liver metastasis in segment II

    Paola Tombesi , Francesca Di Vece , Silvia Rinaldi , Matteo Bertini , Sergio Sartori
    Despite percutaneous laser thermal ablation (LTA) of liver tumors being regarded as a safe technique, major complications can occur. We report the first case of hemorrhagic cardiac tamponade after LTA of a colorectal metastasis in segment II of the liver. Unpredictable heat diffusion causing indirect thermal injury to the pericardium with resultant hemorrhagic reaction was hypothesized as the most likely cause of tamponade. A pericardial drain was emergently placed, 200 mL of bright red blood were drained, and the patient showed rapid hemodynamic improvement. For lesions located in segment...
    Published on: 1 Jul 2016
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  • Original Article

    Preoperative liver functional volumetry performed by 3D-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT: a preliminary study

    Hiroshi Yoshida , Hiroshi Makino , Tadashi Yokoyama , Hiroshi Maruyama , Atsushi Hirakata , Junji Ueda , Yasuhiro Mamada , Nobuhiko Taniai , Eiji Uchida
    Aim: The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry. Methods: The study group comprised 15 patients who underwent preoperative 3-dimensional (3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015. The diagnosis was...
    Published on: 1 Jul 2016
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  • Original Article

    Identifying microRNA panels specifically associated with hepatocellular carcinoma and its different etiologies

    Jing Shen , Abby B. Siegel , Helen Remotti , Qiao Wang , Regina M. Santella
    Aim: Deregulation of microRNAs (miRNAs) expression has been identified in hepatocellular carcinoma (HCC), but few results are consistent. The objective of this study is to investigate “HCC tumor type specific” and “tumor common” miRNA panels. Methods: The authors integrate and analyze clinical, etiologic and miRNA profiles data from 9 types of solid tumors in The Cancer Genome Atlas (TCGA) and HCC data from Columbia University Medical Center (CUMC). Results: Levels of 33 miRNAs were significant different between HCC tumor and paired non-tumor tissues (over 2-fold changes) after Bonferroni...
    Published on: 1 Jun 2016
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  • Review

    Physiological potential of cytokines and liver damages

    Fathia A. Mannaa , Khaled G. Abdel-Wahhab
    Cytokines are soluble extracellular small molecular weight protein or peptide. They are produced by virtually every nucleated cell type in response to injurious stimuli to control body metabolism, infection, inflammation and tissue or neuronal damage; therefore acting as messengers between tissues and the immune system; and participating in many physiological processes through their either anti-inflammatory or pro-inflammatory characteristics. Many cytokines have multiple cellular sources and targets, as well as many natural inducers and inhibitors. In pathophysiological conditions and...
    Published on: 1 Jun 2016
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  • Original Article

    Hepatoprotective and antioxidant activity of Bombax ceiba flowers against carbon tetrachloride-induced hepatotoxicity in rats

    Manish M. Wanjari , Rachna Gangoria , Yadu Nandan Dey , Sudesh N. Gaidhani , Narendra K. Pandey , Ankush D. Jadhav
    Aim: The flowers of Bombax ceiba are traditionally used as home remedy in the treatment of jaundice and spleen enlargement. The present work investigated the effect of aqueous extract of flowers of Bombax ceiba (BCAE) on experimentally induced hepatotoxicity in rats to substantiate its traditional use as hepatoprotective agent. Methods: Hepatotoxicity was induced in rats by carbon tetrachloride (CCl4) treatment; at the same time vehicle or BCAE (250 or 500 mg/kg) or silymarin (25 mg/kg) were administered daily orally for seven days. Hepatotoxicity was assessed by estimating the activities...
    Published on: 1 Jun 2016
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  • Review

    Murine double minute 2, a potential p53-independent regulator of liver cancer metastasis

    Atul Ranjan , Kaustav Bera , Tomoo Iwakuma
    Hepatocellular carcinoma (HCC) has emerged as one of the most commonly diagnosed forms of human cancer; yet, the mechanisms underlying HCC progression remain unclear. Unlike other cancers, systematic chemotherapy is not effective for HCC patients, while surgical resection and liver transplantation are the most viable treatment options. Thus, identifying factors or pathways that suppress HCC progression would be crucial for advancing treatment strategies for HCC. The murine double minute 2 (MDM2)-p53 pathway is impaired in most of the cancer types, including HCC, and MDM2 is overexpressed in...
    Published on: 6 May 2016
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  • Review

    Human telomerase disease mutants and its relation with hepatocarcinoma

    Yin-Nan Chen , Yan-Min Zhang
    Telomerase is a special reverse transcriptase, which adds telomeric DNA repeats to the ends of chromosome to offset loss. A vast majority of cancer cells have been shown that their telomerase was up-regulated and sustain proliferation and growth. Hepatocellular carcinoma (HCC) is one of the most commonly occurring cancers worldwide. It is also one of the leading causes of cancer death, and is connected with abnormal telomerase function. However, reports about the telomerase mutations and HCC are still insufficient. In this review, the structure and mechanism of action of telomerase,...
    Published on: 6 May 2016
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  • Original Article

    Can gender predict virological response to standard antiviral therapy for chronic hepatitis C? A retrospective study

    Paola Belci , Alessandro Collo , Maria Martorana , Andrea Evangelista , Sara Giunti , Roberto Gambino , Maurizio Cassader , Simona Bo , Marilena Durazzo
    Aim: The liver is a sexually dimorphic organ presenting gender differences in its metabolism, functions, enzyme activity, membrane lipid composition and immune response. This paper aimed to assess whether gender may predict virological response to standard antiviral therapy in subjects with chronic hepatitis C (CHC). Methods: The authors retrospectively analyzed 100 patients with genotype 1 CHC (55 men, 45 women), who performed standard antiviral therapy (interferon and ribavirin for 12 months) in the period 2002-2012, evaluated with blood tests and abdominal ultrasound to compare different...
    Published on: 6 May 2016
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  • Original Article

    Surgical resection or radiofrequency ablation in the management of hepatocellular carcinoma: single center experience

    Wael Mansy , Morsi Mohammed , Sameh Saber
    Aim: The aim of this study is to prove or disprove the superiority of surgical resections over radiofrequency ablation (RFA) with respect to efficacy and safety. Methods: The study was conducted in Zagazig University Hospitals, which included 40 patients with hepatocellular carcinoma (HCC) during the period from November 2011 to December 2014, using either liver resection or RFA. Results: Hepatic resection was done in 20 patients (13 males, 7 females). Interventional RFA was done in 20 patients (12 males, 8 females). There was no in-hospital mortality after resection. One- and two-year...
    Published on: 1 Apr 2016
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  • Case Report

    Spontaneous rupture of hepatocellular carcinoma

    Amer Hawatmeh , Khalid Jumean , Ahmed Abu Arqoub , Hamid Shaaban
    This is a very interesting case of a 64-year-old female with a history of chronic hepatitis C infection, with abdominal pain and was found to have ruptured hepatocellular carcinoma (HCC). She was managed with the two-stage therapeutic approach first using transarterial embolization to provide adequate hemostasis and then surgical resection with an excellent outcome. This case report exemplifies the importance of early diagnosis and treatment of ruptured HCC.
    Published on: 1 Apr 2016
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  • Original Article

    Arterial blood supply of hepatocellular carcinoma is associated with efficacy of sorafenib therapy

    Xiang-Hua Zhang , Qian Zhu , Jing Li , Liang Huang , Jian-Jun Yan , Feng Xu , Jun Li , Yi-Qun Yan
    Aim: There are some previous reports concerning the relationship between prognosis of patients treated with sorafenib and parameters of computed tomography (CT) and magnetic resonance imaging (MRI). This study presents monocentric experience with sorafenib in the treatment of hepatocellular carcinoma (HCC) patients and will try to identify predictive factors for survival based on the correlation of results from imaging and survival. Methods: A total of 38 HCC patients treated from April 2009 to December 2010 with sorafenib were included in this study. HCCs were classified as good arterial...
    Published on: 1 Apr 2016
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  • Case Report

    Nutrition profile of a liver transplant recipient

    Neha Bakshi , Kalyani Singh
    Malnutrition is almost universally present in patients undergoing liver transplantation. In this report, a male adult patient was followed from his pre-liver transplant phase until chronic post-transplant phase (3 months after the transplant). Improvement in nutrition status, quality of life, and performance status was seen from the pre-transplant to chronic post-transplant phase. Day to day nutrition monitoring and gradual increase in calorie and protein intake was seen in the acute post-transplant phase, but during pre- and chronic post-transplant phase, lack of nutrition support was...
    Published on: 1 Apr 2016
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  • Letter to Editor

    Microwave coagulation therapy: the future is quite rosy

    Paola Tombesi , Francesca Di Vece , Sergio Sartori
    Published on: 1 Apr 2016
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Dietary incorporation of jojoba extract eliminates oxidative damage in livers of rats fed fumonisin-contaminated diet

    Mosaad A. Abdel-Wahhab , Olivier Joubert , Aziza A. El-Nekeety , Hafiza A. Sharaf , Ferial M. Abu-Salem , Bertrand H. Rihn
    Aim: This study aimed to determine the composition of ethanol extract of jojoba seeds, and to evaluate its hepatoprotective effects in rats fed fumonisin B1 (FB1)-contaminated diet. Methods: Jojoba seeds were extracted in 95% ethanol, and the chemical composition was determined. Male rats were divided into six groups and treated for 8 weeks as follows: (1) Untreated control; (2) FB1-contaminated diet (80 mg/kg diet); (3) low dose (0.5 mg/kg b.w.) jojoba extract; (4) high dose (1.0 mg/kg b.w.) jojoba extract; (5) low dose jojoba extract plus FB1; and (6) high dose jojoba extract plus FB1....
    Published on: 9 Mar 2016
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Coffee, Traditional Chinese Medicine and cannabinoids as potential tools for prevention and treatment of hepatocellular carcinoma

    Stefano Gitto , Ranka Vukotic , Pietro Andreone
    In the last decade, the incidence of hepatocellular carcinoma (HCC) is growing in both Europe and United States. Conventional therapies such as liver resection, transplantation, ablation, chemoembolization and sorafenib are not enough to avoid a significant mortality. Many studies suggested the positive effect of caffeine for prevention of HCC. Nevertheless, the amount of therapeutic caffeine and the high-dose safety are unknown. Many authors proposed Traditional Chinese Medicine as preventive and/or curative approach. Although it reveals limits such as the uncertain safety profile and the...
    Published on: 9 Mar 2016
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Curcumin: an adjuvant therapeutic remedy for liver cancer

    Shilpa Sharma , Anshul Tanwar , Devendra K. Gupta
    The molecular signalling pathways for hepatocellular carcinoma and hepatoblastoma have been extensively studied. The treatment of these highly vascular tumors mainly revolves around chemotherapy and surgery. Yet there is a high associated morbidity and mortality due to advanced stages, adverse effects owing to chemotherapy and recurrence. The role of Curcumin as an adjuvant remedy is explored in this article. Curcumin stimulates apoptosis of cancer cells, acts as anti-proliferative agent, has anti-angiogenic action, prevents tumor invasiveness and metastasis and prevents recurrence. It also...
    Published on: 9 Mar 2016
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Beneficial and detrimental effects of natural dietary products on the risk of hepatocellular carcinoma, and their roles in its management

    Rodolfo Sacco , Caterina Conte , Sara Marceglia , Valeria Mismas , Giampaolo Bresci , Antonio Romano , Roberto Eggenhoffner , Luca Giacomelli
    Hepatocellular carcinoma (HCC) is a common solid malignancy and a leading cause of cancer-related death worldwide. The mechanisms underlying the pathogenesis and development of HCC are complex and heterogeneous. Although mainly related to hepatitis B and C chronic infection; HCC may also arise from diet-associated conditions such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Furthermore, toxins and nutrients such as mycotoxins and alcohol have an established role in the pathogenesis of chronic liver diseases, whereas specific diet patterns or foods have been...
    Published on: 9 Mar 2016
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  • Original Article

    Predictive factors for the success of “one-off” ablation in single hepatocellular carcinoma patients who underwent percutaneous radiofrequency ablation

    Jian-Yun Long , Jing Li , Jie Cao , Liang Huang , Xiang-Hua Zhang , Jin-Kai Liu , Yi-Qun Yan
    Aim: To investigate the technique' s effectiveness and evaluate the risk factors affecting the success of "one-off" percutaneous ultrasound-guided radiofrequency ablation (RFA) for single hepatocellular carcinoma (HCC). Methods: A total of 462 consecutive patients who received RFA from February 2010 to December 2013 at a single center (Eastern Hepatobiliary Surgery Hospital, Shanghai, China) were enrolled in the study. The patients were followed up for at least 6 months. Herein, this study adopted a new terminology named "one-off" ablation which is defined as achieving complete necrosis and...
    Published on: 29 Feb 2016
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  • Original Article

    Fascin-1 depletion from hepatocellular carcinoma cells inhibits migfilin and vasodilator-stimulated phosphoprotein expression and enhances adhesiona

    Vasiliki Gkretsi , Dimitrios P. Bogdanos
    Aim: Extracellular matrix (ECM)-adhesions and their interaction with actin cytoskeleton are fundamental for hepatocellular carcinoma (HCC). Fascin-1, an actin-bundling protein, is correlated with poor HCC prognosis, and is known regarding the molecular mechanism of its action. In this study, the authors investigated Fascin-1 basic molecular mechanism and cellular properties in HCC cells. Methods: Fascin-1 was silenced by small interfering RNA and the expression of actin. The ECM-adhesion-related proteins were assessed along with the cells’ adhesion capacity in two cell lines that differ in...
    Published on: 29 Feb 2016
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  • Original Article

    Portal vein thrombosis in liver transplantation: radiologic evaluation, risk factors, and occult diagnosis

    Adam Hauch , Carl Winkler , Eric Katz , Peter W. Lundberg , Mary Killackey , Anil S. Paramesh , Luis A. Balart , Nathan J. Shores , Martin Moehlen , Ward Miller , Douglas P. Slakey , Joseph F. Buell , Bob H. Saggi
    Aim: Portal vein thrombosis (PVT) in the liver transplant recipient poses many challenges. Unfortunately, the risk factors and effects on outcomes of PVT are not well-defined. Methods: This study analyzed the experience with PVT in liver transplant program from 2007 to 2013. This included the effectiveness of PVT diagnostics and its risk factors using logistical regression. The primary endpoints were Kaplan-Meir patient and graft survival. The secondary endpoints were the length of stay (LOS), transfusion rate, and overall morbidity. Independent predictors of survival were identified using...
    Published on: 29 Feb 2016
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  • Review

    Recent updates of genetic and genomic alterations in hepatocellular carcinoma

    Zhang Zhao , Jian Huang
    Hepatocellular carcinoma (HCC) is one of the most common malignant cancers worldwide. However, the molecular mechanisms underlining the development and progression of HCC remain unclear. Genetic and genomic alterations are common events in various types of cancers including HCC. With the development and application of next generation sequencing technology, novel genetic and genomic alterations in HCC have been identified. Here, the article reviews recent updates on the genetic and genomic alterations in HCC
    Published on: 29 Feb 2016
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  • Review

    Role of antiviral therapy in patients with chronic hepatitis B or C virus in preventing the development of hepatocellular carcinoma

    Laura Scribano , Veronica Vanin , Giorgia Gottardo , Diana Sacchi , Francesco Paolo Russo
    Patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are at significant risk for hepatocellular carcinoma (HCC). The most important risk factor associated with HCC is liver cirrhosis, which is again predominantly caused by chronic HBV or HCV infection. The most effective approach to avoid HCC development is to prevent HBV and HCV infection through vaccination. Indeed, HBV vaccine is the first vaccine demonstrated to prevent cancers. However, a vaccine for HCV is not available. Thus, the prevention of HCV-related HCC and to a large extent HBV-related HCC (among...
    Published on: 15 Jan 2016
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  • Review

    Interventional radiology therapies for liver cancer

    Romaric Loffroy , Louis Estivalet , Sylvain Favelier , Pierre Pottecher , Pierre-Yves Genson , Jean-Pierre Cercueil , Denis Krausé
    Hepatocellular carcinoma (HCC) is the fifth most frequently found primary malignant tumor in the world. Hepatic surgery and liver transplantation are considered optimal for the curative treatment of HCC. However, only 15-20% of HCCs may be surgically treated. Most of the surgically-non-eligible patients have to receive locoregional image-guided interventional treatments including intra-arterial and percutaneous ablative therapies. The goal of this paper is to review these interventional oncology approaches. Ablative therapeutic approaches include chemical therapies (such as ethanol or acetic...
    Published on: 15 Jan 2016
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  • Original Article

    Association of serum levels of epidermal growth factor with disease severity in patients with unresectable hepatocellular carcinoma

    Mohamed Ahmed Samy Kohla , Om Kolsoum Al-Haddad , Ali Nada , Mohamed Al-Warraky , Manar Obada , Mohamed Amer , Sameera Ezzat , Ashraf Abou Gabal
    Aim: Epidermal growth factor (EGF) is a mitogen for hepatocyte grown in vitro, and its expression is up-regulated during liver regeneration. EGF also plays an important role in tumor initiation and progression. The goal of this study is to assess whether EGF is associated with advanced hepatocellular carcinoma (HCC) and also whether it is a predictive factor of shortened survival. Methods: Serum EGF levels were evaluated in a total of 151 subjects: 51 patients with unresectable HCC, (21 of them were eligible for transarterial chemoembolization (TACE) and serum EGF levels were measured...
    Published on: 15 Jan 2016
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  • Case Report

    Hepatocellular carcinoma and type 2 diabetes mellitus: two cases highlighting changes in tumor glycogen content

    Kunio Takegoshi , Eikichi Okada , Kazuhiro Nomoto , Kouji Nobata , Takuro Sawasaki , Mitsuhiro Terada , Hirofumi Terakawa , Takashi Kobayashi , Kazuhisa Yabushita , Tatsuho Sugimoto , Shintaro Terahata
    This article reports two patients with hepatocellular carcinoma (HCC) and type 2 diabetes mellitus (T2DM), who showed marked changes in hepatocellular glycogen content. Periodic acid-Schiff (PAS)-positive and diastase-PAS-negative (glycogen-storing) hepatocytes were detected in both background liver parenchyma and in HCC tissues. In HCC tissues, the number of glycogen-storing cells resembling hepatocytes was considerably reduced and unevenly distributed as compared with hepatocytes in background liver. To be known, changes in hepatocellular glycogen content in T2DM patients have not been...
    Published on: 15 Jan 2016
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Synergistic curative effect of chicory extract and cisplatin against thioacetamide-induced hepatocellular carcinoma

    Hanaa A. Hassan , Hanaa M. Serag , Nabil M. Abdel-Hamid , Mahmoud M. Amr
    Aim: Hepatocellular carcinoma (HCC) is the dominant form of primary liver cancer and is histologically and etiologically distinct from other forms of primary liver cancer. The objective of this study was to elucidate the synergistic effect and the role of chicory extract [inulin (IN)] as a chemo-sensitizer for cisplatin (CIS) treatment of HCC. Methods: Five groups of rats were treated for 4 months. These groups consisted of the control group, a group receiving thioacetamide (TAA) (200 mg/kg b.w) in drinking water, a group injected intraperitoneally with a single dose of CIS (7.5 mg/kg b.w)...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Protective effects of Amaranthus hybridus against aflatoxin B1 and fumonisin B1-induced genotoxicity in H4IIE-luc cells

    Mohamed I. M. Ibrahim , Rialet Pieters , Sekena H. Abdel-Aziem , Anna M. van der Walt , Cornelius C. Bezuidenhout , John P. Giesy , Mosaad A. Abdel-Wahhab
    Aim: Protective effects of aqueous extract of Amaranthus hybridus against aflatoxin B1 (AFB1) and/or fumonisin B1 (FB1) on the H4IIE-luc cell line were determined by use of the methyl thiazol tetrazolium viability assay and disruption of DNA integrity. Methods: H4IIE-luc cells were incubated with different concentrations of AFB1 and/or FB1 for 24 and 48 h with or without aqueous extract of A. hybridus. Results: AFB1 decreased the viability of cells after 24 and 48 h of exposure. EC50 values for AFB1 were 10.5 and 1.8 μmol/L for the two periods, respectively. When the 48 h exposure to...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Preventive role of chamomile flowers and fennel seeds extracts against liver injury and oxidative stress induced by an immunosuppressant drug in rats

    Fathia A. Mannaa , Nagi A. Ibrahim , Soliman S. Ibrahim , Khaled G. Abdel-Wahhab , Nabila S. Hassan , Saida G. Mohammed
    Aim: The present study was conducted to investigate the protective effect of chamomile flowers methanolic extract (CFME) and fennel seeds methanolic extract (FSME) on azathioprine (AZA), an immunosuppressant drug, which induced a liver injury and oxidative stress in rats. Methods: Rats were divided into 6 groups (8 rats each) and treated orally for 28 consecutive days as follows. Group 1: rats were given normal saline and used as controls; group 2: rats treated with CFME (200 mg/kg); group 3: rats treated with FSME (200 mg/kg); group 4: rats treated with AZA (25 mg/kg); and groups 5 and 6:...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Natural products and hepatocellular carcinoma: a review

    Asma M. Alnajjar , Hussien A. Elsiesy
    Hepatocellular carcinoma (HCC) is the fifth commonest cause of malignancy and the third cause of cancer mortality. There are different treatment options for HCC ranging from loco-regional therapy to surgical treatment. Different regimen of systemic chemotherapy has been tried with a poor response. Several studies aimed at discovering more molecules for the management of HCC. Those studies aimed at recognizing and targeting several signaling and molecular pathways that lead to cellular proliferation and tumor formation. In this review, we discussed the role of several agents found in natural...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Effects of natural compounds in treatment and prevention of hepatotoxicity and hepatocellular carcinoma

    Mohamed A. Hamzawy , Ezzeldein S. M. El-Denshary , Mosaad A. Abdel-Wahhab
    Liver diseases are most common disorders in the world and characterized by rapid changes from steatosis to chronic hepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Natural products that attained great attention is to be used in the prevention and treatment of multiple diseases in humans. Several researches have been reported numerous natural and phytochemical compounds that may counteract or prevent the hepatic injury and primary liver cancer. The conservative treatment of liver toxicity and HCC may face awkward challenges in chemotherapy such as therapeutic failure or...
    Published on: 15 Oct 2015
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  • Review

    “PERISH” flowchart for selection of the patients with resectable hepatocellular carcinoma

    Cuneyt Kayaalp , H. Kerem Tolan , Mehmet Caglikulekci
    A selection of patients with hepatocellular carcinoma (HCC) for surgical resection is crucial and algorithms/staging systems help surgeons to decide on a standard treatment for each patient and each HCC stage. However, there are always diffi culties in remembering and/or recalling the contents of the algorithms/staging systems. Moreover, most algorithms/staging systems do not include data about the extent of hepatectomy, intra-hepatic distribution of tumor(s), and technical feasibility of resection, all of which are vital in the surgeons’ decision-making process. Here, we aimed to present a...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Can sorafenib be discontinued in hepatocellular carcinoma patients with a complete response to treatment?

    Jing Li , Liang Huang , Yi-Qun Yan
    Published on: 15 Oct 2015
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  • Review

    Microwave coagulation therapy of hepatocellular carcinoma

    Yong-Song Guan
    Microwave coagulation therapy (MCT) is a relatively new method of tumor ablation compared to other minimally invasive local therapies for hepatocellular carcinoma (HCC). It is a thermal ablation modality based on the application of heat, potentially leading to larger ablation zones. In recent years, there is a steady increase in the application of this modality to the treatment of HCC because it offers several advantages in the management of tumors larger than 3 cm in diameter. This article reviews the advances in MCT for the treatment of HCC in recent years including its brief history,...
    Published on: 15 Oct 2015
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  • Topic: Natural Products and Hepatocellular Carcinoma

    Natural products and hepatocellular carcinoma

    Mosaad A. Abdel-Wahhab
    Published on: 15 Oct 2015
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  • Review

    Expectations for partial splenic arterial embolization simultaneous transcatheter arterial chemoembolization for hepatocellular carcinoma

    Toru Ishikawa
    Hepatocellular carcinoma (HCC) is frequently complicated by cirrhosis, and it is not unusual for treatment options to be limited as a result of pancytopenia due to hypersplenism. Partial splenic embolization (PSE) has been performed for thrombocytopenia resulting from hypersplenism. However, the safety and effi cacy of concurrent transcatheter arterial chemoembolization (TACE) with PSE for HCC remain unclear. Thrombocytopenia has been improved, and treatment continued using concurrent PSE. In addition, the hepatic functional reserve could be maintained even after treatment for HCC....
    Published on: 15 Oct 2015
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  • Original Article

    Sorafenib suppresses hepatitis B virus gene expression via inhibiting JNK pathway

    Hyun Kook Cho , Ju Ran Kim , So Young Kim , Yi Yi Kyaw , Aye Aye Win , Jae Hun Cheong
    Aim: Hepatitis B virus (HBV) infection is a major cause of chronic liver diseases. Sorafenib is a multikinase inhibitor and an approved anti-liver cancer drug. Here we demonstrated the antiviral effect of sorafenib on HBV gene expression. Methods: To investigate the effect of sorafenib on HBV gene expression, a luciferase assay was performed with ×1.3 Cp-luciferase HBV construct and reverse transcriptase polymerase chain reaction (PCR), real-time PCR, and Western blotting analyses were performed using HepG2 cells derived from hepatocellular carcinoma and Chang liver cells derived from a...
    Published on: 15 Jul 2015
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  • Original Article

    Long-term immune-modulatory side effects of radiofrequency ablation in patients with liver metastases and hepatocellular carcinoma

    Thaddeus Till Wissniowski , Thomas Gress , Pietro Di Fazio
    Aim: Used as a palliative therapy for unresectable liver cancer, radiofrequency ablation (RFA) is associated with the induction of immunological responses. Here, we show strong evidence of tumor-specific peripheral blood mononuclear cells (PBMCs) 12 months after RFA. Methods: Three patients with colorectal cancer (CRC) metastases to the liver and two patients with primary hepatocellular carcinoma (HCC) were enrolled in this study. PBMC, isolated 12 months after RFA, were stimulated with normal and tumor tissue lysate. Interferon gamma secretion was evaluated by flow cytometry and...
    Published on: 15 Jul 2015
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  • Editorial

    Radiofrequency, microwave, and laser ablation of liver tumors: time to move toward a tailored ablation technique?

    Paola Tombesi , Francesca Di Vece , Sergio Sartori
    Published on: 15 Jul 2015
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  • Original Article

    Laparoscopic radiofrequency ablation for hepatocellular carcinoma

    Anna Sánchez-López , Anna Pallisera-Lloveras , Ramon Saiz-Mendiguren , Manuel Ferrer-Marsal , José Carlos Vicens-Arbona , José Andrés Cifuentes-Ródenas , Jose Manuel Ramia
    Aim: The optimal treatment for hepatocellular carcinoma (HCC) is either surgical resection or liver transplantation, but only one-third of the patients are suitable candidates for surgery. Laparoscopic radiofrequency ablation (RFA) in selected patients is a safe, feasible technique, which has proved to be superior to the percutaneous approach in patients with severe liver disease or in lesions in which the percutaneous approach is impossible. The aim of this study is to present our experience with laparoscopic RFA and demonstrate its safety as an alternative therapeutic procedure in...
    Published on: 15 Jul 2015
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  • Editorial

    Preneoplastic foci in mice fed diethyl 1, 4-dihydro, 1, 4, 6-trimethyl 3, 5-pyridine decarboxylate are resistant to protoporphyrin accumulation

    Samuel W. French , M. Waheed Roomi
    Published on: 15 Jul 2015
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  • Review

    Hepatoma and trematode infestation: a short review

    Viroj Wiwanitkit
    Hepatoma is a common cancer that can be seen around the world and clinical correlation between infection and hepatoma is evident. Hepatitis virus infection is proved for its relationship with hepatoma. However, the knowledge of other infections is still limited. In this short review, the relationship between hepatoma and some trematode infestation including echinococcosis fascioliasis, opisthorchiasis, clonorchiasis and schistosomiasis are described and discussed. Opisthorchiasis and clonorchiasis are confi rmed for cholangiocarcinoma carcinogenesis but still lack evidence for hepatoma...
    Published on: 15 Jul 2015
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  • Original Article

    Aqueous extract of Corchorus olitorius decreases cytotoxicity of aflatoxin B1 and fumonisin B1 in H4IIE-luc cells

    Mohamed I. M. Ibrahim , Rialet Pieters , Sekena H. Abdel-Aziem , Anna M. van der Walt , Cornelius C. Bezuidenhout , John P. Giesy , Mosaad A. Abdel-Wahhab
    Aim: Afl atoxin B1 (AFB1) and fumonisin B1 (FB1) are important food-borne mycotoxins. Co-contamination of foodstuffs with these two mycotoxins is well-known and has been implicated in a possible development of hepatocellular carcinoma in humans living in regions of the world where exposures to these mycotoxins in grain are greatest. The aim of the current study was to evaluate the potential protective effects of an aqueous extract of Cochorus olitorius (C. olitorius, moroheiya) against cytotoxicity of AFB1 and/or FB1 in H4IIE-luc rat hepatoma cells, using assays to measure cell viability...
    Published on: 15 Jul 2015
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  • Editorial

    The evolving role of laparoscopic ablation

    Joseph F. Buell
    Published on: 15 Jul 2015
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  • Review

    Hepatocellular carcinoma in elderly patients: a concise review on systemic therapy with sorafenib

    Lombardi Giuseppe , Vitale Alessandro , Sara Lonardi , Bellu Luisa , Pambuku Ardi , Marsico Valentina , Crivellari Gino , Aliberti Camillo , Cillo Umberto , Zagonel Vittorina
    The treatment of hepatocellular carcinoma (HCC) in elderly patients is unclear. In particular, the efficacy and safety of sorafenib as a systemic treatment in these patients is still under debate. We performed a concise review of sorafenib therapy in this population. However, it is important to make any decisions on treatment for elderly patients with HCC through a multidisciplinary team that includes experts in the liver disease. Patients with good clinical conditions should be treated with sorafenib.
    Published on: 15 Jul 2015
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  • Original Article

    Anti-proliferative and apoptotic effificacy of diallyl disulfide on Ehrlich ascites carcinoma

    Osama M. Ahmed , Rasha R. Ahmed
    Aim: This study was conducted to assess the in vivo and in vitro anti-tumor effects of diallyl disulfide (DADS) against Ehrlich ascites carcinoma (EAC) and to suggest its probable mechanism of action. Methods: EAC was induced in female mice by intraperitoneal injection of EAC-cells from stock mice. EAC-bearing mice were orally treated with 100 mg/kg body weight for 2 weeks beginning from the 1st day of EAC intraperitoneal transplantation. Cytotoxicity effects of DADS against EAC-cells in vitro were investigated at different concentrations (0, 6.25, 12.5, 25, 50, and 100 μg/mL) of DADS using...
    Published on: 15 Jul 2015
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  • Case Report

    Resection of hepatocellular carcinoma after combined treatment with transarterial chemoembolization and sorafenib: a case report and literature review

    Kenneth Siu Ho Chok , Ian Yu Hong Wong , See Ching Chan , Ronnie Tung Ping Poon , Chung Mau Lo
    Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) invasion and metastatic lymph node metastases has a poor prognosis, and surgical resection is seldom indicated. We report how an initially unresectable HCC in a 36-year-old Chinese male with distant lymph node metastases and tumor thrombosis in the IVC was successfully downstaged and ultimately resected together with the IVC. After the disease had been downstaged, curative resection of the tumor and IVC was conducted with immediate reconstruction of the IVC. The patient has survived for more than 2 years after the surgery. In...
    Published on: 15 Jul 2015
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  • Original Article

    Salvage transplantation for post-resection recurrence in hepatocellular carcinoma associated with hepatitis C virus etiology: a feasible strategy?

    Bhavin Bhupendra Vasavada , Chao-Long Chan
    Aim: The aim was to analyze the feasibility of salvage liver transplant after liver resection in hepatocellular carcinoma (HCC) with hepatitis C virus (HCV) etiology. Methods: All the patients diagnosed with HCC with HCV etiology who underwent living donor liver transplant from July 2002 to November 2012 were studied. Their recurrence rate, mortality, and prognostic factors were analyzed and compared between primary transplant and salvage transplant for up to 5 years post-transplant. Results: One hundred and nine patients underwent a liver transplant for HCC associated with HCV etiology...
    Published on: 15 Apr 2015
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  • Editorial

    The evolving role of transarterial chemoembolization in themanagement of hepatocellular carcinoma

    Georgios Tsoulfas
    Published on: 15 Apr 2015
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  • Original Article

    Repeat liver surgery by laparoscopy for a malignant recurrence after previous open or laparoscopic resection

    Luigi Cioffi , Andrea Belli , Corrado Fantini , Alberto D'Agostino , Gianluca Russo , Giulio Belli
    Aim: This paper reported the experience of one center on repeat laparoscopic liver surgery for metastasis and hepatocellular carcinoma (HCC) with a review of the literature. Methods: This retrospective study included 24 patients who underwent laparoscopic re-intervention (hepatic resection and radiofrequency ablation) for recurrent HCC in cirrhosis (n = 17) and for recurrent malignant metastases (n = 7) after a previous open or laparoscopic procedure. Patients were divided into two groups according to the first surgical approach. Group 1 underwent open resection and laparoscopic procedure...
    Published on: 15 Apr 2015
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  • Editorial

    Laparoscopic hepatectomy in cirrhotic patients with hepatocellular carcinoma: technical aspects and potential benefits

    Osamu Itano , Takuya Minagawa , Yuko Kitagawa
    Published on: 15 Apr 2015
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  • Original Article

    Role of diabetes mellitus on the recurrence rate of hepatocellular carcinomas after radiofrequency ablation in chronic hepatitis C patients

    Abd Allah Ahmed El-Sawy , Mohamed Abd El-Raouf Tawfik
    Aim: The aim was to assess the impact of hyperglycemia on the recurrence of hepatocellular carcinoma (HCC) as well as evaluate survival after curative ablation by radiofrequency. Methods: This study, which was conducted retrospectively on 107 chronic hepatitis C (CHC) patients with 159 HCCs, was presented to the Hepatology Unit of Internal Medicine Department at Tanta University Hospitals. All lesions were curatively treated by radiofrequency ablation (RFA) and the surveillance of HCC recurrence was evaluated radiologically every 3 months for periods between 6 and 36 months. Of 107...
    Published on: 15 Apr 2015
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  • Case Report

    Successful living donor liver transplantation in a cystic fibrosis patient with combined hepatocellular carcinoma and cholangiocarcinoma

    Falk Rauchfuß , Felix Dondorf , René Fahrner , Michael Ardelt , Yves Dittmar , Utz Settmacher
    Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) is a rare tumor entity. In this report, we describe a case of a young patient who developed a liver tumor in a cirrhotic liver caused by cystic fibrosis. All diagnostic findings suggested that this tumor was an HCC. We performed living donor liver transplantation. Histological examination of the tumor revealed combined HCC and CC as an incidental finding. Two years after the transplantation, the patient is in good clinical condition and is disease-free.
    Published on: 15 Apr 2015
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  • Editorial

    Hepatoma Research: the beginning of a new forum

    Joseph F. Buell
    Published on: 15 Apr 2015
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  • Review

    Notch signaling in hepatocellular carcinoma: molecular targeting in an advanced disease

    Kevin M. Sokolowski , Mariappan Balamurugan , Selvi Kunnimalaiyaan , T. Clark Gamblin , Muthusamy Kunnimalaiyaan
    The use of alternative therapeutic approaches in advanced carcinogenesis is a growing investigative base. One such cancer, primary liver cancer, is one of the most commonly occurring cancers worldwide and often presents in late stage disease consequently preventing traditional curative modalities. As a result, hepatocellular carcinoma (HCC), representing the majority of primary liver cancer, is the third most common cause of cancer-related deaths globally. Survival rates are linked to stage of presentation as well as concomitant cirrhosis limiting the 5-year survival in these patients to...
    Published on: 15 Apr 2015
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  • Original Article

    Combined radiofrequency and chemoembolization vs. chemoembolization in management of hepatocellular carcinoma

    Ahmed Kamal El Dorry , Eman Mahmoud Fathy Barakat , Amal Tohamy Abd ElMoez , Mervat Abd Fatah Mawad , Nevien Fouad El-Fouly , Mohamed Kamal Shaker
    Aim: Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. If left untreated, liver cancer has a poor prognosis with more than 90% of patients dying of the disease within 5 years of diagnosis. The aim of this study is to assess the value of combined radiofrequency ablation (RFA), followed by trans-arterial chemoembolization (TACE) in the management of HCC. Methods: Fifty HCC patients with chronic liver disease were categorized into two groups according to the modality of locoregional treatment: 25 HCC patients treated with RFA followed by TACE within 5 days and 25...
    Published on: 15 Apr 2015
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  • Case Report

    Combined sarcomatoid hepatocellular and cholangiocarcinoma: a case report and literature review

    Julian Shun Tsang , Kenneth Siu Ho Chok , Rex Kwok Him Au-Yeung , Chung Mau Lo
    Hepatic sarcomatoid carcinomas are very rare. The majority of cases contain sarcomatoid features with either hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) elements alone. These are aggressive tumors and carry an unfavorable prognosis. We describe an extremely rare tumor sub-type of combined sarcomatoid HCC and CC in a hepatitis B virus carrier presenting with abdominal pain. Pre-operative imaging suggested a segment VI hepatocellular cancer with no metastatic spread. En bloc surgical resection with the right adrenal gland, Gerota's fascia and right hemidiaphragm was performed....
    Published on: 15 Apr 2015
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