Latest
  • 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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